poster presented at the ddw 2014
Post on 01-Nov-2015
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50,000
Community Hospital Ardmore, Oklahoma
Snorri Olafsson, MD, PHD, MPH
Francisco E. Ramirez, MD
Neil Nedley, Md
DAVID LIVELY, RNA Change in Anesthesia Protocol for GI Endoscopic Procedures Decreased the Workload of a GI Lab
Background
The GI lab in a community hospital in the small town of Ardmore, Okla-homa, was one of the few places in America where registered nurses, under the supervision of an endos-copist, have been administering propofol in approximately 50,000 GI procedures without an anesthe-siologist since 1994.
At the end of 2012 a change in hos-pital policy required an anesthesiolo-gist to administer the anesthesia during all GI procedures.
Methods
Using the hospital database and the records of the billing department we quantified the number of procedures and their cost during 2011, 2012 and 2013 to see the effect of the policy change. The same number of endos-copists worked all years and were available equally. There was no lack of referrals for endoscopy with a steady waiting list of 2-3 weeks. Our lab is almost the only center doing endoscopies in our area.
Results Conclusion
In the GI lab, during 2011, 1632 EGDs and 2176 colonoscopies were done, a total of 3808 procedures.During 2012, 1668 EGDs and 2042 colonoscopies were done, a total of 3710 procedures. During 2013, 1514 EGDs and 1797 colonoscopies were done, a total of 3211 proce-dures. The percentage decrease from 2013 to 2012 being 9% for EGDs and 12% for colonoscopies a total decrease of 11%, from 2013 to 2011 being 7% for EGDs and 17% for colonoscopies a total decrease of 13%.
The anesthesia reimbursement added a cost of at least $150.20 (Medicare reimbursement) per endo-scopic procedure after the change in policy.
In the GI lab, during 2011, 1632 EGDs and 2176 colonoscopies were done, a total of 3808 procedures.
During 2012, 1668 EGDs and 2042 colonoscopies were done, a total of 3710 procedures. During 2013, 1514 EGDs and 1797 colonoscopies were done, a total of 3211 procedures. The percentage decrease from 2013 to 2012 being 9% for EGDs and 12% for colonoscopies a total decrease of 11%, from 2013 to 2011 being 7% for EGDs and 17% for colonoscopies a total decrease of 13%.
The anesthesia reimbursement added a cost of at least $150.20 (Medicare re-imbursement) per endoscopic proce-dure after the change in policy.
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