Endoscopy Unit Efficiency: Quality Redefined

Gellad, Ziad F.; Thompson, Cole P.; Taheri, Javad

doi:10.1016/j.cgh.2013.06.005

Cited by 30 publications

(25 citation statements)

References 9 publications

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“…To evaluate the impact of sedation policy on endoscopy unit efficiency, we based our efficiency measures on our prior work outlining a conceptual framework for endoscopy unit efficiency. 16 Our primary outcome was the total procedure time, which is the time interval from the administration of sedation to the completion of the colonoscopy. We chose this interval as primary because it defines the time the physician is involved in the case.…”

Section: Endoscopy Unit Efficiency Measuresmentioning

confidence: 99%

Bolus Administration of Fentanyl and Midazolam for Colonoscopy Increases Endoscopy Unit Efficiency and Safety Compared With Titrated Sedation

Finn

Boyd

Lin

et al. 2017

Clinical Gastroenterology and Hepatology

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Section: Endoscopy Unit Efficiency Measuresmentioning

confidence: 99%

Bolus Administration of Fentanyl and Midazolam for Colonoscopy Increases Endoscopy Unit Efficiency and Safety Compared With Titrated Sedation

Finn

Boyd

Lin

et al. 2017

Clinical Gastroenterology and Hepatology

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“…Indeed, there is a current lack of data on the performance of interventional units, which highlights the ongoing need to collect operational data to develop metrics that can be used to identify areas for improvement. Ideally, it would be desirable to establish processes , intermediate indicators that capture how well a system performs, and use these to identify aspects of an EU that must receive attention in order to improve outcome measures such as throughput level 12 . The aim of this study was to: (1) analyze operations performance data; and (2) define metrics that can be used as benchmarks to improve efficiency in a single academic interventional endoscopy center.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of interventional endoscopy unit efficiency metrics at a tertiary academic medical center

Yang¹,

Summerlee²,

Suarez

et al. 2015

Endosc Int Open

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Background and study aims: There is an increasing demand for interventional endoscopic services and the need to develop efficient endoscopic units. The aim of this study was to analyze performance data and define metrics to improve efficiency in a single academic interventional endoscopy center. ]Patients and methods: The prospective operations performance data (6-month period) of our interventional endoscopy unit (EU) was analyzed. First-case start time (FIRST) delay was defined as any time the first patient of the day entered the endoscopy room after the scheduled time. Non-endoscopy time (NET) and total time (TT) were defined as non-procedural and total time elapsed in the EU, respectively. Time-interval between successive patients (TISP) was defined as the time from one patient departure from the room until the time of arrival of the next patient in the room. Results: A total of 1421 patients underwent 1635 endoscopic procedures. FIRST was delayed (54.2 % cases) by 13.6 min (range 1 – 53), but started within 15 min of the scheduled time in 85 % of the cases. NET accounted for 9.1 hours (67.2 %) of 13.5 hours TT/day. TISP (37.1 min, range 5 – 125) comprised 54.2 % of the NET, and was delayed (> 30 min) in 49.8 % of cases. “Patient flow” processes (registration, admission, transportation, scheduling) accounted for 50.1 % of TISP delays. Conclusions: Delays in NET, specifically TISP, rather than FIRST, were identified as a cause for decreased efficiency. “Patient flow” processes were the main reasons for delays in TISP. This study identifies potential process measures that can be used as benchmarks to improve efficiency in the EU.

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“…Regardless, DES can be used to identify areas of inefficiency and model changes to the current “status quo” to improve the way care is delivered. As healthcare changes, an increased focus on value is necessary which encompasses both the quality of the care we provide but also the efficiency in which it is done 18.…”

Section: Discussionmentioning

confidence: 99%

Efficiency of endoscopy units can be improved with use of discrete event simulation modeling

et al. 2016

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Background and study aims: The projected increased demand for health services obligates healthcare organizations to operate efficiently. Discrete event simulation (DES) is a modeling method that allows for optimization of systems through virtual testing of different configurations before implementation. The objective of this study was to identify strategies to improve the daily efficiencies of an endoscopy center with the use of DES. Methods: We built a DES model of a five procedure room endoscopy unit at a tertiary-care university medical center. After validating the baseline model, we tested alternate configurations to run the endoscopy suite and evaluated outcomes associated with each change. The main outcome measures included adequate number of preparation and recovery rooms, blocked inflow, delay times, blocked outflows, and patient cycle time. Results: Based on a sensitivity analysis, the adequate number of preparation rooms is eight and recovery rooms is nine for a five procedure room unit (total 3.4 preparation and recovery rooms per procedure room). Simple changes to procedure scheduling and patient arrival times led to a modest improvement in efficiency. Increasing the preparation/recovery rooms based on the sensitivity analysis led to significant improvements in efficiency. Conclusions: By applying tools such as DES, we can model changes in an environment with complex interactions and find ways to improve the medical care we provide. DES is applicable to any endoscopy unit and would be particularly valuable to those who are trying to improve on the efficiency of care and patient experience.

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Endoscopy Unit Efficiency: Quality Redefined

Cited by 30 publications

References 9 publications

Bolus Administration of Fentanyl and Midazolam for Colonoscopy Increases Endoscopy Unit Efficiency and Safety Compared With Titrated Sedation

Bolus Administration of Fentanyl and Midazolam for Colonoscopy Increases Endoscopy Unit Efficiency and Safety Compared With Titrated Sedation

Evaluation of interventional endoscopy unit efficiency metrics at a tertiary academic medical center

Efficiency of endoscopy units can be improved with use of discrete event simulation modeling

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