ASC Operations Best Practices to Improve Colonoscopy Turnover Efficiency

John Gleason is administrator and Gail Wells, RN, is director of outpatient clinical operations at the Berks Center for Digestive Health in Wyomissing, Pa., a partner with Physicians Endoscopy since 2001.

Q: What do you do to ensure a smooth and fast turnover between colonoscopy patients?

John Gleason and Gail Wells, RN: Obviously anesthesia services are key to moving the patients through in an efficient way. The physical layout of your facility is also important to make the transition smoother. If the recovery room is right outside of the procedure room you can quickly facilitate handoff of the patient from the room to the recovery personnel. The "report" is given more easily in the latter scenario.

What has really made our documentation process more efficient is to have the medical assistant in the room document some of the procedure throughout the procedure. This includes things such as devices used, biopsies taken, abdominal pressure, patient repositioning, cecal time and start time. All of these and more can be entered or documented throughout but definitely before the procedure is completed, thus facilitating the close of the chart and documentation of the procedure.

As the procedure is coming to a close, a sophisticated call light system allows you to notify the scope room personnel that they will be needed in short order. The call system will allow the room personnel to differentiate between an emergency call and a notification of the completion of a case.

An electronic report writer, which is used to document the procedure, captures images and generates a report immediately following the procedure when the doctor through the electronic system pulls from the database of documentation to rapidly complete a final report and discharge instructions. Also, the nurse anesthetist or nurse giving sedation upon completion of the procedure should take the patient to recovery, give report and retrieve the next coming patient. This allows the medical assistant to clean up and prepare the room for the next patient.

The person cleaning scopes retrieves the scope, sets up the new scope and at the same time helps prepare the room for the next patient. It is a team effort. If necessary, we move a patient from the stretcher to a stepdown area where they can be monitored but not hold up a recovery bay.

Learn more about Berks Center for Digestive Health.

Thank you to Physicians Endoscopy for arranging this interview.


Read other recent columns providing best practices for GI in ASCs:

- 5 Quick Guidelines to Improve Turnover Time Between Colonoscopies

- Michelle Steele of Eastside Endoscopy Shares Advice for GI ASC Administrators

- Guidelines for When to Code for Screening and Diagnostic Colonoscopies in an ASC

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