Facility characteristics
Attachment H2 – Table 1 |
|||
Number of eligible facilities, by sub-state region and survey administration |
|||
|
National SECAP |
State SECAP |
Total |
Region |
|||
Region 1 |
|
|
|
Region 2 |
|
|
|
Region 3 |
|
|
|
Region 4 |
|
|
|
Region 5 |
|
|
|
Region 6 |
|
|
|
Total |
|
|
|
Facility characteristics
Attachment H2 – Table 2 |
|||
Surveys and response rate, by sub-state region and survey administration |
|||
|
National SECAP |
State SECAP |
Total |
Region |
|
|
|
Region 1 |
|
|
|
Region 2 |
|
|
|
Region 3 |
|
|
|
Region 4 |
|
|
|
Region 5 |
|
|
|
Region 6 |
|
|
|
Total |
|
|
|
Facility characteristics
Attachment H2 – Table 3 |
||||
Mean number of providers performing sigmoidoscopies and
colonoscopies, |
||||
|
ASC |
Hospital |
Physician Practice |
Total |
Flexible sigmoidoscopy |
||||
Gastroenterologist |
|
|
|
|
Primary Care Provider |
|
|
|
|
Internist |
|
|
|
|
Family practitioner/ General practitioner |
|
|
|
|
Surgeon |
|
|
|
|
General surgeon |
|
|
|
|
Colorectal surgeon |
|
|
|
|
Non-physician endoscopist |
|
|
|
|
Other |
|
|
|
|
Total |
|
|
|
|
Colonoscopy |
||||
Gastroenterologist |
|
|
|
|
Primary Care Provider |
|
|
|
|
Internist |
|
|
|
|
Family practitioner/ General practitioner |
|
|
|
|
Surgeon |
|
|
|
|
General surgeon |
|
|
|
|
Colorectal surgeon |
|
|
|
|
Non-physician endoscopist |
|
|
|
|
Other |
|
|
|
|
Total |
|
|
|
|
Number of facilities |
|
|
|
|
Facility characteristics
Attachment H2 – Table 4 |
|||||
Number of procedure rooms, video monitors, and endoscopes
for lower endoscopies, by region |
|||||
|
Procedure rooms |
Video monitors |
Colonoscopes |
Flexible sigmoidoscopes |
Other lower endoscope |
Mean per Facility |
|
||||
Region 1 |
|
|
|
|
|
Region 2 |
|
|
|
|
|
Region 3 |
|
|
|
|
|
Region 4 |
|
|
|
|
|
Region 5 |
|
|
|
|
|
Region 6 |
|
|
|
|
|
Total in Region |
|
||||
Region 1 |
|
|
|
|
|
Region 2 |
|
|
|
|
|
Region 3 |
|
|
|
|
|
Region 4 |
|
|
|
|
|
Region 5 |
|
|
|
|
|
Region 6 |
|
|
|
|
|
|
Facility characteristics
Attachment H2 – Table 5 |
|||||
Number of procedure rooms, video monitors, and endoscopes for
lower endoscopies, by facility type |
|||||
|
Procedure rooms |
Video monitors |
Colonoscopes |
Flexible sigmoidoscopes |
Other lower endoscope |
Mean per Facility |
|
||||
ASC |
|
|
|
|
|
Hospital |
|
|
|
|
|
Physician practice |
|
|
|
|
|
Total |
|
||||
ASC |
|
|
|
|
|
Hospital |
|
|
|
|
|
Physician practice |
|
|
|
|
|
|
Facility characteristics
Attachment H2 – Table 6 |
||||
Average room time typically scheduled for flexible
sigmoidoscopy |
||||
|
Flexible Sigmoidoscopy* |
Colonoscopy* |
||
|
State |
Nation |
State |
Nation |
ASCs |
|
|
|
|
Hospitals |
|
|
|
|
Physician practices |
|
|
|
|
*Among those facilities that perform the procedure |
Facility characteristics
Attachment H2 – Table 7 |
||||
Percentage of facilities typically using sedation and anesthesia for colonoscopy
in State and the nation, by facility type |
||||
|
Opioids/Benzodiazepines |
Propofol |
||
|
State |
Nation |
State |
Nation |
ASCs |
|
|
|
|
Hospitals |
|
|
|
|
Physician practices |
|
|
|
|
|
Characteristics of the individuals performing screening and follow-up examinations
Attachment H2 – Table 8 |
||||
