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

Abstract

ABSTRACT: Introduction: The Plan-Do-Study Act (PDSA) ramp is a framework that uses initial small changes to build consensus and momentum for subsequent, iterative process improvement. Our aim was to study its impact on endoscopy unit efficiency and throughput. Methods: Following a granular time-and-motion analysis to evaluate baseline performance (phase 1) we instituted successive interventions and measured their impact on core efficiency metrics including procedure volume and turnover time (phases 2-3). Results: We identified that inefficiency in turnover of anesthesia-supported endoscopy was the most crucial issue. Implementation of pre-procedure anesthesia visit in phase 2 reduced turnover time by 15.5 (95% CI 3.9-27.1 minutes). Subsequent changes (phase 3) including front-loaded procedure scheduling and parallel in-room preparation resulted in an 18% increase in procedure volume. Conclusion: The PDSA ramp model is an effective means of assessing operational processes, developing novel interventions, and building consensus to improve the real-world productivity in a resource-conscious manner. MESH TERMS: Time and Motion Studies; Endoscopy, Gastrointestinal; Workflow; Efficiency, Organizational; Operative Time; Recovery Room; Cost savings; Hospital Units; Patient Care Team; Benchmarking; COVID-19