About the NZGRS

The NZGRS is a service improvement tool that enables endoscopy units to assess how well they provide a patient-centred service. It comprises a web-based assessment tool that makes a series of statements requiring a Yes or No answer.  From the answers submitted, the system automatically calculates the NZGRS scores, which provides a summary view of a service. To achieve this, the scale has three different layers: Domains, Standards and Measures.

The NZGRS comprises a total of 19 standards, divided into four domains. Each standard is underpinned by several measures, which are categorised from level A to D.

Level A represents excellent adherence to the measures.


There are four domains: Clinical Quality, Quality of Patient Experience, Workforce and Training of Endoscopists. 


The standards within each domain provide a more detailed picture of what the domain comprises. The standards are qualitatively different, and therefore no standard is more or less important than another. There are 19 patient centred standards, outlined in the table below:

Clinical Quality Domain

Quality of Patient Experience Domain

1. Leadership and organisation

7. Respect and dignity

2. Safety

8. Consent process including patient information

3. Comfort

9. Patient environment and equipment

4. Quality

10. Access and booking

5. Appropriateness

11. Productivity and planning

6. Results

12. Aftercare

13. Patient Involvement

Workforce Domain

Training of Endoscopists Domain

14. Teamwork

17. Environment, training opportunity and resources

15. Workforce delivery

18. Trainer allocation and skills

16. Professional development

19. Assessment and appraisal


Each standard is underpinned by a series of descriptive measures that describe in specific detail the level of service/care provided. The measures are grouped into four incremental levels (A-D). Each individual measure is assessed by the endoscopy team, requiring either a Yes or No answer. The aim for services is to reach level B in all standards, with level B indicating attainment of minimum requirements and level A being an aspirational target for high-performing services.


Levels begin to create a more complete picture of what is happening within the service by describing in words the different levels of achievement for a standard. These levels range from the most basic level of service provision (level D) to best practice (level A). While scoring a standard with levels gives an accurate picture, the scoring process can be subject to bias. To minimise bias all descriptors have been underpinned with measures.



How level is achieved?


Service is outward looking with excellent adherence to requirements

Service answers ‘yes’ to all measures in a standard


Service is proactive to changes with a good adherence to requirements

Service answers ‘yes’ to all level D-B measures but ‘no’ to one or more level ‘A’ measures


Service is reactive to changes with basic adherence to requirements

Service answers ‘yes’ to all level D and C measures but ‘no’ to one or more level B measures

D Service has basic adherence to requirements

Service answers 'yes' to all level D measures but 'no' to one or more level C measures

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