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105 DEVELOPMENT OF A NOVEL COLON CANCER SCREENING CENTRE (CCSC) IN CALGARY RJ Hilsden, A Rostom, A Czapski, D Pontifex, RB Bridges This abstract describes the process and associated challenges of developing a community endoscopy facility in Calgary. Currently, 32,000 procedures are performed annually at 3 hospitals (11 endoscopy rooms). Screening colonoscopy has placed demands upon already limited endoscopy capacity, which will be further exacerbated by Calgary's rapidly growing and aging population.
Department of Medicine, University of Calgary, Calgary, Alberta
PRINCIPLES: The CCSC is a collaboration of the Calgary Health Region (CHR) and the University of Calgary/Division of Gastroenterology to provide organized, high quality and efficient colonoscopy services for colon cancer screening. This added capacity will increase resources for diagnostic and therapeutic procedures by removing screening procedures from hospital endoscopy units. All physicians working at the CCSC will continue to provide hospital care. Therefore, access to GI care for all patients will be improved.
CONTRACT: The contract between the CHR and the University took nearly two years to complete. Key activities included (1) estimation of required annual colonoscopies, (2) development of costing model, (3) identification of reportable quality measures and (4) agreement on financial reinvestment. The contract requires 10,000 colonoscopies in year 1 and 20,000 annually by year 5.
DESIGN: The facility will include 6 endoscopy suites and 24 recovery beds. Design of the facility required several months and was guided by evaluation of units in Canada and US. The design focused on providing a highly efficient unit, emphasizing patient comfort, safety and privacy.
ACCREDITATION: The facility will require accreditation as a non-hospital surgical facility by the Alberta College of Physicians and Surgeons. Challenging issues include requirement for all physicians to maintain ACLS certification, use of LPNs in the recovery room and type and number of nurses in endoscopy suites.
INNOVATION: Several innovations will help maximize access, efficiency and cost-savings: (1) paperless unit utilizing electronic medical record, (2) nurses will provide pre-endoscopy assessment and education, (3) open-access screening, (4) web-based referral system and (5) comprehensive quality assurance program.
RESEARCH & EDUCATION: The facility will provide financial reinvestment for research, public education and health care provider training. Two endoscopy suites were specifically designed for training with a larger floor plan and video conferencing capability. Facilities for public education include a lecture theatre and computer-based education center.