Here are four best practices for GI/Endoscopy in surgery centers.
1. Work with primary care physicians to increase colorectal screenings. Most ASCs rely on their physicians to bring cases to the center, but primary care physicians in your community may also be a valuable source of referrals. GI centers should talk to primary care physicians about the importance of colon cancer screenings and your center's availability. If primary care physicians are aware that your center performs screenings, they may recommend colon cancer screenings to their patients and then send them your way. "We do a lot of work in just educating the [physician] community, talking to primary care physicians, OB/GYNs and other specialists about colon cancer," says Nancy Nikolovski of Physicians Endoscopy Center in Houston, Texas. "They're still the gatekeepers, and they really do direct patients' care, so they are instrumental in making sure patients get screened."
2. Practice good infection control. Generally, GI/endoscopy-driven ASCs go through a multi-stage high-level disinfection process. The first stage requires removal of gross contamination by suctioning the scope's channel with a high volume of water and detergent in addition to wiping down the exterior of the scope after a procedure. Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, says GI/endoscopy-driven ASCs often fall into the trap of skipping this crucial first step with the belief that jumping ahead to the second stage of brushing the scope will be sufficient enough in removing gross contamination.
"One of the biggest misnomers that I've come across is ASCs believe there is no need to suction the channel and wipe down the scope before soaking and brushing the equipment," Mr. Sweeney says. "To this day, a lot of people don't understand this first step is critical to make sure there is no gross contamination because simply brushing is not intended to remove that amount of bioburden."
Mr. Sweeney explains ASCs should follow manufacturer recommendations, which may include using approximately 500 mL of enzymatic detergent and water to suction and flush out channels. Skipping the first step of suctioning enzymatic detergent through the suction channels will not only affect the efficacy of the channels being properly reprocessed but will also release high volumes of gross contamination into the soaking stage. "High-level disinfection is dependent on every stage being performed properly. A breakdown early on can affect the efficacy of the process later," he says.
3. Train staff on proper use of scopes. Scopes, just like any other piece of equipment, could potentially require more maintenance if not used or maintained properly. Felix Mariani, administrator of Allegheny Regional Endoscopy Center, says his vendor regularly conducts in-services for staff members on how to properly handle and clean scopes.
"Our staff is extremely well-trained on how to clean and handle scopes. We place strong emphasis on retraining and maintaining competency," he says. "The better our scopes are handled, the better we are able to maintain lower costs related to our scopes."
Staff members also take advantage of the additional benefit of the in-services provided by vendors. "A part of our vendor's in-services also includes information on proper coiling and sink sizes to prevent needless scope damage," Mr. Mariani says.
4. Recruit quality specialists. Successfully recruiting GI specialists is critical to expanding the GI specialty, as the addition of quality GI physicians means the addition of new patients. Dianne Wallace, executive director of Menomonee Falls (Wis.) Ambulatory Surgery Center, says this can be done by actively marketing a facility's state-of-the-art equipment and demonstrating a competent staff who can assist physicians. "ASCs will have to sell themselves based on the quality of their equipment and whether they have a skilled staff who understands GI," says Ms. Wallace. "Physicians are going to look to see who provides the best quality care and has the best staff and equipment, like scopes and video equipment for GI procedures. ASCs have to prove to physicians it is worth their while to join their facility."
1. Work with primary care physicians to increase colorectal screenings. Most ASCs rely on their physicians to bring cases to the center, but primary care physicians in your community may also be a valuable source of referrals. GI centers should talk to primary care physicians about the importance of colon cancer screenings and your center's availability. If primary care physicians are aware that your center performs screenings, they may recommend colon cancer screenings to their patients and then send them your way. "We do a lot of work in just educating the [physician] community, talking to primary care physicians, OB/GYNs and other specialists about colon cancer," says Nancy Nikolovski of Physicians Endoscopy Center in Houston, Texas. "They're still the gatekeepers, and they really do direct patients' care, so they are instrumental in making sure patients get screened."
2. Practice good infection control. Generally, GI/endoscopy-driven ASCs go through a multi-stage high-level disinfection process. The first stage requires removal of gross contamination by suctioning the scope's channel with a high volume of water and detergent in addition to wiping down the exterior of the scope after a procedure. Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, says GI/endoscopy-driven ASCs often fall into the trap of skipping this crucial first step with the belief that jumping ahead to the second stage of brushing the scope will be sufficient enough in removing gross contamination.
"One of the biggest misnomers that I've come across is ASCs believe there is no need to suction the channel and wipe down the scope before soaking and brushing the equipment," Mr. Sweeney says. "To this day, a lot of people don't understand this first step is critical to make sure there is no gross contamination because simply brushing is not intended to remove that amount of bioburden."
Mr. Sweeney explains ASCs should follow manufacturer recommendations, which may include using approximately 500 mL of enzymatic detergent and water to suction and flush out channels. Skipping the first step of suctioning enzymatic detergent through the suction channels will not only affect the efficacy of the channels being properly reprocessed but will also release high volumes of gross contamination into the soaking stage. "High-level disinfection is dependent on every stage being performed properly. A breakdown early on can affect the efficacy of the process later," he says.
3. Train staff on proper use of scopes. Scopes, just like any other piece of equipment, could potentially require more maintenance if not used or maintained properly. Felix Mariani, administrator of Allegheny Regional Endoscopy Center, says his vendor regularly conducts in-services for staff members on how to properly handle and clean scopes.
"Our staff is extremely well-trained on how to clean and handle scopes. We place strong emphasis on retraining and maintaining competency," he says. "The better our scopes are handled, the better we are able to maintain lower costs related to our scopes."
Staff members also take advantage of the additional benefit of the in-services provided by vendors. "A part of our vendor's in-services also includes information on proper coiling and sink sizes to prevent needless scope damage," Mr. Mariani says.
4. Recruit quality specialists. Successfully recruiting GI specialists is critical to expanding the GI specialty, as the addition of quality GI physicians means the addition of new patients. Dianne Wallace, executive director of Menomonee Falls (Wis.) Ambulatory Surgery Center, says this can be done by actively marketing a facility's state-of-the-art equipment and demonstrating a competent staff who can assist physicians. "ASCs will have to sell themselves based on the quality of their equipment and whether they have a skilled staff who understands GI," says Ms. Wallace. "Physicians are going to look to see who provides the best quality care and has the best staff and equipment, like scopes and video equipment for GI procedures. ASCs have to prove to physicians it is worth their while to join their facility."