Diversity of endoscopy center operations and practice variation across California’s safety-net hospital system: a statewide survey

BACKGROUND: Little is known about endoscopic services provided or operational practice variation within California public hospital endoscopy centers. METHODS: A survey was distributed to all 18 California public hospitals with endoscopy centers to assess operational practices. RESULTS: Eight of 18 hospitals responded to the survey. Six of the eight responding hospitals used a closed access system for patient referrals. Mean wait time for an endoscopic procedure was 42.4 ± 37.7 days (N = 8) with a mean procedure no-show/cancellation rate of 14.5 ± 8.0% (N = 7). All responding public hospitals performed colonoscopy, esophagogastroduodenoscopy, PEG tube placement, and endoscopic retrograde cholangiopancreatography (ERCP) with two hospitals performing endoscopic ultrasound. There was significant practice variation in the documentation of endoscopic quality and performance measurements among the responding hospitals. Multiple methods were used to communicate pathology results to patients: GI clinic visit (6/8), primary physician (4/8), telephone (2/8) or letter (1/8). CONCLUSION: Our study highlights the diversity and practice variations of endoscopy center operations at California public hospitals and serves as a catalyst for future collaborations among safety-net hospitals.