How to run an endoscopy unit? Experience in the Federal Republic of Germany. Results of a survey of 31 centers

Abstract

A survey of 31 German hospitals (14 university hospitals with a special gastrointestinal service, 13 key hospitals with specialized GI units, mainly university teaching hospitals, and 4 smaller hospitals without specialization) showed that a service providing the usual gastrointestinal endoscopic procedures is available in all university and key hospitals. In the university hospitals, an average of 4,765 procedures per year are performed, in the key hospitals with specialized GI units 5,558, and in the smaller hospitals without specialization 2,935. Such special methods as ERCP, PTC and operative endoscopy are usually restricted to special clinics. The number of doctors and nursing staff is adequate at university hospitals and in specialized key hospitals. Smaller hospitals without specialization need more nursing staff. All hospitals need more rooms. The supply of instruments is sufficient at university and key hospitals, but more instruments are needed in general non-specialized hospitals. German endoscopic units are relatively well equipped with X-ray machines, but further X-ray equipment is still needed to achieve less dependence on centralized radiological departments. There is a distinct need for more waiting and recovery rooms. At the present time, there is no optimal endoscopic unit in Germany. Better and appropriate outfitting of the units, and an optimized floor-plan encompassing endoscopy rooms, rooms for preparation and after-care are needed--which is not practical in the case of existing hospitals, but must be considered when planning new hospitals.