GI Unit Leadership: Shaping a High-Performing Endoscopy Unit (On-Demand) | February 2026-09_Sachdev

09_Sachdev_Delay Management

Pdf Summary

This presentation by Dr. Makanwal S. Sachdev emphasizes that delay management in endoscopy units is fundamentally a leadership responsibility. Delays are predictable, measurable, preventable, and patterned occurrences that leaders must own to enhance unit performance. Delays result in staff frustration, physician and patient dissatisfaction, anesthesia conflicts, revenue loss, and quality degradation.<br /><br />Four main zones cause delays: scheduling fragility, patient readiness issues, turnover vulnerabilities, and institutional bureaucracy. Scheduling delays come from unrealistic templates, shared resources, and lack of buffers. Leaders are urged to use historical data to model realistic procedural times and build buffer periods. Patient readiness delays, often caused by NPO violations, medication conflicts, and transportation delays, are largely preventable through mandatory pre-procedure calls, medication checklists, and dedicated oversight.<br /><br />Turnover delays stem from inconsistent processes, unclear accountability, supply gaps, and scope cleaning delays. Leadership can improve this by assigning room turnover leads, enabling parallel processing, standardizing stocking, tracking metrics daily, and enhancing communication with tech aids like real-time time tracking. Hospital-specific issues include shared procedural suites, variable anesthesia coverage, lack of dedicated transporters, and slow bureaucracy. Leadership solutions include dedicated transporter roles and anesthesia alignment meetings.<br /><br />LEAN methodologies—parallel processing, standardization, and staggered arrivals—can reduce throughput times significantly. Emotional intelligence is crucial for managing delay without blame, fostering psychological safety, and maintaining calm leadership under pressure, which sustains performance.<br /><br />Quality must never be compromised for efficiency; key quality guardrails include maintaining adenoma detection rates, withdrawal time, cecal intubation rates, and bowel prep adequacy, with speed applied to turnover but not to inspection.<br /><br />Leaders must also mitigate regulatory burdens by shielding teams from documentation burnout and integrating compliance into workflows.<br /><br />A proactive delay dashboard measuring start times, turnover, patient readiness failures, anesthesia delays, and case durations is recommended for data-driven management.<br /><br />Ultimately, delays are leadership opportunities to anticipate friction, design around variability, protect quality, and build resilient, high-performing endoscopy teams.

Keywords

delay management

endoscopy units

leadership responsibility

scheduling delays

patient readiness

turnover delays

institutional bureaucracy

LEAN methodologies

emotional intelligence

quality guardrails