Percentage of all flexible sigmoidoscopies and colonoscopies
performed, |
||||
|
ASC |
Hospital |
Physician Practice |
Total |
Flexible sigmoidoscopy |
||||
Gastroenterologist |
|
|
|
|
Primary Care Provider |
|
|
|
|
Internist |
|
|
|
|
Family practitioner/ General practitioner |
|
|
|
|
Surgeon |
|
|
|
|
General surgeon |
|
|
|
|
Colorectal surgeon |
|
|
|
|
Non-physician endoscopist |
|
|
|
|
Other |
|
|
|
|
Total |
|
|
|
|
Number of facilities |
|
|
|
|
Colonoscopy |
||||
Gastroenterologist |
|
|
|
|
Primary Care Provider |
|
|
|
|
Internist |
|
|
|
|
Family practitioner/ General practitioner |
|
|
|
|
Surgeon |
|
|
|
|
General surgeon |
|
|
|
|
Colorectal surgeon |
|
|
|
|
Non-physician endoscopist |
|
|
|
|
Other |
|
|
|
|
Total |
|
|
|
|
Number of facilities |
|
|
|
|
Characteristics of the individuals performing screening and follow-up examinations
Attachment H2 – Table 9 |
||||
Percentage of facilities in State authorizing non-physician endoscopists to perform flexible sigmoidoscopies and colonoscopies
with varying levels of supervision, by facility
type |
||||
|
ASC |
Hospital |
Physician Practice |
Total |
Flexible sigmoidoscopy |
||||
A physician is present for the entire exam |
|
|
|
|
A physician is present only when the flexible sigmoidoscope is withdrawn |
|
|
|
|
The non-physician endoscopist is unsupervised, but… |
|
|
|
|
A physician is “immediately available” in clinic |
|
|
|
|
A physician is “immediately available” in hospital |
|
|
|
|
A physician is “immediately available” by beeper/phone |
|
|
|
|
The non-physician endoscopist is authorized to perform the entire exam unsupervised |
|
|
|
|
Other |
|
|
|
|
Non-physician endoscopists do not perform flexible sigmoidoscopy |
|
|
|
|
Number of facilities |
|
|
|
|
Colonoscopy |
||||
A physician is present for the entire exam |
|
|
|
|
A physician is present only when the colonoscope is withdrawn |
|
|
|
|
The non-physician endoscopist is unsupervised, but… |
|
|
|
|
A physician is “immediately available” in clinic |
|
|
|
|
A physician is “immediately available” in hospital |
|
|
|
|
A physician is “immediately available” by beeper/phone |
|
|
|
|
The non-physician endoscopist is authorized to perform the exam unsupervised |
|
|
|
|
Other |
|
|
|
|
Non-physician endoscopists do not perform colonoscopy |
|
|
|
|
Number of facilities |
|
|
|
|
Screening and follow-up tests currently being performed
Attachment H2 – Table 10 |
||||
Procedures currently being performed in State and the
nation |
||||
|
Flexible Sigmoidoscopy |
Colonoscopy |
||
|
State |
Nation |
State |
Nation |
Percent of facilities that perform the procedure |
|
|
|
|
Mean number of procedures performed per week per facility * |
|
|
|
|
Percent of procedures performed for screening* |
|
|
|
|
Percent of procedures that are incomplete* |
|
|
|
|
Mean number of procedures possible per week per facility* |
|
|
|
|
Number of facilities |
|
|
|
|
*Among those facilities that perform the procedure |
Screening and follow-up tests currently being performed
Attachment H2 – Table 11 |
||||||
Procedures currently being performed by facility
type |
||||||
|
Flexible Sigmoidoscopy |
Colonoscopy |
||||
|
ASC |
Hospital |
Physician Practice |
ASC |
Hospital |
Physician Practice |
