Neal K. Kaushal, MD, MBA from the Irvine Medical Center at the University of California in Los Angeles reports on his Original Article “Using efficiency analysis and targeted intervention to improve operational performance and achieve cost savings in the endoscopy center.”

In recent years, the demand for endoscopic services has increased dramatically. This is due to many different factors, from increased awareness among the public about colon cancer screening to new developments in therapeutic endoscopy techniques. Along with this change, however, a new reality has presented itself. The cost of healthcare is increasing, and one of the most rapid areas of growth has been in operational and facility cost in order to deliver essential services.

The endoscopy unit is one of the highest areas of healthcare cost within the field of Gastroenterology. As such, it is important to not only deliver quality patient care, but to do so in an efficient and cost-effective manner. Management of the endoscopy unit is important in achieving overhead cost savings.

Dr. Kaushal discusses his article in this video interview.

In this work, we aimed to devise a generalizable methodology and a validated performance metric by which endoscopy units can determine their own process flow, find areas of resource constraint, and improve efficiency in order to achieve cost savings. We studied 2248 patients undergoing a total of 2713 procedures in our center. Using our unique methodology and performance metric – True Completion Time (TCT) – we identified the bottleneck of our process flow as the 10-bed sector of the unit which serves as the communal pre-procedure and recovery area. By implementing key interventions to operational protocols, we were able to achieve a reduction of 12.2% in TCT across all cases studied, savings of overtime and per diem nursing costs totaling 30%, and annual cost savings of $312,618 or 11% of total operating expenses.

Several groups have previously studied efficiency in the endoscopy unit. One of the established principles as a result of these studies is that room turnover time and room-to-endoscopist ratio are the main drivers of efficiency in the endoscopy unit. However, our study serves as the first study to show that these factors are not necessarily the determinants of endoscopic efficiency. Rather, we show that each center has its own unique resource constraints, and we publish a methodology that may be generalizable across endoscopy units in different settings in order to bring these to light so that they may be studied and used to improve workflow and achieve cost savings in the endoscopy center.

Read the article abstract online.

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