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Ambulatory Endoscopy in Ontario- Current Practice Patterns

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Ambulatory Endoscopy in Ontario- Current Practice Patterns

  1. 1. Doug Hemphill MD, FRCP(C)<br />Barrie Endoscopy<br />The Royal Victoria Hospital, Barrie, ON<br />Ambulatory Endoscopy in Ontario- Current Practice Patterns<br />
  2. 2. Ambulatory Clinics in Ontario<br />Little known about out of hospital endoscopy activity in Ontario<br />No requirement to declare site of endoscopic activity with CPSO, OMA, or specialty organizations<br />No accreditation process or organization<br />Ministry could be aware (Tray fee E749 or group billing numbers)<br />Estimate of proportion of Ontario colonoscopies done in out of hospital settings is 20% (Linda Rabeneck- personal communication)<br />
  3. 3. Ambulatory Endoscopy in Ontario- Finding the Clinics<br />Diverse group- Surgeons/Gastros/Other, endoscopists who have and those that don’t have hospital privileges.<br />Sources of information <br />Industry<br />Registration<br />Word of mouth<br />We don’t have a complete list<br />
  4. 4. Endoscopy Clinics in Ontario<br />Albany Clinic<br />Barrie Endoscopy<br />Bluewater Surgical Centre<br />Bray<br />Brunswick Clinic<br />Byrne<br />Digestive Health<br />Desai<br />Downsview Endoscopy<br />Durham Endoscopy Centre<br />Elkashab<br />Endoscopy Clinic of Greater Toronto<br />Farmed Endoscopy<br />Gastroenterology Group<br />GTA Endoscopy<br />Holly Street Endoscopy<br />Intestinal Health<br />Kensington Endoscopy<br />Maple Endoscopy <br />Missisauga Colonoscopy<br />North Scarborough Endoscopy<br />North Toronto GI Clinic<br />North York Endoscopy<br />Markham Endoscopy<br />Oakville Endoscopy Centre<br />Oshawa Clinic Endoscopy<br />Ottawa Endoscopy<br />Patel<br />Polyclinic<br />PES-Rudd Clinics<br />SCOPE Clinic<br />Surrey Clinic<br />Toronto Clinic<br />The Toronto GI Clinic<br />Upper Canada Lower Bowel<br />Vaughan Endoscopy<br />West GTA Endoscopy<br />
  5. 5. Endoscopy Clinics in Ontario<br />Albany Clinic<br />Barrie Endoscopy<br />Bluewater Surgical Centre<br />Bray<br />Brunswick Clinic<br />Byrne<br />Digestive Health<br />Desai<br />Downsview Endoscopy<br />Durham Endoscopy Centre<br />Elkashab<br />Endoscopy Clinic of Greater Toronto<br />Farmed Endoscopy<br />Gastroenterology Group<br />GTA Endoscopy<br />Holly Street Endoscopy<br />Intestinal Health<br />Kensington Endoscopy<br />Maple Endoscopy <br />Missisauga Colonoscopy<br />North Scarborough Endoscopy<br />North Toronto GI Clinic<br />North York Endoscopy<br />Markham Endoscopy<br />Oakville Endoscopy Centre<br />Oshawa Clinic Endoscopy<br />Ottawa Endoscopy<br />Patel<br />Polyclinic<br />PES-Rudd Clinics<br />SCOPE Clinic<br />Surrey Clinic<br />Toronto Clinic<br />The Toronto GI Clinic<br />Upper Canada Lower Bowel<br />Vaughan Endoscopy<br />West GTA Endoscopy<br />
  6. 6. 1. How many years has your clinic been in operation? (22 responses)<br />Average 6.86 yrs<br />Range 3 months to 40 years<br />11 Clinics 3 yrs or less<br />
  7. 7. 2. How many doctors perform endoscopies at your clinic on a regular basis? (22 responses)<br />General Surgeons 2.9/clinic 58 Total<br />Gastroenterologists 3.43/clinic 72 Total<br />Other 1<br />Number of Clinics GI only 5<br />Number of Clinics General Surgery Only 1<br />
  8. 8. 3. What proportion (%) of doctors working regularly at your clinic have active hospital privileges?<br />100% hospital privileges 10 clinics<br />0% hospital privileges 6 clinics<br />20%-90% hospital privileges 6 clinics<br />
  9. 9. 4. How many procedures are done in your clinic per year? (21 clinics responded)<br />
  10. 10. 5. Can patients be referred for gastroscopy only (not associated with a colonoscopy)?<br />
  11. 11. 6. How many procedure rooms at your clinic are used for endoscopy most days?<br />15 of 19 clinics have unused procedure rooms for future expansion<br />
  12. 12. 7. How are your patients referred?<br />
  13. 13. 8. Do patients have their procedure performed on the same day as the consultation?<br />
  14. 14. 9. Indications for referral for endoscopy at your clinic.<br />
  15. 15. 10. What types of co morbidity exclude patients from having procedures at your clinic?<br />
  16. 16. 11. What therapeutic procedures do you perform at your clinic?<br />
  17. 17. 12. Which colonoscopy prep do you most commonly use?<br />
  18. 18. 13. What sedation agents are used at your clinic?<br />
  19. 19. 14. What patient monitoring is performed?<br />
  20. 20. 15. Nurses- what proportion are RNs vs. RPNs?<br />
  21. 21. 16. Scope Reprocessing.<br />
  22. 22. 17. What indicators of quality care do you regularly monitor and record?<br />
  23. 23. 18. Are you an accredited with any organization?<br />
  24. 24. 19. Is your clinic involved in marketing or advertising?<br />
  25. 25. 20. Does your clinic charge patients a non-OHIP fee?<br />
  26. 26. END<br />

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