Percent of facilities that perform the procedure |
|
|
|
|
|
|
Mean number of procedures performed per week per facility * |
|
|
|
|
|
|
Percent of procedures performed for screening* |
|
|
|
|
|
|
Percent of procedures that are incomplete* |
|
|
|
|
|
|
Mean number of procedures possible per week per facility* |
|
|
|
|
|
|
Number of facilities |
|
|
|
|
|
|
*Among those facilities that perform the procedure |
Screening and follow-up tests currently being performed
Attachment H2 – Table 12 |
||
Typical waiting time for various endoscopy procedures for
State and the nation |
||
|
State |
Nation |
Screening flexible sigmoidoscopy* |
||
1-2 weeks |
|
|
3-4 weeks |
|
|
1 – 2 months |
|
|
3 – 4 months |
|
|
5 – 6 months |
|
|
More than 6 months |
|
|
Screening colonoscopy* |
||
1-2 weeks |
|
|
3-4 weeks |
|
|
1 – 2 months |
|
|
3 – 4 months |
|
|
5 – 6 months |
|
|
More than 6 months |
|
|
Follow-up colonoscopy* |
||
1-2 weeks |
|
|
3-4 weeks |
|
|
1 – 2 months |
|
|
3 – 4 months |
|
|
5 – 6 months |
|
|
More than 6 months |
|
|
* Among those facilities that perform procedure |
Maximum number of screening and follow-up examinations with widespread screening.
Attachment H2 – Table 13 |
||||
Limiting factors to increasing the number of endoscopies, in
State and the nation |
||||
|
Flexible Sigmoidoscopy |
Colonoscopy |
||
|
State |
Nation |
State |
Nation |
Time |
|
|
|
|
Insufficient time – few open appointments |
|
|
|
|
Insufficient utilization due to cancellations or “no shows” |
|
|
|
|
Physicians & Staffing |
|
|
|
|
Insufficient number of physicians available to perform procedures |
|
|
|
|
Insufficient nursing staff to assist with procedures |
|
|
|
|
Insufficient ancillary staff to help with room turnover |
|
|
|
|
Insufficient staff or physicians to monitor the sedation or anesthesia |
NA |
NA |
|
|
Space & Equipment |
|
|
|
|
Insufficient procedure rooms |
|
|
|
|
Insufficient prep and/or recovery areas |
|
|
|
|
Insufficient endoscopes or monitors |
|
|
|
|
Insufficient reimbursement |
|
|
|
|
Other |
|
|
|
|
Not applicable, not planning to perform more procedures |
|
|
|
|
Maximum number of screening and follow-up examinations with widespread screening.
Attachment H2 – Table 14 |
||||
Primary limiting factor to increasing the number of
endoscopies, in State and the nation |
||||
|
Flexible Sigmoidoscopy |
Colonoscopy |
||
|
State |
Nation |
State |
Nation |
Time |
|
|
|
|
Insufficient time – few open appointments |
|
|
|
|
Insufficient utilization due to cancellations or “no shows” |
|
|
|
|
Physicians & Staffing |
|
|
|
|
Insufficient number of physicians available to perform procedures |
|
|
|
|
Insufficient nursing staff to assist with procedures |
|
|
|
|
Insufficient ancillary staff to help with room turnover |
|
|
|
|
Insufficient staff or physicians to monitor the sedation or anesthesia |
NA |
NA |
|
|
Space & Equipment |
|
|
|
|
Insufficient procedure rooms |
|
|
|
|
Insufficient prep and/or recovery areas |
|
|
|
|
Insufficient endoscopes or monitors |
|
|
|
|
Insufficient reimbursement |
|
|
|
|
Other |
|
|
|
|
Not applicable, not planning to perform more procedures |
|
|
|
|
Maximum number of screening and follow-up examinations with widespread screening.
