New Anesthesia Services in Office-Based Endoscopy: An Anesthesia Business Plan

Abstract

Purpose: Colonoscopy is the preferred method of screening for colorectal cancer in the United States. This screening tool has contributed to rapid and exponential growth in the number and complexity of gastrointestinal endoscopic procedures performed in the last few decades. In recent years, there has been an increased number of outpatient facilities that specialize in diagnostic endoscopic procedures, without an associated overnight stay. The patient’s ability to tolerate diagnostic endoscopic procedures is crucial to perform a complete and thorough examination. Studies have demonstrated that patients prefer deep levels of sedation to tolerate these exams. Patient preferences, combined with the need for faster recovery times have created an increased demand for business relationships between gastroenterologists and anesthesia practitioners. Certified Registered Nurse Anesthetists (CRNAs), are well trained to administer this method of sedation. The purpose of this project is to answer the research question: Can a business plan be developed for CRNAs implementing office-based gastroenterology clinic practices, to address specific considerations for the provision of this type of anesthesia service? Methods: Literature searches investigating the business of anesthesia and office-based facility standards were conducted to help identify considerations for newly established anesthesia services for outpatient endoscopy settings. Information obtained was used to develop a business plan to assist CRNAs to implement this type of collaborative practice. The American Association of Nurse Anesthetists (AANAs) conducts an annual survey to obtain member’s compensation data. This data was incorporated into the business plan for an accurate comparison of hypothetical employment scenarios in outpatient office-based endoscopy. Results: A business plan for an office based gastroenterology clinic that addressed the considerations necessary for starting anesthesia services was developed for this project. The business plan effectively describes essential elements of billing for services, facility readiness, and compensation models. The plan was utilized to establish an independent anesthesia practice capable of contracting services for office-based endoscopy. Conclusion: The business plan created for this project was utilized to start an anesthesia business in Minnesota. The plan was determined to be effective as a solitary document in which to articulate components necessary for starting an anesthesia business operated by this practitioner. Pertinent data was collected from various sources and serves the purpose of sharing the vision and plan for business success. This project served to answer the research question of if an anesthesia specific business plan could be created to assist in an the development of an office-based anesthetizing site, complete with elements necessary for addressing facility readiness and billing capabilities. Data Sources: American Association of Nurse Anesthetists, Medscape, PubMed, Cochrane Library, CINAHL, and Google Scholar