Making room for quality and progress
Date: June 14, 2011
The new endoscopy suite at Hopkins will improve patient flow and promote medical discovery.
For faculty in the Division of Gastroenterology at The Johns Hopkins Hospital, backups in the endoscopy suite are as predictable as rush hour traffic and much more frustrating. Severe space limitations routinely delay diagnostic and treatment procedures for patients, many of them acutely ill.
“Currently, we’re bursting at the seams,” says Tony Kalloo, director of the Division of Gastroenterology and Hepatology. He provides an aggravating example: Despite growing demand for endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic ultrasound (EUS), a two-part procedure for diagnosing and treating pancreatic cancer patients, only one room in the suite is large enough to contain the numerous devices required for the procedures.
Such logjams will vanish next year when the endoscopy suite moves to the new clinical buildings, where procedure rooms will nearly double in number from eight to 14, each large enough for ERCP procedures.
Housed on Level 2 of the Sheikh Zayed Tower, the new suite’s expansive dimensions will raise the quality and quantity of endoscopy practice at Hopkins Hospital, says Kalloo, who took a hands-on approach to the new suite’s design. “It’s really allowing us to provide better patient care.”
With an ample supply of procedure rooms, “we will put inpatients on the schedule more quickly,” an upgrade that will also cut the cost of prolonged hospital stays, Kalloo says. The ability to schedule procedure times as needed will “vastly improve the situation for faculty” as well.
It will become easier to conduct procedures in rooms that are approximately twice as large as those currently in use, Kalloo says. “Access to equipment will be easier, and clinicians will be able to move freely without bumping into one another.” The department move will also provide a dedicated space for cytopathologists, who currently must wait in the hallway along with their equipment carts when they aren’t taking biopsy specimens during endoscopic procedures.
The new suite will feature a bevy of patient- and family-centered care amenities. “We actually had relatives of two former patients give input into the design,” Kalloo says. Their responses factored prominently in the decision to install a digital tracking board to update patients on wait times and inform families of a patient’s status from pre-op through recovery. The family members also stressed the need for privacy during sensitive conversations between patients and providers, says Kalloo.
As his family consultants advised, private space in the suite has been reserved for discussions about diagnoses and treatment. Privacy will extend to the 37 pre-op and recovery bays (up from 21) that will be separated by walls rather than curtains, as is now the case.
Endoscopy nurse manager Donalynn Parks is also working “to get everyone prepared” for the new culture of care in the new clinical buildings. During down times in the current suite, she encourages her staff to invite family members to visit kin in the pre-op and recovery area, a practice that will become customary in the new suite. A clinical customer care coordinator, on site to assist patients and families when questions and concerns arise, will boost care coordination and communication, Parks says.
Strength in merging
In another quantum leap for care and efficiency, endoscopy services for inpatients and outpatients will be consolidated in the new suite. Physicians and staff will no longer waste time shuttling between endoscopy services in the hospital and the outpatient center, nor will it be necessary to maintain duplicate inventory systems for each practice.
Since 2009, Parks has been cross-training staff members in the skills specific to both inpatient and outpatient care practices, enabling them to rotate between the two when the suite opens. “There’s been a lot of behind-the-scenes work in preparation for the move,” she says. “A lot of changes are in store for the nurses, and we’re trying to take it one step at a time.”
Tied to the new suite’s promise of a higher caliber of care is the sizable new conference room, a particular point of pride for Kalloo, who has long hoped for a space large enough to hold all division physicians and nurses. Currently, “we don’t have a space big enough for staff education or conferences,” Kalloo says. “If we want to train nurses in a new procedure, it has to be done in bits and pieces.”
The conference room will be wired to receive live transmissions of endoscopic procedures, taking clinician education to a new level, Kalloo says. “You can truly teach in a live fashion and ask questions back and forth.”
An array of new technology promises as well to improve safety and efficiency in the endoscopy suite’s future home. A new barcode system for tracking fluoroscopic scopes will replace a paper-based surveillance system that made it difficult to know “what scope touched what patients,” Parks says. With electronic tracking, “you can push a button and see how often each scope was used and who used it.” A state-of-the-art system for washing scopes will raise the patient safety bar yet higher.
The new endoscopy suite is also designed for equipment and technologies yet to come in the rapidly advancing discipline, Kalloo says. “As new procedures come along, we have built rooms with the capability to accommodate future visions and dreams.”