Q: What is the challenge you face in creating a clinical sound anesthesia policy that meets accreditation standards?
Linda Beaver: We don’t really give anesthesia. Our ASC administers propofol, which is an agent to put people in a deep monitored state. With anesthesia policies, part of the issue is that we use propofol, which is not really an MAC or general anesthesia. It falls somewhere in between. We had a lot of discussions with the head of anesthesiology and physicians, trying to describe how propofol should be described because patients are still breathing and they don’t know what’s going on. So there was some difficulty there.
Q: How is Gateway Endoscopy tackling this issue?
LB: We spoke with an accreditation surveyor who suggested that on our patient consent form for anesthesia, there probably needs to be a separate entity listed. On the permit that we have as far as consent form for providing anesthesia, we are working to have conscious sedation in addition to monitored anesthesia and general anesthesia. We have not implemented this quite yet because the consent form is driven by our anesthesia group, but that was one of the things we are currently addressing.
Q: In what other ways are you ensuring your ASC’s anesthesia policies are meeting accreditation requirements?
LB: We do actually treat propofol like a narcotic, so we are constantly counting and monitoring it, which is above and beyond what is necessary, but the surveyor suggested that it would be a very good policy to have in order to keep our ASC accountable. So we count our units of propofol at beginning and end of each day. This way, we’re accounting for how much was used each day.
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