21 GI & Endoscopy-Driven ASCs to Know

Rachel Fields -

Here is a list of 21 notable GI and endoscopy-driven ASCs.

Ambulatory Endoscopy Clinic of Dallas (Dallas, Texas).
The Ambulatory Endoscopy Clinic of Dallas opened in April 1993 as the first licensed free-standing surgery center exclusively for GI procedures in North Texas. According to the center's site, the facility was opened by a group of physicians who wanted to create a facility that provided efficient, easily accessible care for patients and featured a staff dedicated exclusively to GI health. In Jan. 1995, Healthcare Corporation of America joined the center as its general partner, and the facility is currently operated under Ambulatory Surgery Division of HCA. AECD has been accredited by AAAHC since 1995 and named a "substantially compliant" facility every year since its initial accreditation. Featuring one OR and two procedure rooms as well as nine practicing physicians, the center states its mission is "[providing] economical, high-quality ambulatory care in a manner consistent with the needs of the community we serve."

Amarillo Endoscopy Center (Amarillo, Texas).
Amarillo Endoscopy Center is a Medicare-approved, GI-driven center that performs a variety of procedures, including colonoscopy, upper endoscopy, capsule endoscopy and remicade treatments. The ASC features two GI physicians —Amit K. Trehan, MD, and Srinivas Pathapati, MD. According to Freida Toler, administrator of Amarillo Endoscopy Center, physicians have input about every staff member hired at the center, effectively building cohesion between physicians, nurses and other staff members. She says she also cross-trains employees and moves them through different departments in order to encourage collaboration and break down walls between physicians and employees. "Periodically staff members move through different areas of the ASC they haven't been in for a while to maintain competency in all areas, as well as to ensure they aren't working with the same people all the time," she says. "Surgical teams tend to form cliques, so we try to make sure everyone gets a chance to work with different people."

Berks Center for Digestive Health (Wyomissing, Pa.). Berks Center for Digestive Health was founded in Dec. 2001 through a partnership between Digestive Disease Associates' physicians and Physicians Endoscopy. The center is currently owned by 10 GI physicians and features 13 GI physician users and is accredited by the AAAHC. The center, which is 100-percent focused on GI procedures, houses three procedure rooms and schedules 17 patients per day in each room. According to Berks Center for Digestive Health executive director John Gleason, the ASC has plans to move to a new facility within the next year and a half, as well as to expand to four procedure rooms. "We are extremely efficient and customer service-oriented," he says. "Despite handling so many patients, we consistently get very positive feedback on patient satisfaction surveys about the kind and service-oriented staff."

Eastside Endoscopy Center (Bellevue, Wash.). Eastside Endoscopy Center opened in 1995 and specializes in upper endoscopies and colonoscopies, which are performed in three procedure rooms. The center, which is managed by Physicians Endoscopy, has been accredited by the AAAHC since 1996 and was the first endoscopy center in Washington to achieve AAAHC accreditation. According to Michelle Steele, administrator of Eastside Endoscopy, the ASC recently implement an electronic medical record, allowing staff to track times and easily identify areas of delays and target them for improvement. She said the center also successfully implemented anesthesia services, contracting with a local anesthesia group to administer propofol in the facility. "One of the reasons I believe patient satisfaction is high is because our patients are now awake and alert after the procedure and are able to remember discussing their procedure results with the gastroenterologist," she says. She calls the center "a family" and credits its success to the combination of great physicians, RNs, medical assistants, techs and its corporate partner, Physicians Endoscopy.

Endoscopy Center of St. Louis (St. Louis, Mo.). The Endoscopy Center of St. Louis currently has two facilities in the St. Louis and St. Charles, Mo., metropolitan areas, both of which provide upper and lower endoscopic gastrointestinal procedures with state-of-the-art equipment. Both facilities are accredited by AAAHC and staffed by board-certified endoscopists, anesthesiologists and registered nurses specifically trained in endoscopy. The center features 11 practicing physicians, including David Cort, MD, and David Walden, MD, who have been featured on local news stations speaking about gastrointestinal procedures. In an interview with Becker's ASC Review, Susan Rahn, clinical manager of the Endoscopy Center of St. Louis, shared the centers' secrets for maintaining accreditation — both have been accredited since their openings in 2005 and 2007. She said her ASCs take advantage of the various seminars, conferences and learning materials available for ASCs, as well as use accreditation surveys as a learning experience for future growth.

