LEAN Methodology to Improve Endoscopy Unit Efficiency in a Multi-subspecialty Ambulatory Surgery Center: A Pilot Study.

Abstract

Background and objective Efforts to improve gastrointestinal (GI) endoscopy unit efficiency may lead to increases in colon cancer screening volumes. LEAN management principles applied to GI endoscopy unit practices may serve as a novel foundation for efficiency improvements.We conducted apilot study in an outpatient, hospital-based GI endoscopy unit with the goal of improving endoscopy efficiency by using LEAN principles Methodology A single endoscopist and anesthesiologist along with the nursing care team implemented changes to their practice based on LEAN principles. Efficiency metrics were tracked before these changes and after to assess for improvements. Results We observed statistically significant improvements in waiting room time (13.1 minutes vs. 25.6 minutes, p<0.001), recovery room duration (55.5 minutes vs. 61.8 minutes, p=0.01), total facility time (172.5 minutes vs. 196.1 minutes, p<0.001), and true completion time (19.7 minutes vs. 32.3 minutes, p=0.002) after the implementation of LEAN interventions. Conclusions A systematic and standardized approach using LEAN methodology canimprove GI endoscopy unit operational efficiency. Larger studies are needed to validate our findings and generalize the results to the field broadly.