Work Backward When Outfitting for GI

Older rooms in some HOPDs and dedicated GI centers are only about 200 square feet to 250 square feet, which must feel like working in a closet. Think about it — if you have two to three people in the room, plus the patient, and all the equipment, you have very little room to maneuver. Ideally, GI suites are 300 square feet to 400 square feet, which allows for complete access around the patient.

The pandemic is making facilities rethink the way they schedule and process patients.

After dedicating enough space to the reprocessing area and procedure rooms, turn your attention to the patient prep/recovery spaces, the number of which depends on how many procedure rooms you have. In general, you need 1.5 recovery spaces for every procedure room. Of course, this is just a general average.

Once the scope and patient care areas are mapped out, you can begin to think about an impression-making lobby. But don't go overboard — the project's budget would be better spent elsewhere. One major reason you don't want to put too much space or resources in your lobby: COVID-19. With coronavirus cases still surging, avoid planning a huge lobby with lots of seating where patients gather while waiting for their procedures. The pandemic is making facilities rethink the way they schedule and process patients. Even after the pandemic ends, contact-reducing practices will likely remain the norm.

Cost considerations

The capital equipment needed to outfit a GI procedure room can cost between $300,000 and $350,000, and upwards of $500,000 if you hang the equipment from ceiling-mounted booms. On top of equipment costs, you'll also need to add $250 to $350 per square foot for construction costs, depending upon in which part of the country you're building. You also need to factor in the cost of the scopes, which can run $20,000 to $45,000 each. Of course, the number of scopes needed is affected by the types of procedures performed and reprocessing time at your facility.

Incorporating the costs for space and equipment, you're looking at spending an average of $550,000 to $650,000 per procedure room. So, if you have a three-procedure-room set up, total costs will average $1.5 to $1.9 million.

In addition, you'll want to weigh the pros and cons of adding the following:

• Automated endoscope reprocessors. A reprocessing area designed with efficiency in mind and outfitted with state-of-the-art equipment improves patient safety, increases scope throughput and can reduce the number of full-time staff you need to employ. A pass-through automated endoscope reprocessor (AER) is an in-wall unit that provides a barrier between dirty and clean areas. On one side of the wall, scopes are placed inside the AER after they've been cleaned. In the AER, the scopes are disinfected and when done, they're removed on the other side of the wall, and are dried and stored.

Of course, the technology comes with a cost: AERs cost approximately $120,000. However, they can reduce the number of techs needed to work in the reprocessing area — one person to do the intensive manual cleaning and a second to remove the scopes from the AER, dry them and store them until they are needed again.

• Barcode scanning systems. Another technology that improves efficiency for a cost — around $150,000 to $200,000 — is a barcode scanning system. It allows you to trace the lifecycle of a specific scope wherever it is in the process. If a surgeon is looking for a specific scope, this system allows you to find out exactly where it is and when it'll be ready.
• Drying cabinets. When it comes to scope-drying technology, you have a lot of choices in terms of how much you want to invest in the efficiency of the cabinet. The type of drying cabinet you use greatly affects the speed at which your facility can reprocess its scopes. Previously, most drying cabinets were just that: a place where you hung your scopes to dry. However, because of the scopes' extremely narrow channels, bacteria can develop from moisture, something that occurs in standard, drying cabinets. Today, regulatory associations are "encouraging" centers to use drying cabinets that have a blower in them that circulates air, drying the scopes more efficiently.

But again, added efficiency is synonymous with added cost. A drying cabinet with a blower that circulates air through the entire cabinet can run between $5,000 and $6,000. But the latest drying technology goes even further. There are cabinets on the market with tubes that connect to each scope and blow air through individual channels. Efficient? Absolutely. But they do cost $15,000 to $20,000.