Fleming Island Surgery Center (Orange Park, Fla.). Fleming Island Surgery Center was founded in Jan. 2007 and currently performs approximately 8,000 cases per year, 65 percent of which are GI. The center features five GI specialists who routinely use the ASC and between four and five general surgeons who perform GI cases at the center. The center is accredited by the AAAHC and is affiliated with Borland-Groover Clinic, the largest gastroenterology clinic in the Southeastern United States. According to Lindsay Allen, special services coordinator for Borland-Groover Clinic, the center's success can be traced back to the staff's commitment to patient satisfaction. "Our physicians and staff have adopted a culture that embraces excellence in patient care and satisfaction," she says. "Our credo states that customer satisfaction is our top priority, and it is everyone's job. Our administrative team continuously does a great job promoting this culture within our facility."

GastroIntestinal Associates Endoscopy Center (Wasau, Wis.). GI Associates Endoscopy Center was opened in 2008. Accredited by the AAAHC and certified by Medicare, GI Associates Endoscopy Center was designed "to create a calm, caring environment" for patients and family members, according to the ASC's website. Since its opening, the center has participated in ASGE Quality and Safety in Endoscopy Center's continuing education programs, according to COO Cathleen Rohling. The center also applied for and was awarded ASGE Unit Recognition Certification, one of only several hundred in the country — and the first provider in Wisconsin — to earn the distinction. In a release following the center's recognition, medical director Raymond L. Hartke, MD, said, "Our patients deserve the highest standard of care. At GI Associates, we work daily to provide the highest quality outcomes and experience for our patients. We are honored to be recognized by ASGE for our efforts to enhance patient safety and quality." Ms. Rohling added that the GI Associates Endoscopy Center's practices are undergoing review currently, and the staff is working on developing audit tools to continually improve the ASC's processes.

Gwinnett Endoscopy Center (Lawrenceville, Ga.)
. Gwinnett Endoscopy Center is affiliated with Atlanta Gastroenterology Associates and specializes exclusively in gastroenterology. The center, which opened in 2000 and is accredited by AAAHC, expanded its services in 2008 to include hemorrhoid banding. The center is owned by 36 physician owners and used by an additional eight physicians and features three procedure rooms. According to Atlanta Gastroenterology Associates managing partner Steven Morris, MD, the center's success can be credited to a combination of skilled and experienced physicians and staff and "attention to individual patient needs."

Jacksonville Center for Endoscopy (Jacksonville, Fla.). The Jacksonville Center for Endoscopy was established in 1998 and is currently a state-licensed, Joint Commission-accredited, AHCA-certified ASC owned and operated by the physicians of Borland-Groover clinic. The center, which has two locations in Jacksonville, performs colonoscopies, upper endoscopy and sigmoidoscopy and staffs only nurses trained specifically in endoscopy. The center performs more than 32,000 procedures annually. Since its inception, JCE has been determined to implement health information technology to improve quality and safety, as well as streamline workflow, increase patient throughput and maximize revenues. JCE administrator Cindy Hall says the center aimed to "ensure that our physicians had access to patient information that was up-to-date to the minute." Since the implementation of an EMR, JCE has saved more than $26,000 and is now completely paperless, according to Ms. Hall.

Lincoln Endoscopy Center (Lincoln, Neb.).
Lincoln Endoscopy Center opened in July 1998 and features three suites equipped with state-of-the-art Olympus equipment. The ASC was the first free-standing endoscopy center in Nebraska and is accredited by the state, Medicare and AAAHC. The center performs a variety of GI and endoscopic procedures, including colonoscopies, upper endoscopies, flexible sigmoidoscopies, capsule video endoscopies and many others. The center recently added HALO ablation technology, which removes the diseased layer of cells from the esophagus and treats Barrett's esophagus, a precancerous condition, without incisions. The ASC is deeply involved with the Lincoln community and participates in various charity events every year, including the Crohn's and Colitis Foundation of America Walk in Lincoln in 2010 and the Chubby Bubby Benefit, a bake sale that raised funds for spinal muscular atrophy. Becky Johnson, clinical director of Lincoln Endoscopy Center, credited the center's financial success to careful planning for purchasing equipment. She said she attends at least one large ASC conference every year to network with others in the industry and glean better practices about keeping up with advancing technology and saving money.

