1. The GI Lab at Denver Health
General intro
AIDET
Today we’re here to share a little bit about DH, the GI Lab and some of the exciting things we have going on.
We’ll talk a little bit about growth, capacity and how you can get in and fit in with what we’re doing
Brian Listy, RN – GI Lab Manager
Diogo Barbosa – GI Lab Care Navigator

2. Denver Health…
A comprehensive, integrated health system providing level one care for all, regardless of ability to pay
Twenty-five percent of all Denver residents receive their health care at Denver Health
Provide access to the highest quality health care, whether for prevention, or acute and chronic diseases, regardless of ability to pay
Basic intro to DH
We been doing this for a very long time – 157 years
Clearly, we don’t care if you have the ability to pay

3. Denver Health… Start with basic intro to DH
“We been doing this for a very long time”
Clearly, we don’t care if you have the ability to pay

4. The New Look of Denver Health…
Start with basic intro to DH
“We been doing this for a very long time”
Clearly, we don’t care if you have the ability to pay

5. The GI Lab at Denver Health…
Direct Access endoscopy: colonoscopy, flexible sigmoidoscopy and EGD
Our dedicated team of Doctors and Nurses provides expert, patient centered care
~3000 colonoscopies annually (5,000 total procedures)
In-house, patient centered scheduling
Increasing capacity for new patients
GI Lab intro, 12 pre-post bays, 4 procedure rooms
Team of 6 MDs, 14 RNs, techs, scheduling team; we’re a pretty typical OP endoscopy center
Our doctors are DH employees, not outside group
Scheduling is probably the most exciting thing we’ve been doing for the past year or so,
If you’re looking for a way to have the greatest positive impact on your clinic, look at scheduling
We’re actively growing and hiring and this is almost completely related to improvements in our scheduling process and other changes to process and workflow

6. GI Lab Timeline…
<4,000 procedures
No growth plan
Stable capacity
Not staffed for growth
CCSP funded Navigation started
2014
New leadership
Strategic plan developed
Scheduling identified as key process
Stable volume & capacity
2015
New EMR
Scheduling pilot
Staff expansion
Increased volume
Capacity action plan developed
Navigation capacity increase
2016
Patient centered, creative scheduling
New hours of operation
Aggressive volume expansion (+7.5%)
Aggressive capacity expansion (+11%)
External referral focus
2017
Continued Capacity expansion
Focus on access
500+ additional procedures
Strengthening existing partner relationships
Building new partner relationships
80% by 2018
2018
Overview of growth and capacity
80 by 18 adds value to department, organization and SOC

7. Key Changes in the GI Lab…
2016
Epic implementation
Internalized scheduling
Stable capacity (avg. ~108 appts./week)
Small increase in volume
Increased navigation volume
Epic = simplified internal referral process, better/faster communication and easier, more reliable scheduling
Scheduling = full control of appts. & schedule fill, flexible, patient centered, quality control, experimentation, piloting
Schedulers that are a part of the team, bought in to the mission, work directly with clinical staff, fully vested in completed procedure
Navigation has exploded, started 3 years ago with 200 patients and this last year we navigated 700+ (2015=200, 2016=300, 2017=700+)

8. Key Changes in the GI Lab…
2017
Scheduling fully functional
Patient centered, creative scheduling
New hours of operation
Aggressive volume growth plan (+7.5% YTD over 2016)
Aggressive capacity expansion (+11% YTD over 2016)
External referral focused
Started the year with a brand new scheduling team which has been THE key to success in 2017
We ask every patient when THEY need to have their procedure
We give them options, Flexible days/times
Real time adjustments
Work directly with clinical staff/MDs
Aligned patient schedule with staff schedule, over time these had gotten off track
Planned for +5% volume
Planned for +3% capacity
Revisiting/improving existing partnership, looking for opportunities to improve
Streamlining external referral process
Improving existing relationships
Looking for new opportunities to partner
Open to feedback on current process

9. Navigation in the GI Lab…
DH and CCSP have partnered for more than 10 years
CCSP grant funded patient navigation started 2014
Denver Health’s CCSP funded Patient Navigator has navigated over 1,250 patients to date
Average of 450 GI patients navigated per year
2016 was a BIG year! 700+ patients navigated

10. Navigation in the GI Lab…
Navigation continuity (10 patients diagnosed with CRC)
It’s all about Patient relationships
Clinical relationships are crucial too (MD, RN, navigators, etc.)
Navigating YOUR patient to and through Denver Health

11. Capacity in the GI Lab…
Capacity increase due to scheduling changes and procedural efficiency gains
Aligned MD and RN schedules with patient schedule
Greatest capacity gained from 4th procedure room
Average 119 appointments/week (+11%)
Planned additional 2-4 appointment slots per week
Adding a 4th procedure room allowed us to reduce average procedure time by 6 minutes
We actually gained 11 slots per week, almost triple our target
Looking to add an additional 2-4 (or 11) additional slots in the coming year

12. External referrals to the GI Lab…
YES! The GI Lab does accept external referrals
Colonoscopy, EGD, flex sig, ERCP, EUS
Medicare, Medicaid, commercial, uninsured*
Timely follow-up communication
Detailed report with HD images given to patient at DC
Detailed report with HD images faxed or ed to provider
Scheduling
In-house, responsive, flexible, creative and patient centered
How do you refer to the GI Lab at DH?
*Must be a resident of the City and County of Denver and meet financial criteria
Diogo should cover the insurance piece on this slide

13. Link: Direct Access Referral Form
Accessing services in the GI Lab…
REQUEST FOR ELECTIVE DIRECT ACCESS FLEXIBLE SIGMOIDOSCOPY, COLONOSCOPY, OR UPPER GI ENDOSCOPY
Link: Direct Access Referral Form
Demo, open link and brief discussion of form
Important to complete accurately
Patient and provider contact info crucial
Symptom vs. asyptom
Major reasons for denial other than UNDER AGE = incomplete/illegible form, missing contact info (pt or provider)

14. GI Lab Contacts and Connections…
GI Lab Key Contacts
GI Lab Scheduling
Brian Listy, RN
Manager
Joel Levine, MD
Chief Gastroenterologist
Diogo Barbosa
Care Navigator
Visit
Digestive and Liver Health
For more information

15. Other Denver Health Contacts
Denver Health Contacts and Connections…
Other Denver Health Contacts
Website: DenverHealth.org
Main Hospital:
Enrollment Office:
Enrollment Van:
Community Cancer
Resource Center
For your convenience, Denver Health accepts a variety of insurance plans including:
Medicaid, Medicare and many more

16. Thank you!
Questions?