Differences in patient outcomes after outpatient GI endoscopy across settings: a statewide matched cohort study

Plan-do-study-act (PDSA) interventions to improve real-world endoscopy unit productivity

“…[6] With more than 20 million procedures performed annually, GI endoscopy represents the highest volume procedure performed in ambulatory care centers in the United States and improved efficiency has the potential to provide substantial benefit. [1,2]. This study demonstrates that the PDSA ramp model is effective at maximizing efficiency and productivity in a resource neutral manner.…”

“…proved efficiency has the potential to provide substantial benefit [1,2]. This study demonstrated that the PDSA ramp model is effective at maximizing efficiency and productivity in a resource neutral manner.…”

“…LAC + USC, Los Angeles County University of Southern California; CRNA, certified registered nurse-anesthetist; PAT, pre-admission testing. 1 Day L, Belson D Gastroenterol Res Pract 2015; 764153. 2 Kaushal, K, Chang K, Lee J et al Gastrointesti Endosc 2014; 79: 637-645.…”

“…In the previous two decades, widespread screening for GI malignancies, an aging population, and reduced endoscopist training set the context for this shortfall. [1][2][3] The post-pandemic shortage of nurses and technicians in the worldwide remains problematic, particularly in safety net (under-served) settings with limited resources available to support operations Operations analysis, including time and flow studies, emerged in the early 20 th century to optimize manufacturing. [5] Despite widespread adoption in anesthesia and surgical settings, these strategies have only recently been introduced to endoscopy units (EU).…”

Outcomes after outpatient endoscopy: Can administrative data tell the whole story?

“…Likewise, for nonscreening colonoscopy, chest pain, abdominal pain, and diverticulosis/diverticulitis accounted for 18.5% of hospital visits, suggesting that hospital visits may have been contaminated by patients presenting for preexisting symptoms. Last, the HOPD patient cohort appeared to have more comorbidities despite matching, which could have resulted in higher rates of hospital visits due to their comorbidities, unrelated illnesses, or other factors such as prior healthcare-seeking behavior (Supplementary Table 12 in Lin et al 2 ). The use of 7-day hospital visit rates has also been questioned because they appear to correlate better with patients' prior hospital visit rates than to the endoscopic procedure.…”