Memorial Mission Surgery Center (Chattanooga, Tenn.).
Memorial Mission Surgery Center was one of 48 endoscopy units in the country recognized by the American Society for Gastrointestinal Endoscopy Unit Recognition Program in June 2010. The program honors endoscopy units that follow ASGE guidelines on privileging, quality assurance, endoscopy reprocessing and CDC infection control and guidelines. In an interview with Becker's ASC Review, Sharon Rosser, RN, endoscopy manager, and Brent A. McLean, ASC administrator, credited teamwork, patient feedback and quality ancillary departments as reasons for the center's success. "Everyone works together to make sure the patients are cared for in a safe and efficient way," they said. "In addition to credentials, all new hires are assessed to see whether or not they "will fit" with the culture. This emphasis, in combination with the perks of working in an ASC, allows us to hire only the best of the best, which translates directly to better patient outcomes."

Michigan Endoscopy Center (Farmington Hills, Mich.). Michigan Endoscopy Center is a physician-owned joint venture with Physicians Endoscopy. The center was founded in Jan. 2003 by senior physician leadership and has since earned AAAHC accreditation. Sixteen physician owners have majority ownership of the center, and three physician non-owners also use the ASC, which focuses primarily on digestive health and GI procedures. Michigan Endoscopy Center has three licensed ORs and three procedure rooms and continues to look for opportunities to expand services by recruiting new physicians and establishing partnerships with group practices and physician organizations, according to administrator Brien Fausone. He credits Michigan Endoscopy's success to its "all star team of care givers [and] clinicians" — all of the center's GI nurses have more than 15 years experience, and its endoscopy technicians are all certified and have worked side-by-side with the center's physicians prior to joining Michigan Endoscopy Center.

Midtown Endoscopy Center (Atlanta, Ga.). Midtown Endoscopy Center features four procedure rooms and performs only gastroenterology procedures. The center, which is affiliated with Atlanta Gastroenterology Associates, is owned by 36 physician owners and utilized by 17 physician users. The center opened in 2001 and is certified by the AAAHC. According to Atlanta Gastroenterology Associates, the center recently expanded its serves to include hemorrhoid banding (2008), liver biopsy (2009) and Bravo pH (2010). The center, like all of AGA's endoscopy centers, provides patients easy access to quality care and offers procedures that are otherwise only provided in hospitals.

MNH Surgical Center (Maitland, Fla.). MNH Surgical Center, which is partnered with Covenant Surgical Partners in Nashville, Tenn., was established in 1998 and has since earned AAAHC and Medicare accreditation, as well as ACLS certification for all its physicians and nursing staff. The center's five physicians perform a variety of procedures, including upper endoscopy, colonoscopy, hemorrhoid banding and desiccation, liver biopsy, abdominal paracentesis and esophageal manometry. According to the center's site, the center was "designed with high quality of care, safety, patient privacy and convenience in mind." MNH Surgical Center specializes in the examination of the upper and lower gastrointestinal tract.

New York GI Center (Bronx, N.Y.). New York GI Center is a single-specialty GI ASC in Bronx, N.Y. The center opened in 2007 and has since earned AAAHC accreditation. Over the last three years, the center has cared for more than 21,000 patients, opened its fifth OR and expects to perform around 10,500 cases in 2010. A joint venture between private practice physicians and a major academic medical center, NYGI contains "safety-based technology," such as 100 percent disposable endoscopic accessories, end tidal CO2 monitoring and a video laryngoscope for emergency intubations, according to NYGI president James C. DiLorezo, MD. "We have strived to create a culture of quality by instituting measures such as single-dose, single-use vials and a comprehensive infection control program long before they were required," he said. The ASC also employs rigorous employee re-training in-services for endoscope reprocessing, use of argon plasma coagulation and cautery devices. Staff members are supported financially for pursuing additional certification.

Old Town Endoscopy Center (Dallas, Texas). Old Town Endoscopy Center is staffed by Digestive Health Associates physicians and contains multiple GI endoscopy procedure rooms with state-of-the-art safety and diagnostic equipment. The center is certified by Medicare and licensed by the state of Texas, and its physicians are all board-certified gastroenterologists who specialize in endoscopic procedures such as colonoscopies, upper endoscopies and flexible sigmoidoscopies. The center's patient satisfaction surveys repeatedly earn high marks, and the center's staff credits Old Town's high patient satisfaction, low infection rates and patient focus as reasons for its success.

