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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(05): E642-E648
DOI: 10.1055/a-2290-0263
Original article

Plan-do-study-act (PDSA) interventions to improve real-world endoscopy unit productivity

Christopher Bradley
1   Department of Internal Medicine, Division of Gastroenterology, University of Southern California Keck School of Medicine, Los Angeles, United States (Ringgold ID: RIN12223)
,
Matt Sumethasorn
1   Department of Internal Medicine, Division of Gastroenterology, University of Southern California Keck School of Medicine, Los Angeles, United States (Ringgold ID: RIN12223)
,
Jin Sun Kim
2   Division of Gastrointestinal Liver Disease, University of Southern California, Los Angeles, United States (Ringgold ID: RIN5116)
,
Sarah Wang
1   Department of Internal Medicine, Division of Gastroenterology, University of Southern California Keck School of Medicine, Los Angeles, United States (Ringgold ID: RIN12223)
,
Leslie Martinez
3   Los Angeles County Department of Health Services, Los Angeles, United States (Ringgold ID: RIN5141)
,
Megan Chang
3   Los Angeles County Department of Health Services, Los Angeles, United States (Ringgold ID: RIN5141)
,
Lillian Lemus
3   Los Angeles County Department of Health Services, Los Angeles, United States (Ringgold ID: RIN5141)
,
Behrod Katebian
3   Los Angeles County Department of Health Services, Los Angeles, United States (Ringgold ID: RIN5141)
,
Dara Bruce
1   Department of Internal Medicine, Division of Gastroenterology, University of Southern California Keck School of Medicine, Los Angeles, United States (Ringgold ID: RIN12223)
,
Andy Lee
3   Los Angeles County Department of Health Services, Los Angeles, United States (Ringgold ID: RIN5141)
,
Rachel Baden
3   Los Angeles County Department of Health Services, Los Angeles, United States (Ringgold ID: RIN5141)
,
Hal Yee
3   Los Angeles County Department of Health Services, Los Angeles, United States (Ringgold ID: RIN5141)
,
James Buxbaum
1   Department of Internal Medicine, Division of Gastroenterology, University of Southern California Keck School of Medicine, Los Angeles, United States (Ringgold ID: RIN12223)
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Abstract

Background and study aims The Plan-Do-Study Act (PDSA) ramp is a framework that uses initial small changes to build consensus and momentum for subsequent, iterative process improvement. Our aim was to study its impact on endoscopy unit efficiency and throughput.

Methods Following a granular time-and-motion analysis to evaluate baseline performance (phase 1) we instituted successive interventions and measured their impact on core efficiency metrics including procedure volume and turnover time (phases 2–3).

Results We identified that inefficiency in turnover of anesthesia-supported endoscopy was the most crucial issue. Implementation of a pre-procedure anesthesia visit in phase 2 reduced turnover time by 15.5 minutes (95% confidence interval 3.9–27.1 minutes). Subsequent changes (phase 3) including front-loaded procedure scheduling and parallel in-room preparation resulted in an 18% increase in procedure volume.

Conclusions The PDSA ramp model is an effective means of assessing operational processes, developing novel interventions, and building consensus to improve the real-world productivity in a resource-conscious manner.

Keywords

Quality and logistical aspects - Preparation - Quality management - Performance and complications

Supplementary Material



Publication History

Received: 30 October 2023

Accepted after revision: 06 March 2024

Accepted Manuscript online:
19 March 2024

Article published online:
03 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2024; 56(07): 555-555
DOI: 10.1055/a-2280-6811

 

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