title: A survey of the practice of after-hours and emergency endoscopy in Canada.
abstract: OBJECTIVE
  To determine staffing and practice patterns for after-hours endoscopy service in Canada.
  
  
  METHODS
  A link to a web-based survey was sent by e-mail to all clinical members of the Canadian Association of Gastroenterology in February 2011. A priori, it was planned to compare variations in practice among gastroenterologists (GIs) performing endoscopy in different regions of Canada, between pediatric and adult GIs, and between university and community hospitals.
  
  
  RESULTS
  Of 422 potential respondents, 168 (40%) responded. Of the 139 adult GIs, 61% performed after-hours endoscopy in the endoscopy suite where daytime procedures were performed, 62% had a trained endoscopy nurse available for all procedures, 38% had access to propofol sedation, 12% reprocessed the endoscopes themselves or with the help of a resident, 4% had out-of-hospital patients come directly to their endoscopy suite and 53% were highly satisfied. The adult endoscopists practising at community hospitals were more likely to have an anesthetist attend the procedure. Regional differences were noted, with more involvement of anesthetists (13%) and availability of propofol (50%) in Ontario, more frequent reprocessing of endoscopes in the central reprocessing units in British Columbia (78%) and almost universal availability of a trained endoscopy nurse (96%) with concomitant higher endoscopist satisfaction (84% highly satisfied) in Alberta.
  
  
  CONCLUSIONS
  More than one-third of surveyed endoscopists across the country do not have a trained endoscopy nurse to assist in after-hours endoscopy - the time period when urgent patients often present and typically require therapeutic endoscopic interventions. There are significant regional differences in the practice of after-hours endoscopy in Canada.
authors.affiliation: Internal Medicine, University of Manitoba, Winnipeg, Manitoba, British Columbia.
authors.forename: Karuppan Chetty
authors.initials: KC
authors.lastname: Muthiah
authors.forename: Robert
authors.initials: R
authors.lastname: Enns
authors.forename: David
authors.initials: D
authors.lastname: Armstrong
authors.forename: Angela
authors.initials: A
authors.lastname: Noble
authors.forename: James
authors.initials: J
authors.lastname: Gray
authors.forename: Paul
authors.initials: P
authors.lastname: Sinclair
authors.forename: Palma
authors.initials: P
authors.lastname: Colacino
authors.forename: Harminder
authors.initials: H
authors.lastname: Singh
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000458:organization & administration*; D002170:Canada; D002648:Child; D004632:Emergency Medical Services; D016099:Endoscopy, Gastrointestinal / Q000451:nursing / Q000592:standards; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006764:Hospitals, Community; D006785:Hospitals, University; D006801:Humans; D010561:Personnel Staffing and Scheduling