Both patient and procedural factors should be considered in determining staffing
requirements. Patient factors that affect staffing requirements include the level of sedation
that is planned (i.e., whether the patient is receiving no sedation, moderate sedation or deep
sedation) and the medical condition of the patient, which is determined from the history and
physical exam and is reflected in the American Society of Anesthesiology (ASA)
classification of the patient. Procedural factors include the anticipated length of the
procedure and whether the procedure is intended to be diagnostic or if a therapeutic
intervention is planned. Complex interventional procedures, such as endoscopic ultrasound
(EUS) and ERCP may require additional staff for efficiency, but there is no evidence to
suggest that this improves safety or patient outcomes.