Evaluation of interventional endoscopy unit efficiency metrics at a tertiary academic medical center

Background and study aims: There is an increasing demand for interventional endoscopic services and the need to develop efficient endoscopic units. The aim of this study was to analyze performance data and define metrics to improve efficiency in a single academic interventional endoscopy center.] Patients and methods: The prospective operations performance data (6-month period) of our interventional endoscopy unit (EU) was analyzed. First-case start time (FIRST) delay was defined as any time the first patient of the day entered the endoscopy room after the scheduled time. Non-endoscopy time (NET) and total time (TT) were defined as non-procedural and total time elapsed in the EU, respectively. Time-interval between successive patients (TISP) was defined as the time from one patient departure from the room until the time of arrival of the next patient in the room. Results: A total of 1421 patients underwent 1635 endoscopic procedures. FIRST was delayed (54.2% cases) by 13.6min (range 1-53), but started within 15min of the scheduled time in 85% of the cases. NET accounted for 9.1 hours (67.2 %) of 13.5 hours TT/day. TISP (37.1min, range 5-125) comprised 54.2% of the NET, and was delayed (> 30min) in 49.8% of cases. "Patient flow" processes (registration, admission, transportation, scheduling) accounted for 50.1% of TISP delays. Conclusions: Delays in NET, specifically TISP, rather than FIRST, were identified as a cause for decreased efficiency. "Patient flow" processes were the main reasons for delays in TISP. This study identifies potential process measures that can be used as benchmarks to improve efficiency in the EU.