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    A "time-and-motion" study of endoscopic practice: strategies to enhance efficiency.

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    Authors
    Harewood, Gavin C
    Chrysostomou, Kristia
    Himy, Naila
    Leong, Wai Ling
    Affiliation
    Department of Gastroenterology and Hepatology, Beaumont Hospital, Dublin, Ireland.
    Issue Date
    2008-12
    MeSH
    Endoscopy, Gastrointestinal
    Female
    Humans
    Male
    Middle Aged
    Prospective Studies
    Time and Motion Studies
    
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    Citation
    A "time-and-motion" study of endoscopic practice: strategies to enhance efficiency. 2008, 68 (6):1043-50 Gastrointest. Endosc.
    Journal
    Gastrointestinal endoscopy
    URI
    http://hdl.handle.net/10147/136774
    DOI
    10.1016/j.gie.2008.03.1116
    PubMed ID
    19028212
    Additional Links
    http://www.ncbi.nlm.nih.gov/pubmed/19028212
    Abstract
    With the growing demand on endoscopic resources, achieving optimal efficiency has assumed increasing importance.
    This study adopted a time-and-motion approach to assess efficiency in the endoscopy unit of a large teaching hospital and to identify strategies to enhance efficiency.
    Consecutive endoscopic procedures were prospectively observed over the study period, and time intervals of the individual components of each procedure were recorded.
    Tertiary-referral teaching hospital.
    Consecutive patients undergoing endoscopy.
    Prospective recording of endoscopic data.
    Time intervals of the individual components of each procedure.
    Data were prospectively recorded for 400 procedures: 197 EGDs, 123 colonoscopies, 32 flexible sigmoidoscopies, and 48 double procedures (an EGD and a flexible sigmoidoscopy or colonoscopy). Several strategies to improve the efficiency quotient (EQ), the proportion of time that the endoscopist is engaged in performing the procedure or completing postprocedure paperwork, were identified: (1) employing personnel to obtain prior intravenous access and consent of patients increased the EQ by 10.8%, (2) using a 2-rooms-per-endoscopist model increased the EQ by 51.2%, (3) using personnel to both obtain consent and sedate the patient before an endoscopy increased the EQ by 30.9%, and (4) eliminating postprocedure paperwork for the endoscopist in conjunction with preconsent and sedation and a 2-room model increased the EQ by 63.3%.
    Findings represent the experience of a single endoscopy unit in a tertiary-referral center and may not be generalizable to ambulatory surgical centers or other hospital-based endoscopy units. Factors other than procedure-time components may impact the efficiency of a 2-rooms-per-endoscopist model.
    A time-and-motion approach can be used to identify strategies to enhance endoscopic efficiency. The quality of any aspect of endoscopy performance should never be compromised in an attempt to enhance efficiency.
    Item Type
    Article
    Language
    en
    ISSN
    1097-6779
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.gie.2008.03.1116
    Scopus Count
    Collections
    Beaumont Hospital

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