C. N.O. G.O. — No Output, Get Over It
N.O. G.O.
N — No
O — Output,
G — Get
O — Over It
O — Output,
G — Get
O — Over It
Definition: Patients who have produced zero fecal output and zero documented anal releases of wind shall be enrolled in the N.O. G.O. protocol and shall not be discharged until clinical criteria are met.
N.O. G.O. Interventions — Staged Protocol:
| Stage | Timeframe | Intervention | Staff Responsible |
|---|---|---|---|
| 1 | Hours 0–2 | Warm prune juice (8 oz), served with a smile that conveys "you're not going anywhere" | RN |
| 2 | Hours 2–4 | Ambulation x 4 laps around unit, nurse walking alongside saying "just let it happen, we've all been here" | RN or CNA |
| 3 | Hours 4–6 | One (1) cup of coffee — regular, not decaf — regardless of patient's stated caffeine preference | Dietary + RN |
| 4 | Hours 6–8 | Bisacodyl suppository, administered by a nurse who will say "this is for your benefit, and also ours" | RN |
| 5 | Hours 8–12 | Physician direct conversation: "Your feces have a deadline. I need you to meet it." | Attending or Hospitalist |
| 6 | Hours 12+ | Gastroenterology consult — because now this is a revenue-generating consult AND a fecal event | GI Service |
💰 Billing Note
Each stage of the N.O. G.O. protocol represents a billable intervention. Stages 1–3 are bundled into nursing care. Stages 4–6 are separately billable — the bisacodyl is billable, the physician conversation is billable, and the GI consult is very billable. If a patient's constipation advances to a GI consult, that consult generates an additional $1,200–$2,800 in reimbursable charges. In other words, their reluctance to poop is literally our opportunity to provide excellent specialty care and bill for it appropriately. Everyone wins. Especially our revenue cycle.
Questions regarding this policy may be directed to:
David R. Stoolworthy, M.H.A., M.B.A.
Chief Operating Officer — Saint Rectory Memorial Hospital System
Email: dstoolworthy@saintrectory.org
Phone: Ext. 2800
Phone: Ext. 2800