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Optimizing efficiency and operations at a California safety-net endoscopy center: a modeling and simulation approach
Lukejohn W Day1, David Belson2, Maged Dessouky2
1Division of Gastroenterology, San Francisco General Hospital and Trauma Center, San Francisco, California, USA; GI Health Outcomes, Policy and Economics (HOPE) Research Program and Center for Innovation in Access and Quality (CIAQ), Department of Medicine, University of California, San Francisco, California, USA.
Improving endoscopy center efficiency is crucial. Minor, cost-effective changes like optimizing appointment scheduling and reducing recovery times can significantly increase procedure volume and patient throughput.
Area of Science:
- Healthcare Operations Research
- Gastroenterology Efficiency
Background:
- Endoscopy centers require efficiency improvements, yet data is limited.
- Patient throughput, resource utilization, and wait times are key metrics.
Purpose of the Study:
- To identify strategies for enhancing patient throughput in a safety-net endoscopy center.
- To balance resource use with patient wait times.
Main Methods:
- A time and motion study was conducted on outpatients undergoing endoscopy.
- Discrete event simulation modeling was used to evaluate efficiency improvement scenarios.
Main Results:
- A time and motion study showed 53.8 procedures/week with patients spending 2.3 hours.
- Simulation revealed shifting appointments to mornings with reduced times (40-45 min) increased volume (30.5%-52.0%) and decreased patient time (13.0%-17.4%).
- Model predictions were validated by actual implemented changes.
Conclusions:
- Minor, cost-effective changes can maximize endoscopy center efficiency.
- Strategies include reducing appointment times, standardizing recovery, and increasing ancillary staff.
- Findings may not apply to non-safety-net centers.
