Efficiency of an endoscopy suite in a teaching hospital: delays, prolonged procedures, and hospital waiting times

BackgroundIncreased demand for screening colonoscopy necessitates improved efficiency in endoscopy units, especially more efficient use of existing resources. The purpose of this study was to assess the efficiency of the endoscopy unit of a large tertiary care teaching hospital.ObjectiveTo assess the efficiency of the endoscopy unit in a large tertiary care teaching hospital.DesignProspective study from May 16 to September 5, 2003.SettingEndoscopy unit of a 650-bed acute care teaching hospital.PatientsInpatient and outpatient procedures.Main Outcome MeasurementsTime elapsed between endoscopic procedures; the duration of the procedures; procedure delays (>15 minutes between procedures) and the reasons for them.ResultsThe research assistant observed 675 endoscopic procedures done for 625 patients (207 inpatients [33%]). The most common procedure was colonoscopy (42.1%), followed by EGD (36.0%). Overall, procedures for 193 (30.9%) of the 625 patients were delayed (>15 minutes between procedures), 70.5% (136/193) because the physician was not available to start the procedure. The time elapsed between procedures was longer than 30 minutes for 47 of the 193 delayed procedures (24.4%). The duration of procedures was prolonged for about 22% (130/593) of procedures.ConclusionsPhysician unavailability contributed to considerable delays in endoscopic procedures. Strategies to reduce procedure delays could have a favorable impact on the volume of procedures performed in the unit, thereby improving the use of existing resources. We encourage other groups to assess the efficiency of their hospital-based endoscopy units.