Improving efficiency in the endoscopy unit

The demand for endoscopic services is increasing rapidly, and this necessitates optimal efficiency in the endoscopy unit. Aim: To assess the efficiency of an endoscopy unit, concentrating in the delay pre- and post-procedure. Patients: Outpatient/day ward procedures. Methods: We examined the delay in endoscopic procedures between 19 and 30 May 2014. The procedure process was examined at three different stages: stage 1 is from when the 'patients arrives to pre-procedure ward' to 'ready for procedure'; stage 2 is from 'where the patient is ready and waiting to be called' to 'when the endoscopy procedure commences'; and stage 3 is from 'when the ward is contacted to collect patient post procedure' to 'when the patient is discharged from the ward'. Results: The pathways for 238 endoscopic procedures were assessed. In total, 249 episodes of delay were documented. Stage 1 accounts for 28% of the delays; there is 1.1-1.6 hours of a delay per patient at this stage. Stage 2 accounts for 53% of the delays; there is a delay of 2.5-2.75 hours per patient at this stage. Stage 3 accounts for 19% of the delays; there is a delay of 1.75 - 2 hours per patient at this stage. Conclusion: Delays were a major factor affecting optimal use of available day ward/endoscopy resources. Significant delay can occur pre- and post-procedure. Strategies to reduce peri-procedural delays could have a favourable impact on day ward capacity and the volume of procedures performed in the endoscopy unit.