mind: Patients should be in and out of the facility in about 90 minutes.
Here are 5 tips to keep the patients flowing — instead of making a U-
turn at the registration desk and backing up into the waiting room.
1. Have enough restrooms. Anyone who's had a bowel prep
knows the importance of a restroom. No pun intended, but not having
enough restrooms can clog your schedule. I'd suggest at least 1 for the
waiting area and at least 2 in the admitting area. Remember, patients
might still be eliminating from the prep when they arrive for check-in.
While we're on the subject, instruct your admit nurses to screen
patients by asking if they're cleared out — and don't take the patients'
word for it. If a patient has to use the restroom during the admitting
process, tell him not to flush so the nurse can see for herself if it's
clear. Let the doctor know if there are formed particles. You don't
want to wheel a patient into a procedure room and open supplies only
to find out that the doctor can't do the case because the patient is not
adequately prepped.
2. Buy enough scopes. At about $30,000 apiece, GI scopes will
be your biggest equipment expense. How many will you need? I've
never bought less than 10 scopes (7 colonoscopes and 3 uppers) to
start a center. Case mix is extremely important if you have a limited
number of scopes. Ask each of your docs how many slots he can real-
istically fill in a day or a half day (they tend to overpromise). Let's
assume a 70:30 colonoscopy-to-upper endoscopy ratio. If we allow 15
minutes for an EGD, 30 minutes for a colonoscopy and 45 for a dou-
ble procedure — and about 45 minutes for reprocessing, which
involves leak testing, manual cleaning and reprocessing through the
AER — you likely won't run out of scopes:
Kicker
K
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