Innovative endoscopy triage for sustainable care: A reflective proposal for a nurse-led gut-brain pathway, to protect high-yield colonoscopy access, and improve functional outcomes
| Sunday, May 17, 2026 |
| 11:42 AM - 11:54 AM |
| Arthur Streeton Auditorium |
Overview
Gillian Schofield
Details
Escalating demand on endoscopy services versus finite resources, leads to increasing waitlists and potentially worsening outcomes for high yield colonoscopy patients. Functional gut symptoms, suspected as likely Irritable Bowel Syndrome (IBS), affects more than 40% of the global population (Sperber et al.2021), and is the most common reason for presentation to General Practitioner (GP) and Gastroenterologist referral (SaferCare Victoria, 2020). Funnelling all endoscopy referrals down a procedural pathway, even if the likelihood is low yield, is not cost-effective, reinforces a “disease mindset” and risks potential unnecessary colonoscopy complications. For low-risk functional symptom referrals, colonoscopy, particularly if repeated, can reinforce fear, or doubt of finding answers, and fails to address drivers such as diet quality, sedentary lifestyle or impacts of sleep and stress, social disconnection or environmental exposures. Alternatively, using symptom-based criteria, and less invasive screening tools (Faecal Occult Blood Testing for colorectal cancer screening and Faecal Calprotectin for Inflammatory Bowel Disease, may provide a more accurate diagnosis, be safer, more economical, and could eliminate the need for colonoscopy (Black & Ford, 2025).
This proposal reflects on the necessity for a paradigm shift towards a nurse-led gut-brain pathway, which optimises triage, by distinguishing those requiring urgent colonoscopy from patients who may benefit more from holistic, non-invasive self-directed management. Innovating the traditional referral model, implementing nurse-led clinics and coaching sessions. This pathway seeks to safeguard limited colonoscopy resources, promote multi-disciplinary patient-centred care, and ultimately deliver more sustainable value-based health outcomes for both individuals and the healthcare system. Studies have shown nurse-led clinics can improve patient health and quality of life outcomes. By empowering people with better gut health knowledge and health literacy; teaching them to make intentionally healthier choices and promoting self-management strategies, IBS symptoms can reduce, and long-term bowel cancer risks can be reduced.
The author proposes, more innovative, and diverse models of care which involve nurse- led clinics and multidisciplinary plans, are key to sustainability, and keeping up with the provision of equitable, accessible, value-based care. Patient education and supported self-directed care empowerment over modifiable drivers (diet, lifestyle factors, stress management etc), could be the key to improving IBS symptoms and reducing health care system dependence.
Speaker
Ms Gillian Schofield
Queensland Health
Innovative endoscopy triage for sustainable care: A reflective proposal for a nurse-led gut-brain pathway, to protect high-yield colonoscopy access, and improve functional outcomes
Abstract
Escalating demand on endoscopy services versus finite resources, leads to increasing waitlists and potentially worsening outcomes for high yield colonoscopy patients. Functional gut symptoms, suspected as likely Irritable Bowel Syndrome (IBS), affects more than 40% of the global population (Sperber et al.2021), and is the most common reason for presentation to General Practitioner (GP) and Gastroenterologist referral (SaferCare Victoria, 2020). Funnelling all endoscopy referrals down a procedural pathway, even if the likelihood is low yield, is not cost-effective, reinforces a “disease mindset” and risks potential unnecessary colonoscopy complications. For low-risk functional symptom referrals, colonoscopy, particularly if repeated, can reinforce fear, or doubt of finding answers, and fails to address drivers such as diet quality, sedentary lifestyle or impacts of sleep and stress, social disconnection or environmental exposures. Alternatively, using symptom-based criteria, and less invasive screening tools (Faecal Occult Blood Testing for colorectal cancer screening and Faecal Calprotectin for Inflammatory Bowel Disease, may provide a more accurate diagnosis, be safer, more economical, and could eliminate the need for colonoscopy (Black & Ford, 2025).
This proposal reflects on the necessity for a paradigm shift towards a nurse-led gut-brain pathway, which optimises triage, by distinguishing those requiring urgent colonoscopy from patients who may benefit more from holistic, non-invasive self-directed management. Innovating the traditional referral model, implementing nurse-led clinics and coaching sessions. This pathway seeks to safeguard limited colonoscopy resources, promote multi-disciplinary patient-centred care, and ultimately deliver more sustainable value-based health outcomes for both individuals and the healthcare system. Studies have shown nurse-led clinics can improve patient health and quality of life outcomes. By empowering people with better gut health knowledge and health literacy; teaching them to make intentionally healthier choices and promoting self-management strategies, IBS symptoms can reduce, and long-term bowel cancer risks can be reduced.
The author proposes, more innovative, and diverse models of care which involve nurse- led clinics and multidisciplinary plans, are key to sustainability, and keeping up with the provision of equitable, accessible, value-based care. Patient education and supported self-directed care empowerment over modifiable drivers (diet, lifestyle factors, stress management etc), could be the key to improving IBS symptoms and reducing health care system dependence.
This proposal reflects on the necessity for a paradigm shift towards a nurse-led gut-brain pathway, which optimises triage, by distinguishing those requiring urgent colonoscopy from patients who may benefit more from holistic, non-invasive self-directed management. Innovating the traditional referral model, implementing nurse-led clinics and coaching sessions. This pathway seeks to safeguard limited colonoscopy resources, promote multi-disciplinary patient-centred care, and ultimately deliver more sustainable value-based health outcomes for both individuals and the healthcare system. Studies have shown nurse-led clinics can improve patient health and quality of life outcomes. By empowering people with better gut health knowledge and health literacy; teaching them to make intentionally healthier choices and promoting self-management strategies, IBS symptoms can reduce, and long-term bowel cancer risks can be reduced.
The author proposes, more innovative, and diverse models of care which involve nurse- led clinics and multidisciplinary plans, are key to sustainability, and keeping up with the provision of equitable, accessible, value-based care. Patient education and supported self-directed care empowerment over modifiable drivers (diet, lifestyle factors, stress management etc), could be the key to improving IBS symptoms and reducing health care system dependence.
Biography