Attachment H2 – Table 15 |
||||
Measures to address increased need for flexible sigmoidoscopy
|
||||
|
Flexible Sigmoidoscopy |
Colonoscopy |
||
|
State |
Nation |
State |
Nation |
Time |
|
|
|
|
Increase proportion of work day allocated to procedures |
|
|
|
|
Modify block scheduling |
|
|
|
|
Use patient navigators or reminder calls to decrease cancellations and “no shows” |
|
|
|
|
Physicians & Staffing |
|
|
|
|
Increase physician staff |
|
|
|
|
Increase/hire non-physician endoscopists to perform procedures |
|
|
|
|
Increase nursing staff to assist with procedures |
|
|
|
|
Increase ancillary staff to help with room turnover |
|
|
|
|
Increase staff or physicians to monitor the sedation or anesthesia |
|
|
|
|
Space & Equipment |
|
|
|
|
Establish a larger screening unit/more procedure rooms |
|
|
|
|
Establish additional prep and/or recovery areas |
|
|
|
|
Purchase or lease more equipment |
|
|
|
|
Other |
|
|
|
|
Not applicable, not planning to perform more procedures |
|
|
|
|
Maximum number of screening and follow-up examinations with widespread screening.
Attachment H2 – Table 16 |
|||||||
Measures to address increased need for flexible sigmoidoscopy
|
|||||||
|
Flexible Sigmoidoscopy |
Colonoscopy |
|||||
|
ASC |
Hospital |
Physician Practice |
ASC |
Hospital |
Physician Practice |
|
Time |
|
|
|
|
|
|
|
Increase proportion of work day allocated to procedures |
|
|
|
|
|
|
|
Modify block scheduling |
|
|
|
|
|
|
|
Use patient navigators or reminder calls to decrease cancellations and “no shows” |
|
|
|
|
|
|
|
Physicians & Staffing |
|
|
|
|
|
|
|
Increase physician staff |
|
|
|
|
|
|
|
Increase/hire non-physician endoscopists to perform procedures |
|
|
|
|
|
|
|
Increase nursing staff to assist with procedures |
|
|
|
|
|
|
|
Increase ancillary staff to help with room turnover |
|
|
|
|
|
|
|
Increase staff or physicians to monitor the sedation or anesthesia |
|
|
|
|
|
|
|
Space & Equipment |
|
|
|
|
|
|
|
Establish a larger screening unit/more procedure rooms |
|
|
|
|
|
|
|
Establish additional prep and/or recovery areas |
|
|
|
|
|
|
|
Purchase or lease more equipment |
|
|
|
|
|
|
|
Other |
|
|
|
|
|
|
|
Not applicable, not planning to perform more procedures |
|
|
|
|
|
|
Maximum number of screening and follow-up examinations with widespread screening.
Attachment H2 – Table 17 |
||||||
Estimated number of facilities and potential to provide
|
||||||
|
Flexible sigmoidoscopy |
Colonoscopy |
||||
Region |
Number of facilities |
Mean number of weekly procedures possible |
Potential Annual Volume |
Number of facilities |
Mean # weekly procedures possible |
Potential Annual Volume |
1 |
|
|
|
|
|
|
2 |
|
|
|
|
|
|
3 |
|
|
|
|
|
|
4 |
|
|
|
|
|
|
5 |
|
|
|
|
|
|
6 |
|
|
|
|
|
|
Total |
|
|
|
|
|
|
|
Attachment H2 – Table 18 |
||||||||||
Potential volume, current volume, and unused capacity for
flexible sigmoidoscopy and colonoscopy, by region – annual
number of procedures |
||||||||||
|
Flexible Sigmoidoscopy |
Colonoscopy |
||||||||
Potential Volume |
Current Volume |
Unused Capacity |
Potential Volume |
Current Volume |
Unused Capacity |
|||||
Region |
||||||||||
Region 1 |
|
|
|
|
|
|
||||
|
|
|
|
|
|
|||||
Region 2 |
|
|
|
|
|
|
||||
|
|
|
|
|
|
|||||
Region 3 |
|
|
|
|
|
|
||||
|
|
|
|
|
|
|||||
Region 4 |
|
|
|
|
|
|
||||
|
|
|
|
|
|
|||||
Region 5 |
|
|
|
|
|
|
||||
|
|
|
|
|
|
|||||
Region 6 |
|
|
|
|
|
|
||||
|
|
|
|
|
|
|||||
Total |
|
|
|
|
|
|
||||
|
|
|
|
|
|
|||||
|
File Type | application/msword |
File Title | Table 2-1 |
Author | Battelle |
Last Modified By | Manninen, Diane L |
File Modified | 2009-11-25 |
File Created | 2009-11-25 |