A “time-and-motion” study of endoscopic practice: strategies to enhance efficiency

Harewood, Gavin C.; Chrysostomou, Kristia; Himy, Naila; Leong, Wai Ling

doi:10.1016/j.gie.2008.03.1116

Cited by 31 publications

(23 citation statements)

References 5 publications

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“…Recent published work from our endoscopy department has used a ''time and motion'' approach to identify several practice changes, which enhance endoscopic efficiency [3]. Three measures have been demonstrated to enhance efficiency:…”

Section: Methodsmentioning

confidence: 99%

“…Recent research from our endoscopy department has used a ''time and motion'' approach to identify several changes which increase practice efficiency [3]. In this study, we reviewed the clinical activity of the endoscopy unit of a major teaching hospital from 2000 to 2007 and applied these practice changes to assess their potential impact on endoscopy waiting times for routine outpatient procedures.…”

Section: Introductionmentioning

confidence: 99%

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Potential impact of enhanced practice efficiency on endoscopy waiting times

et al. 2009

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Maintaining timely access to endoscopic services is becoming more challenging in the face of growing demand. Modifications in routine clinical practice can significantly impact procedure waiting times. In an era where economic aspects of medical care are becoming increasingly important and where there is growing focus on waiting times as a measure of clinical performance, these findings underscore the importance of providing clinical care in the most efficient manner possible.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Potential impact of enhanced practice efficiency on endoscopy waiting times

et al. 2009

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“…It is for this reason that understanding patient's perceptions and factors that affect it are critical; however there is a dearth of research on this important aspect of endoscopy. Existing studies of the pre-procedure process have centered solely on enhancing efficiency by maximizing the number of patients that can be accommodated, improving work flow, and increasing productivity and utilization [7,8,11,12]. Implementation of these data may help maximize endoscopic efficiency, but this may not necessarily improve patient experience, and actually has the potential to harm it.…”

Section: Discussionmentioning

confidence: 99%

Patient preferences and factors related to the pre-procedure process at a large, urban county hospital

Day¹,

Nazareth²,

Sewell³

2013

OJGas

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Background: Evaluation of the pre-procedural process prior to endoscopic procedures has never been conducted. Methods: Prospective cross-sectional, multilanguage survey was administered to outpatients undergoing endoscopy at a large, diverse county hospital that examined patients' pre-procedural preferences. Multivariate logistic regression was used to assess the relationship between patient preferences and several patient-related variables. Results: 128/156 outpatients completed the survey. The majority of respondents were female (53.1%), did not speak English (61.7%), were of Asian (39.1%) or Hispanic (29.7%) racial background, and had a mean age of 56.1 ± 15.7 years. Most patients underwent colonoscopy (48.4%) with 90.6% of patients knowing the indication for their procedure. While waiting for their endoscopic procedure, 42.2% of patients preferred waiting in a gurney while 28.1% preferred to wait in a chair. In terms of being comfortable wearing a hospital gown and sitting in a chair or gurney in the pre-procedure area, mean patient anxiety scores were 5.2 ± 3.3 and 6.1 ± 3.2, respectively (scale of 1 -10). Race was associated with several pre-procedural patient preferences; Hispanics were less comfortable than Asians wearing a hospital gown while sitting in a chair with other patients prior to their procedure (OR = 0.3, CI 0.1 -1.0) while Whites and African-Americans were less likely than Asians to prefer sitting in a chair as compared to a gurney before their procedure (OR = 0.09, CI 0.008 -0.9 and OR = 0.07, CI 0.007 -0.8, respectively). Patients who had undergone a prior endoscopic procedure were less comfortable wearing a hospital gown and sitting in a chair (OR = 0.3, CI 0.1 -0.7) or gurney (OR = 0.4, CI 0.2 -1.0) in the pre-procedure area. Conclusion: A patient's race and having had a prior endoscopic procedure were the most powerful predictors on pre-procedure patient preferences while sex, type of endoscopic procedure and patient knowledge of the indication for their procedure were not. Our study highlights the importance of patient preferences and factors involved in the pre procedure process at a large, diverse county hospital.

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“…In the context of endoscopy, we have previously demonstrated that efficiency of practice can be improved by employing personnel to obtain prior intravenous access and consent of patients prior to the procedure and implementing a 2-suite-per-endoscopist model [12], such practice significantly changes the shortening procedure waiting times [13]. Similarly, Zamir and Rex [14] demonstrated room turnover time to be a key determinant of procedure efficiency.…”

Section: Discussionmentioning

confidence: 99%