A discrete event simulation model to evaluate operational performance of a colonoscopy suite

Area of Science:

• Gastroenterology
• Health Services Research
• Operations Research

Background:

• Colorectal cancer is a leading cause of cancer death and is preventable through colonoscopic screening.
• High colonoscopy costs necessitate optimizing resource utilization for efficient screening facilities.

Purpose of the Study:

• To evaluate resource allocation for optimal use of colonoscopy screening facilities.
• To identify key factors influencing patient throughput and resource utilization in colonoscopy suites.

Main Methods:

• Development of a discrete event simulation model of a colonoscopy suite using computerized database data.
• Comparison of operational configurations by varying endoscopist numbers, procedure rooms, patient arrival times, and turnaround times.
• Analysis of performance measures including patient capacity, resource utilization, and patient waiting times.

Main Results:

• Maximum patient capacity is linearly related to the number of procedure rooms, with benefits seen in larger suites.
• Increasing procedure rooms enhances intake and recovery resource efficiency.
• Procedure room turnaround time significantly impacts patient throughput and resource utilization, especially with room-to-endoscopist ratios of 1:1 to 2:1.
• Adjusting patient arrival schedules can reduce waiting times without extending the clinic day.

Conclusions:

• Maintain a procedure room to endoscopist ratio between 1:1 and 2:1 for optimal resource utilization.
• Evaluate the impact of turnaround times on system performance before implementing process improvements.
• Consider key resource utilization as a critical factor in decision-making for colonoscopy suite management.