Using efficiency analysis and targeted intervention to improve operational performance and achieve cost savings in the endoscopy center - 15/03/14
Abstract |
Background |
With an increasing demand for endoscopy services, there is a greater need for efficiency within the endoscopy center. A validated methodology is important for evaluating efficiency in the endoscopy unit.
Objective |
To use the principles of operations management to establish a validated methodology for evaluating and enhancing operational performance in the endoscopy center.
Design |
Biphasic prospective study with pre-intervention and post-intervention efficiency data and analysis.
Setting |
Tertiary-care referral teaching hospital.
Patients |
Scheduled outpatients undergoing endoscopy.
Intervention |
Determination of the rate-limiting step, or bottleneck, of the endoscopy unit and reducing inefficiencies.
Main Outcome Measurements |
Staffing costs and a novel performance metric, True Completion Time (TCT).
Results |
Data were prospectively recorded for 2248 patients undergoing a total of 2713 procedures (phase I: 255 EGD, 305 colonoscopy, 91 EGD/colonoscopy, 375 EUS, 44 ERCP, 75 EUS/ERCP; phase II: 243 EGD, 328 colonoscopy, 99 EGD/colonoscopy, 335 EUS, 38 ERCP, 109 EUS/ERCP). The bottleneck of the operation was identified as the 10-bed communal pre-procedure/recovery room. On-time procedure starts increased by 51% (P < .001), and TCT was reduced by 12.2% (P < .001) across all cases studied. Overtime and per diem nursing costs were reduced by 30%, whereas full-time employee staff was reduced by 0.85. Annual cost savings were calculated as $312,618 or 11.02% of total operating expenses.
Limitations |
This study is not directly tied to quality outcomes, and inpatient procedures transported to the endoscopy unit were not directly studied.
Conclusion |
Room turnover time and room-to-endoscopist ratio are not necessarily the driving parameters behind endoscopy unit efficiency. A focus on developing a methodology for identifying factors constraining operational efficiency can improve performance and reduce costs in the endoscopy center.
Le texte complet de cet article est disponible en PDF.Abbreviations : CDDC, MAC/GA, TCT
Plan
| If you would like to chat with an author of this article, you may contact Dr Kaushal at nkaushal@uci.edu. |
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| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
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| See CME section: p. 663. |
Vol 79 - N° 4
P. 637-645 - avril 2014 Retour au numéro
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