Physical Plant Design
MEC’s patient flow is streamlined in order to register, admit, provide procedural services to, and discharge a patient within a modular sequential flow. Each area is a separate module within the facility, allowing specialized work to be performed within that area, while providing easy transport of the patient to the next point in the process. In this way, once a patient begins the process at the front of the facility, each module represents one step closer to the discharge point at the rear of the facility. Throughout the process, attention is paid to the confidentiality of patient information in order to minimize any Health Insurance Portability and Accountability Act (HIPAA) or regulatory concerns. In addition, maintaining a focus on patient safety and comfort is vital throughout the entire flow process within the facility.

Regular time studies are performed across all areas of the facility and are compared with benchmark standards to ensure that no area within the center unnecessarily slows the flow to the next step in the process. For instance, when the nursing notes module of our clinical reporting software was implemented, we initially experienced slower than expected patient registration times. By comparing these times with our benchmarks, we were able to redeploy staff and modify our process to drive registration times back down to an acceptable level.

Staffing Design
Recruitment and retention of high-quality staff is critical for the delivery of an efficient patient experience. In-depth staff training is provided for new members of the team and, where possible, staff members are cross-trained to enable them to perform work in multiple areas in the facility. For instance, medical assistants rotate through the various procedure rooms and the decontamination room on a five-week cycle. In addition, certain medical assistants are also cross-trained in front-office operations in order to provide vacation or emergency coverage in this area if needed.

Long ago, the Board of Managers adopted a discretionary staff incentive that has resulted in high productivity from the staff. On a quarterly basis, the Board approves a pool of money that equates up to 3.0% of the entire ownership distribution for that period. This pool is then distributed to the employees, based on merit and individual contribution levels to the success of the operations. The staff therefore understand that their own earning potential is directly tied to the financial performance of the center, which means that circumstances such as add-on cases are welcomed and medical supply expenditures are closely monitored by the nursing personnel.

Sedation Methodology
Nearly all patients undergo sedation with profofol administered by certified registered nurse anesthetists (CRNAs). A specialized team of nurse anesthetists oversees the process, monitored by MD anesthesiologists. This allows the gastrointestinal proceduralist or colorectal surgeon to focus entirely on the procedure.

The center’s experience with profofol has been excellent. We have found that overall patient satisfaction for those receiving profofol is higher than that for procedures performed using other common sedatives on the market. In addition, each of our physicians has voiced great support for the continued use of this sedation model.