Conducting a Root Cause Analysis to Improve Patient Selection Process

Date of Award

Summer 6-12-2019

Document Type

DNP Project

Project Team Faculty Member

Cynthia Schmidt

Project Team Faculty Member

Kevin Stein

Project Team Faculty Member

Andrew Griffin


preoperative assessment, outpatient procedures, gastrointestinal procedure, office-based anesthesia, office-based sedation


Office-based gastrointestinal (GI) facilities care for a high volume of outpatients undergoing quick endoscopic procedures. Over the past three decades, the number of outpatient GI procedures has dramatically increased and is projected to continue to rise. Given the rising number of outpatient GI procedures, it is essential to maximize the safety of such practice. The aging population and rising number of individuals with multiple co-morbidities increase the risk for complications during anesthesia. Limited resources also make it more difficult to treat complications that may arise during the anesthetic. A gastrointestinal office, located in a relatively small, southern Illinois city, elected to evaluate their current practice in selecting patients they provide upper and lower GI procedures under conscious sedation. The goal of this project was to enhance patient safety by improving the current preoperative assessment and patient selection process based on current guidelines and research. Currently there is no uniform practice guidelines to help guide the selection of patients with various comorbidities undergoing office-based procedures receiving office-based sedation. However, recommendations have been made based upon expert opinion and best practice.

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