Pacific Endoscopy Center (Pearl City, Hawaii). Pacific Endoscopy Center is a free-standing single-specialty center specializing in endoscopy. The center opened in May 2008, aiming to bring down the high rate of colon cancer deaths in Hawaii. In an interview with Hawaii News Now upon the ASC's opening, CEO Yousif A-Rahim, MD, stressed the importance of colonoscopies to catch cancer early, saying, "We get about 765 cases of colon cancer per year, and about a third of these patients will actually die within one year." The center cost $3 million to develop and offers high-definition technology, which "allows [Hawaii] doctors for the first time to detect hard-to-find flat or depressed polyps which actually carry a higher risk of cancer," according to the report. Pacific Endoscopy Center staffs three physicians ¬— Dr. A-Rahim, Darrell Lee, MD, and Robert Wong, MD.

Physicians Endoscopy Center (Houston, Texas). A joint venture with HCA Ambulatory Surgery Division, Physicians Endoscopy Center has 18 physician owners and eight procedure rooms and performs around 1,200 cases every month. The ASC was founded by several physicians who wanted "a centralized, convenient and patient-focused center to perform procedures at lower cost than hospitals," says PEC administrator Nancy Le Nikolovski. The AAAHC-accredited center opened in Dec. 2002 and performs GI procedures exclusively. Going forward, PEC is looking to launch a hemorrhoid ligation clinic to complement colonoscopies and is considering the addition of colorectal surgeons to offer more comprehensive services to patients. The center may also offer propofol anesthesia to increase patient comfort and satisfaction in the future. As to why the center continues to enjoy success, Ms. Le Nikolovski credits its "very specialized care," saying the center is "staffed with highly-trained endoscopy nurses and technicians." She adds that PEC uses the latest high-definition endoscopes from Olympus to improve patient care.

Southern Crescent Endoscopy Suite (Stockbridge, Ga.). Southern Crescent Endoscopy Suite is affiliated with Atlanta Gastroenterology Associates and opened in 1994. The ASC performs exclusively gastroenterology procedures and contains seven procedure rooms that are used by seven physician users. The center is AAAHC-accredited and owned by a group of 36 physicians. The center expanded its services by adding hemorrhoid banding in 2008 and Bravo pH in 2010. Steven Morris, MD, managing partner of AGA, credits the center's success to a combination of technology ¬— Southern Crescent features "high definition scopes and full-function EMR" as well as supervised propofol administration — with individual attention to patient needs and a skilled staff.

Surgery Center at Tanasbourne (Hillsboro, Ore.). Surgery Center at Tanasbourne, which was opened in March 2009 by Providence Health and Services, is a free-standing, multi-specialty facility with four ORs and two procedure rooms. The center is managed through a joint venture with Blue Chip Surgical Partners and stands at around 17,000 square feet. The center features state-of-the-art medical technology and performs, in addition to GI, general surgery, orthopedics, gynecology, plastic surgery, pain management, spine and ear, nose and throat procedures. According to ASC administrator Cindy Givens, the Surgery Center at Tanasbourne recently underwent efforts to grow case volume for colonoscopies by contacting its hospital partner's primary care group, meeting with community physicians and marketing directly to consumers. She said the center drives referrals by following up with physicians about the patient's experience — an aspect of the relationship that ASCs might sometimes overlook. "I make sure the loop is closed," she says. "When they send a referral over, we follow up with them to let them know the patient was scheduled on this date, or that we were not able to contact the patient, or that the patient was referred on to another provider."

Surgery Center of Joliet (Joliet, Ill.). The Surgery Center of Joliet opened in 2008 and specializes in colonoscopy, EGD and upper and lower GI diagnostics and screenings. The center houses two procedure rooms, two endoscopy rooms and three operations rooms and contains a portable endoscopy machine that allows patients to undergo endoscopic procedures in one of its ORs. According to Marge Schillaci, administrator of the Surgery Center of Joliet, the ASC keeps costs low by decreasing inventory of high-cost items. "We looked at what we were keeping on the shelf and also specifically how long it took us to get the item," she said in an interview with Becker's ASC Review. "Based on what our volumes were and actually looking at our usage, we no longer kept more on the shelf than we actually needed." She said this strategy improved cash flow to the center and decreased holding costs. In addition to GI procedures, Surgery Center of Joliet also performs ENT, general surgery, pain management, plastics, podiatry and orthopedic procedures.

Read more about GI & endoscopy-driven ASCs:

-6 Ways GI/Endoscopy-Driven ASCs Will Change in the Next Five Years

-Cutting Costs by Reducing Medical Waste: Q&A With Karen Smith of Central Illinois Endoscopy Center

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