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ACHS Hospital Accreditation PART II Combined Endoscopy Unit

This document outlines the combined endoscopy unit accreditation process at ACHS Hospital, focusing on patient safety, checklist and assessment forms, endoscopic complications, discharge processes, infection control measures, and follow-up procedures.

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ACHS Hospital Accreditation PART II Combined Endoscopy Unit

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  1. ACHSHospital AccreditationPART IICombined Endoscopy Unit Ms Cecilia YEUNG WM, CEU & SUR, CMC 24-6-2010

  2. ACESS TO CEU

  3. Access prioritized • Appointment booking waiting time and case loading • SOPD DATA 2010.xls

  4. Patient safety • Pre-procedure preparation checklist • Pre & intra & post-procedure assessment • Correct patient identification • Informed consent policy • Time out/ sign out policy Checklist and assessment form • Evaluation of endoscopic complication Complication report

  5. Discharge • Discharge advice note • Hotline and pathway of post procedure management • Call back alert • Education for carer on post procedure management

  6. Infection Control • Airflow & Workflow of environment floor plan • Disinfection & sterilization policy and working group • Tracking system : equipment and accessories • Training and audit on reprocessing • 5 S policy

  7. Follow up after ACHS

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