Introducing Manufacturing Efficiency Tools to the Endoscopy Suite: How the Toyota Model Helps Drive Endoscopes

Abstract

Background: Processes in medicine evolve slowly. The manufacturing industry has for many years employed a variety of tools to assess and enhance efficiency. Adaptation of manufacturing tools to the endoscopy suite may improve efficiency. Methods: The rapid processes improvement workshop (RPIW) is a manufacturing industry tool designed to break down production processes into individual parts in order to identify and correct inefficiencies in motion and material use. We applied this technique to routine outpatient procedures performed in our endoscopy unit in an effort to decrease patient waiting times and improve patient flow. Two week-long workshops examined patient travel patterns, nurse and patient walking distances, resource allocation and equipment standardization. Patient travel times, patient cycle times, nurse walking distances, and number of procedures performed per room per day were measured before and after RPIW recommendations were implemented. No new technologies were incorporated during the study interval and the physician portion of the procedures was not changed. Follow-up measurements were made at 60 days to determine if gains were maintained. Results: See Table 1. Incorporation of RPIW recommendations reduced patient waiting and admission times, patient stays, room turn-over times and nursing travel times to the degree that two additional procedures could be added to each room per day. Improvements were largely sustained at 60 days. Conclusion: Industry productivity tools can help improve efficiencies, reduce patient waiting times and potentially increase endoscopy revenue.