Western Health Endoscopic Services provides a comprehensive range of diagnostic and therapeutic endoscopy procedures for inpatients and outpatients.
Western Health has developed a pathway to assist GPs to refer patients who meet the criteria for an urgent (Category 1 - i.e. within one month) Gastrointestinal Endoscopy. This pathway was previously known as the RAGE (Rapid Access to GI Endoscopy) Pathway, but has been modified to be consistent with the new gastroscopy and colonoscopy categorisation guidelines.
Two Pathways have been developed.
DAGE pathway for patients with overt gastrointestinal bleeding
DAGE pathway for patients without gastrointestinal bleeding
A Symptom Guide has also been developed to complement the pathways. This outlines the most important signs or symptoms associated with colorectal cancer and oesophageal or gastric cancer. DAGE symptom guide.
When referral for DAGE is made, it is important that the referring doctor provides the patient with the opportunity to discuss reasons for colonoscopy, its benefits, risks and alternative options before deciding to proceed. After discussion with the referring doctor if the patient has further questions that have not been answered the patient should contact the Endoscopy Liaison Nurse (ELN) on 8346-6015 to seek further advice. If after speaking with the Western Health Endoscopy Liaison Nurse the patient is still not satisfied with information provided, the patient cannot proceed via the DAGE pathway. The patient will be referred to attend Gastroenterology clinic or Standard Endoscopy clinic for consultation to discuss suitability for the procedure and address patient concerns.
Please note this may introduce a significant wait time due to high demand for outpatient clinic appointments. Please see below links from the Gastroenterological Society Australia regarding patient education materials around Colonoscopy, Gastroscopy, and Bowel Preparation:Colonoscopy: https://www.gesa.org.au/resources/patients/colonoscopy/
Bowel preparation: http://cart.gesa.org.au/membes/files/Consumer%20Information/Bowel%20prep.pdf
Please provide these pamphlets to your patients at the time of making a DAGE referral.
The D.A.G.E form is available in versions that can be uploaded into practice software
PDF VersionCOR 179b Gastrointestinal Endoscopy Referral form (2 page).pdf
WH Endoscopy GP Referral Form Dec18- MD.rtf *IMPORTANT DO NOT OPEN UNTIL READING INSTRUCTIONS BELOW*
Medical Director Import Instructions1. DO NOT OPEN IN WORD2. Right click on the link and then select Save As… (Or Save Target As…) and then save the file to a location from where you can later retrieve it i.e. desktop or My documents. 3. Open Medical Director and then LetterWriter4. File menu > Select modify template > Select blank template5. File > Select import - locate downloaded file
Best Practice WH Endoscopy GP Referral Form Dec18 - BP.rtf *IMPORTANT DO NOT OPEN UNTIL READING INSTRUCTIONS BELOW*
Best Practice Import Instructions1. DO NOT OPEN IN WORD2. Right click on the link and then select Save As… (Or Save Target As…) and then save the file to a location from where you can later retrieve it i.e. desktop or My documents. Open a new letter and from templates menu select Import templates3. Locate downloaded file and open4. From File menu select Save as. Type in an appropriate template name and click on save
ZedMedZedmed Import Instructions
ZedMed RTF *IMPORTANT DO NOT OPEN UNTIL READING INSTRUCTIONS BELOW*
1. DO NOT OPEN IN WORD2. Right click on the link and then select Save As… (Or Save Target As…) and then save the file to a location from where you can later retrieve it i.e. desktop or My documents. 3. Click on Tools > Clinical WP Setup > WP Templates4. File > Import Template5. Find the file where you saved it and highlight it and then click Open6. Enter the template name into the Description field. Click on OK
The colonoscopy guidelines make use of the NHMRC colonoscopy surverillance guidelines.For the purposes of colonoscopy referrals, the Victorian DHHS has summarised these guidelines as follows:
Clinical Practice Guidelines for Surveillance Colonoscopy. This guideline should be used in conjunction with the endoscopy referral form when requesting colonoscopies for surveillance of colorectal cancer or colorectal polyps.
After completing the endoscopy referral form, please also attach the relevant supporting documents such as blood tests, radiology imaging results, previous endoscopy and histology reports. This information is critical to enabling us to triage the referral correctly. Without the necessary supporting information as requested on the referral form, it is likely that the referral will be rejected with a request for more information.
The endoscopy referral form and supporting documents should be faxed to the WH Endoscopic Services Booking office on fax number (03) 8345-7378.
Urgent referrals for bronchoscopy or EBUS should be referred to the on call Respiratory Registrar by phoning the Western Health switchboard on 8345 6666 and asking the staff to page the Respiratory Registrar.
Urgent referrals for advanced GI endoscopy procedures such as ERCP, EUS, EMR, complex polypectomy or luminal stenting, especially for patients who are currently inpatients at WH or at other hospitals, should be made to the Gastroenterology Advanced Endoscopy Fellow by phoning the Western Health switchboard on 8345 6666 and asking the staff to page the Endoscopy Fellow.
An important message to referring doctors: The time to procedures is affected by the referral demand we experience for procedures. At times, the volume of referrals is very high, and can result in delays to procedures.
Please note: If you are concerned about the delay for your patient, of if there is a deterioration in the patient's condition that may alter their triage category, please contact the Endoscopy Liaison nurse. You may then be requested to forward us this additional information for potential re-triaging.
Endoscopic Services are provided at Western Hospital Footscray and Sunshine Hospital, Monday to Friday and Sunbury Day Hospital on Tuesday and Thursday.
Please be advised that the Endoscopy lists at Footscray and Sunshine Hospitals are reserved for interventional endoscopy or complex cases that need to be performed in a tertiary hospital environment or for patients whose anaesthetic risk is considered too great for the Sunbury Day Hospital environment for example those with a high BMI or severe cardiac or respiratory comorbidities.
Due to the demand we are experiencing for high acuity procedures and/or from high acuity patients, we are unfortunately unable to accommodate any other requests for procedures to be performed at either Footscray or Sunshine Hospitals for convenience if the patient is able to have their procedure at our Sunbury Day Hospital, which is also a part of Western Health.
Western Health Endoscopic Services is a training and teaching centre for basic and advanced procedures. We train gastroenterology and surgical registrars, an interventional endoscopy fellow, respiratory registrars and a nurse colonoscopist. Patients may have their procedure performed by a trainee or registrar, under the supervision of a qualified specialist.
The Department of Gastroenterology maintains an on-call roster for emergency endoscopic procedures 24 hours per day, 7 days per week, 365 days per year.
Endoscopy Bookings Office
Phone: 8345 6015 or 8345 6955Fax: 8345 7378Email: [email protected]
Endoscopy Registrar - page via switch 8345 6666
For more detailed information, please visit our Endoscopic Services pages: http://www.westernhealth.org.au/Services/Endoscopy/Pages/default.aspx