# Investigation of the actual implementation of “post‐sedation discharge criteria” and “time‐out” immediately before procedure in endoscopy: A nationwide survey study in Japan

## TL;DR

This study surveyed how widely post-sedation discharge criteria and time-out procedures are used in endoscopy across Japan in 2024.

## Contribution

It provides a nationwide snapshot of implementation rates and practices for patient safety measures in endoscopy.

## Key findings

- Post-sedation discharge criteria were implemented in 58% of facilities for endoscopic procedures.
- Time-out procedures were used in 57% of facilities, with common checks including patient identity and medical history.
- The recovery score was the main criterion for discharge in about half of the facilities.

## Abstract

Post‐sedation discharge criteria for outpatient endoscopy and time‐out procedures immediately before endoscopic examinations are important for ensuring patient safety. This study used a web‐based questionnaire to survey the implementation status and current situation of these practices in Japan in 2024.

A self‐administered questionnaire was conducted from December 2023 to January 2024 using Google Forms. Participants were primarily from facilities involved in endoscopy study groups and readers of an endoscopy‐specific e‐newsletter. Additionally, medical staff from endoscopic centers across Japan were invited to participate in collaboration with the Japan Gastroenterological Endoscopy Technicians Society.

A total of 1,495 valid responses (medical staff: 1197 [80%]; doctors: 298) were collected from 1168 facilities, after excluding duplicate responses. Among the participating facilities, 58% were general hospitals, 21% were clinics or health check‐up centers, and 9% were university hospitals or national cancer centers. Post‐sedation discharge criteria were implemented in 58% of facilities for esophagogastroduodenoscopy and 56% for colonoscopy, with the post‐sedation recovery score used as the criterion in about half of these cases. Time‐out procedures were implemented in 57% of the facilities for both esophagogastroduodenoscopy and colonoscopy. Items confirmed during time‐out in more than half of the facilities included: patient's name, details of antithrombotic drugs, content of examination, drug allergies, underlying disease, date of birth, consent form, age, procedure start time, and patient's identification number.

The implementation rate of post‐sedation discharge criteria and time‐out procedures was found to be close to 60%, reflecting the real‐world situation in Japan in 2024.