Response

Abstract

The correspondence from Boix et al provides helpful insight into the aspects of endoscopic procedures that influence overall practice efficiency. Their findings underscore the major role that room turnover time plays in procedure efficiency. By using 2 rooms per endoscopist, they found that procedure numbers per endoscopist increased from 5676 to 6569 over 3 years. These results corroborate the findings from our recent study that further illustrate the role of using 2 rooms per endoscopist to increase efficiency.1Harewood G.C. Chrysostomou K. Himy N. et al.A “time and motion” study of endoscopic practice: strategies to enhance efficiency.Gastrointest Endosc. 2008; 68: 1043-1050Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar In The Toyota Way: 14 Management Principles from the World's Greatest Manufacturer,2Liker J.K. The Toyota way: 14 management principles from the world's greatest manufacturer. McGraw-Hill, New York2003Google Scholar Jeffrey Liker espouses the merits of defining processes in terms of “value added” and “nonvalue added” activities and eliminating waste through minimizing the nonvalue-added components. In the context of endoscopy, we hesitate to use the term nonvalue-added activity when describing ancillary procedural activities, such as intravenous cannula insertion and administering preprocedure sedation because these are essential and valuable components of the procedure. However, recognizing that it is not always necessary for an endoscopist to perform these activities, a 2-rooms-per-endoscopist model does allow endoscopist activity to be refined to maximize the proportion of time that he or she spends actually performing the procedure, thereby enhancing efficiency. The correspondence from Boix et al provides helpful insight into the aspects of endoscopic procedures that influence overall practice efficiency. Their findings underscore the major role that room turnover time plays in procedure efficiency. By using 2 rooms per endoscopist, they found that procedure numbers per endoscopist increased from 5676 to 6569 over 3 years. These results corroborate the findings from our recent study that further illustrate the role of using 2 rooms per endoscopist to increase efficiency.1Harewood G.C. Chrysostomou K. Himy N. et al.A “time and motion” study of endoscopic practice: strategies to enhance efficiency.Gastrointest Endosc. 2008; 68: 1043-1050Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar In The Toyota Way: 14 Management Principles from the World's Greatest Manufacturer,2Liker J.K. The Toyota way: 14 management principles from the world's greatest manufacturer. McGraw-Hill, New York2003Google Scholar Jeffrey Liker espouses the merits of defining processes in terms of “value added” and “nonvalue added” activities and eliminating waste through minimizing the nonvalue-added components. In the context of endoscopy, we hesitate to use the term nonvalue-added activity when describing ancillary procedural activities, such as intravenous cannula insertion and administering preprocedure sedation because these are essential and valuable components of the procedure. However, recognizing that it is not always necessary for an endoscopist to perform these activities, a 2-rooms-per-endoscopist model does allow endoscopist activity to be refined to maximize the proportion of time that he or she spends actually performing the procedure, thereby enhancing efficiency. A 2-rooms-per-endoscopist model enhances efficiency in GI endoscopyGastrointestinal EndoscopyVol. 70Issue 5PreviewTo the Editor: Full-Text PDF