S1245 Scheduled vs Actual Procedure Times in a Tertiary Care Endoscopy Unit

Abstract

INTRODUCTION: As demand for endoscopic procedures increases, it is necessary to evaluate workflows of gastroenterologists to identify opportunities to improve efficiency in endoscopic facilities. This study aims to validate estimated procedure times per our scheduling protocol and compare them with actual procedure times. METHODS: Data was collected from 2496 endoscopy cases from August 1, 2019 to February 12, 2020 at a high-volume tertiary care center endoscopy unit. We quantified differences between scheduled procedure time (SPT) and actual procedure time (APT). Total procedure time (TPT) is the amount of time the schedulers allot for procedures. SPT is the difference between TPT and the time it takes to set up and clean the room. Therefore, SPT is an estimate of how long the procedure alone will take. APT is defined as the time from scope in to scope out, which was determined from our electronic medical record. “On time” procedures are defined as procedures that ended within 5 minutes of the SPT. RESULTS: Of the 2496 cases, 1199 (48.0%) were over the SPT, 705 (28.2%) were under the SPT, and 592 (23.8%) were completed within 5 minutes of the SPT. Inpatient procedures went a mean of 19.8 ± 28.0 minutes over SPT (n = 545). Outpatient procedures went a mean of 6.0 ± 22.4 minutes over SPT (n = 1951). The most frequently performed procedures were EGD (n = 660), colonoscopy (n = 574), and ERCP (n = 349). EGD took a mean of 40.1 minutes (±25.2) and went a mean of 6.5 minutes (±26.1) over the SPT. Colonoscopy took a mean of 44.3 minutes (±16.0) and went a mean of 6.1 minutes (±16.3) over the SPT. ERCP took a mean of 60.9 minutes (±26.2) and went a mean of 18.7 minutes (±26.3) over the SPT. CONCLUSION: The long procedure times for EGD (40.1 minutes) and colonoscopy (44.3 minutes) are likely the result of a higher proportion of therapeutic procedures compared to diagnostic or screening procedures in our endoscopy unit. Approximately half of endoscopic procedures go over their SPT in our endoscopy unit. Inpatient procedures and ERCPs should receive an additional 20 minutes of SPT. EGDs and colonoscopies end a mean of 6 minutes over SPT and do not need to be adjusted as this is within an acceptable range. Our results demonstrate a need to more accurately and reliably schedule endoscopic procedures to maximize efficiency for patients, providers, and the hospital system.Figure 1.: Mean scheduled procedure time versus mean actual procedure time for all inpatient (n = 545) and outpatient (n = 1951) cases.Table 1.: Mean times for our three most common endoscopic procedures (EGD, colonoscopy, ERCP)