The endoscopy department at Bridgewater Ambulatory Surgery Center, Bridgewater, New Jersey, operates within a multispecialty free-standing ambulatory surgery center, which is a joint venture between Hunterdon and Atlantic Health Systems. The team prides itself on its diverse and skilled professionals, ensuring top-notch care for patients.
The department performs approximately 2,000 procedures a year via one dedicated endoscopy room, and there are plans to expand by adding another endoscopy room.
“We are well-equipped with three bays each for endoscopy pre-procedure and recovery, ensuring efficient patient flow and care,” explained Jeanette Cowen, MSN, RN, CNOR.
The department primarily focuses on diagnostic procedures, including esophagogastroduodenoscopies (EGDs) and colonoscopies— crucial for diagnosing and managing various gastrointestinal conditions.
Dr. Sandeep Bhargava, gastroenterologist, said, “I like to bring my patients to this center because it is a state-of-the-art facility that provides hospital level care in an outpatient setting. My patients like the quicker throughput of an ambulatory center. The nurses are hospital trained, and that gives a high level of skill that you don’t see in many outpatient facilities. The anesthesia team is also great.”
The team comprises registered nurses (RNs), surgical technicians, sterile processing technicians, gastroenterologists and anesthesiologists. Three RNs are dedicated specifically for endoscopy: Joanne Colangelo, Cathleene Francis (CGRN), and Lorraine Casterline. The operating room RNs (Leona Kardux, Geraldine Martino, Candace Routel, Arielle Doering, and Jeanette Cowen) and surgical technicians (Shondra McGill and Tiffany Duperrier) are cross-trained and proficient in endoscopy procedures.
Joanne Colangelo, BSN, RN, said, “What I love about the endo team is the synergy we have. Lorraine, Cathy, and I trained together and have been working together for many years. We don’t even need to talk; we know what the others need, and we just do [it]. This is the best team right now that we have had since the center opened in 2018.”
An essential part of any department’s efficiency and infection prevention are the scope processing technicians, and Bridgewater is no different, employing techs Chris Lee, Aliyah Amponsah, and Erika Alvarado to keep scopes safe and patient-ready. Lee said, “This job is not ‘work’ for me. I truly enjoy what I do. I had a terrible experience of having a postop infection many years ago, and my goal is to never let an infection happen to any patient. I know I probably create extra work for myself, but I double and triple check processes to make sure that every scope is free from contamination.”
Anesthesiologists from Hunterdon Health play a crucial role in providing moderate sedation for patients. “The pre-procedure and post-procedure RNs—Vanessa Conyers, Ashley Ridgeway, Caroline Zajac, Daria VanDoren, and Bridget Zinenko—are recognized for their exceptional skill and bedside manner. Their expertise is highly valued by both our patients and physicians, who appreciate the center’s efficiency and patient care standards,” Cowen said.
Daria Van Doren, BSN, RN, CCRN, pre- and post-procedure RN, said, “Patients say they were so nervous before the procedure, but everyone made them feel relaxed, so it ended up being a positive experience.”
The admitting team includes Tracey Timmons, Diana Kasper, Kriya Patel and Janette Arama. Diana Kasper, CST, scheduling/ billing/registration representative, said she enjoys interacting with patients. “They are always so pleasant during the check-in process, in spite of the fact that many have been through the GI prep process.”
The leadership team includes Paula Zuckerman, the executive director; Imily Gonzales, the director of nursing; Dr. Brian Sperling, the medical director; and Dr. Michael Lapicki, the anesthesia director. “Together,” Cowen said, “they guide our center toward excellence, making it a preferred facility for both our gastroenterologists and patients.”
The backbone of the team’s excellence is its years of clinical experience. “Seasoned members with extensive endoscopy experience are always eager to share their knowledge and insights with newer colleagues, fostering a culture of continuous learning and improvement,” Cowen said. “We stay at the forefront of advancements in our field by keeping up with the latest equipment and techniques. Belonging to professional organizations, attending conferences, and staying updated through journals such as EndoPro Magazine and the journal of the Society of Gastroenterology Nurses and Associates, contributes significantly to our expertise.
“Teamwork is essential, and we believe in pitching in to help one another with any task that ensures the day runs smoothly,” Cowen added. “Accurate record-keeping and high patient satisfaction are vital benchmarks of our success, so we diligently monitor these goals. Effective communication is at the heart of our operations. In the procedure room, team members promptly alert others to any malfunctions, and we collaboratively troubleshoot and resolve issues. When patient concerns arise, each team member knows their role and works cohesively to ensure the best possible outcomes for our patients. Continuously monitoring and maintaining the highest standards of patient safety and infection control is paramount. This requires ongoing training, vigilance, and adherence to best practices to prevent any lapses that could affect patient outcomes.”
The team bonds through monthly and as-needed staff meetings, where team members are encouraged to openly discuss concerns. “This practice not only keeps everyone on the same page, but also strengthens our unity,” Cowen said. Colleagues get to know each other in the staff lounge, where folks unwind, share stories and stay updated on each other’s lives. The team also enjoys lunches together.
Challenges are a part of any endo team’s workday, and Bridgewater is not exempt. Cowen said the team has faced staffing shortages. But, she said, the regular staff “rose to the occasion, rearranging their schedules or working extra hours to ensure continuity of care. In addition, we are fortunate to have access to a pool of excellent agency staff who assist us on a day-to-day basis, ensuring that patient care remains unaffected.”
Shondra McGill, CST, CASSPT, CSPM, AST fellow, stated, “I like the pace of the endoscopy cases. I also like being involved in promoting the health and well-being of patients. We work as a team in endoscopy, and everyone feels appreciated for the work they do.”
Other challenges endoscopy teams experience include regulatory compliance, patient volume and scheduling, technology and equipment maintenance, insurance and reimbursement, and patient safety and infection control. Cathy Francis, RN, CGRN, said, “We have put processes in place to go above and beyond what was required, long before they became a standard of practice.” The team’s safeguards and best practices include:
- Effective “Clear and open communication is the cornerstone of our success. By ensuring that all team members are informed and engaged, we can efficiently address any issues and work collaboratively towards common goals.”
- Adherence to guidelines and best practices. “Following established guidelines and recommended practices ensures consistency and high standards of care. Our team rigorously adheres to these protocols to maintain the highest level of patient safety and service quality.”
- Shared goals and teamwork. “We believe that working together with shared goals is crucial for Every team member understands their role and how their efforts contribute to the overall objectives. This collective approach ensures that we all work for each other and, most importantly, for the patient.”
- Philosophy of patient-centered “Our philosophy revolves around centering our efforts on the patient through teamwork. We take the concept of patient-centered care and extend it to encompass the entire team, renaming it to be ‘Teamwork: Centering on the Patient.’ This approach ensures that every decision and action is made with the patient’s best interest in mind.”
By integrating these principles into its daily operations, the team creates a supportive, efficient, and high-performing environment that benefits team members and patients.
Cowen summed up the team, saying, “Despite challenges, our team remains committed to delivering the highest quality of care. By leveraging our collective experience, maintaining open lines of communication, and fostering a supportive work environment, we continue to overcome obstacles and provide exceptional service to our patients.”
