orm_asc_october-2024 - 2

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Vol. 40, No. 10 October 2024 * OR Manager (ISSN 87568047)
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Endoscopy, Saver
Continued from page 1
nary suite, and one pain/minor surgical
procedure room to consider, managing
the center's endoscopy services is an
inherently complex and collaborative endeavor.
" You have to be able to bounce
and spin, " she says. " Because you're
working with so many different professionals,
you need to have good communication
and bargaining skills. "
However, even great communicators
also require practical strategies for ensuring
financial health and patient wellbeing.
OR Manager spoke with leaders
in ambulatory and hospital endoscopy
centers to gain insights into addressing
challenges with resource management,
scheduling, staffing, and more.
Resource management
An article co-authored
by Sumeet Tewani, MD,
FASGE, recommends
that an ASC providing
endoscopy services
have three to four preparation/recovery
bays
per procedure room.
" Below that, you're
probably going to run
into throughput issues, " he says.
Consider an environment like the
clinic for Rockford Gastroenterology Associates,
LTD, where Dr Tewani is co-owner.
Located in Rockford, Illinois, this center
Sumeet
Tewani, MD,
FASGE
has four procedure rooms where 14 physicians
perform an average of 17 to 18
procedures per room per day (the practice
also performs advanced endoscopy
and other procedures at two area hospitals).
Without sufficient recovery bays,
scheduling a series of shorter procedures
(30 minutes or less) could lead to delays.
The precise number of bays depends
on the individual needs of the ASC or
hospital center, Dr Tewani says. When
considering needed resources, such as
equipment, he recommends endoscopy
center leaders consider the following:
* Types and number of procedures. For
example, knowing the ratio of upper
to lower endoscopy procedures will
help determine equipment needs.
* Length of procedures. Advanced
procedures such as endoscopic
retrograde cholangiopancreatography
(ERCP) will take longer than a
screening colonoscopy.
* Reprocessing time. How fast is the
turnaround for scopes and other
equipment?
* Population mix. This helps determine
if pediatric endoscopes are
needed and if so, how many. Population
mix also factors into timing and
staffing. For example, outpatients
come to the hospital setting because
comorbidities (such as sleep
apnea, high BMI, or cardiac conditions)
make them ineligible for procedures
performed in an ASC. These
patients may require additional time
for anesthesia recovery.
Reimbursement of surveillance colonoscopies
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A key issue for ASCs is that Medicare does
not fully cover surveillance colonoscopies for
patients who underwent polyp removal during
a screening colonoscopy. More than 90
healthcare provider and patient advocacy organizations,
including the Ambulatory Surgery
Center Association and the American Society
for Gastrointestinal Endoscopy, have signed a
letter urging the U.S. Departments of Health
and Human Services, Labor, and Treasury
2
ASC Leader | October 2024
to " provide written guidance to clarify that
surveillance colonoscopy after a colonoscopy
that required polyp removal is part of
the screening continuum and that patients
should not face out-of-pocket costs for the
surveillance procedure. "
Reference
ASCA letter advocating coverage of surveillance
colonoscopies. Accessed June
2024.
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