Throughput Benchmarking and Throughput Variance Analysis to Evaluate the Efficiency of an Outpatient Endoscopy Unit

Rising demand for colorectal cancer screening has increased colonoscopy volume, producing backlogs and prolonged wait times. Commonly used metrics such as room utilization provide limited insight into actionable drivers of efficiency; we applied a novel throughput benchmarking framework to quantify performance and identify operational sources of inefficiency. We conducted a pilot study in a four-room outpatient endoscopy unit from July-December 2022. Using routinely recorded timestamps for procedural stages, we derived a realistic daily target throughput (RDTT). Monthly realistic target throughput (RMTT) was calculated from RDTT. Actual monthly throughput (AMT) was benchmarked against RMTT to generate a throughput efficiency ratio (TER = AMT/RMTT) and throughput variance (TV = RMTT - AMT), which was decomposed into seven predefined operational factors. AMT ranged from 567 to 717 procedures per month, whereas RMTT ranged from 1,165 to 1,332, yielding a mean TER of 53%. The largest contributors to variance were rooms closed due to lack of endoscopist assignment (45%), workflow delays (21%), and patient no-shows or late cancellations (11%). In this pilot, we demonstrate that using commonly captured operational metrics, throughput benchmarking provides a practical framework to quantify efficiency and identify specific, actionable drivers of underperformance in endoscopy operations.