Improving Quality and Safety In Your Endoscopy Unit: Live and Virtual

07_Srivastava_Efficiency
Pdf Summary
In this document, Dr. Neetika Srivastava discusses the importance of improving efficiency in the endoscopy unit. She notes that despite limited research on this topic, reducing procedure time does not necessarily enhance efficiency. Instead, operational flow and staffing are more important factors. <br /><br />Dr. Srivastava suggests several strategies for improving efficiency. In terms of facility, she recommends standardizing procedure rooms, maintaining commonly used supplies, and utilizing mobile equipment. She also emphasizes the importance of proper positioning of patients and a centralized, open nursing station in the recovery room. <br /><br />Staffing models play a crucial role in efficiency. Dr. Srivastava advises having one RN per procedure room, as well as dedicated endoscope technicians to improve room turnover. She also suggests having a floater or free agent/circulator to support staff as needed. <br /><br />Integrated information technology is another key aspect of improving efficiency. Dr. Srivastava recommends implementing a single integrated electronic medical record system with prompt access to it. This includes workstations on wheels to facilitate easy documentation and access to patient information. <br /><br />In terms of measurement, she suggests evaluating both structure and process. Structure measures include unit layout, the number of staff members, and IT capabilities. Process measures include preparation time, sedation and procedure times, room turnover time, recovery time, waiting time, flow time, and resource utilization. <br /><br />Dr. Srivastava emphasizes the importance of understanding patient flow and reducing delays. This includes clear instructions and expectations for patients, efficient check-in processes, and mechanisms to address physician behavior that may cause delays. <br /><br />Streamlining workflow processes is essential for improving efficiency. This includes parallel processing of staff, effective communication, and dedicated staff performing specific tasks such as IV access. Dr. Srivastava also recommends scheduling complex cases at the end of the day and identifying and disseminating best practices from the most efficient individuals or teams. <br /><br />Maximizing procedure volume is another strategy she suggests. This involves having one endoscopist per two procedure rooms and minimizing room turnover time and post-procedure paperwork. <br /><br />Lastly, Dr. Srivastava emphasizes the importance of cultural beliefs and leadership in an efficient endoscopy unit. She highlights the need for a strong emphasis on teamwork, adaptability to recognize and implement change, flexibility among staff members, and clear and frequent communication. <br /><br />Overall, Dr. Srivastava emphasizes the need for clear definitions of efficiency, optimization of operational systems, and the identification of strong leaders to foster a culture of teamwork and change.
Keywords
efficiency
endoscopy unit
operational flow
staffing
facility
patient positioning
staffing models
information technology
measurement
workflow processes