P2384 - Multifactorial Determinants of On-Time Starts for Outpatient Endoscopy: An Institutional Analysis

Parth M. Patel, MD¹, Joshua D. Kirschenbaum, MD¹, Jonathan Weng, MD¹, Abdulrahman A. Alhajahjeh, ², Harmony Allison, MD^1
1Tufts Medical Center, Boston, MA; ²University of Jordan School of Medicine, Amman, 'Amman, Jordan

Introduction: Delays in the endoscopy suite, particularly for the first cases of the day, can lead to financial losses, cascading delays, and decreased patient and provider satisfaction. This study investigates the impact of patient, institutional, and procedural factors on on-time starts for the initial daily outpatient endoscopic procedures at Tufts Medical Center over a 5-month period.

Methods: A retrospective observational review of electronic medical records was conducted with IRB approval. Patients aged 18-89 undergoing their first endoscopic procedure of the day at Tufts Medical Center from March 1st to July 31st, 2023, were included (n=347). Data on scope start time, demographics, and procedure type were collected. Due to non-normal data distribution, median differences in time to procedure start were compared across factors using chi-square and Wilcoxon rank-sum tests.

Results: A total of 347 patients were included in the study, with 52.2% being female and 74.8% being English speakers. Lower endoscopies accounted for 60.3% of the cases, with 36.8% of these performed for surveillance purposes. Additionally, 41.9% of the endoscopies were conducted in a fluoroscopy-endoscopy room. The median delay for endoscopy was 15 minutes (IQR: 8-23 minutes). Institutional factors, such as the use of a fluoroscopy-endoscopy room, were associated with significantly longer delays (median 18 minutes vs. 14 minutes for standard rooms, p < 0.001). Advanced endoscopy procedures also had significantly longer delays (median 28.5 minutes, p < 0.001). Specific patient diagnoses further contributed to delays up to 31 minutes (p < 0.001). While language did not significantly impact delays when considering scheduled and actual procedure start times, English-speaking patients experienced longer delays between check-in and procedure start compared to non-English speakers.

Discussion: This retrospective study highlights the multifactorial nature of endoscopy suite delays, with institutional factors such as the type of endoscopy room and complexity of the procedure playing a significant role. Additionally, the presence of fellows and specific patient diagnoses also contribute to increased delays. However, patient factors such as language did not significantly impact delays when considering scheduled start and scope-in times. Understanding these factors can help institutions and healthcare providers optimize endoscopy scheduling and resource allocation to minimize delays and improve overall efficiency and patient satisfaction.


Disclosures:


Parth M. Patel, MD¹, Joshua D. Kirschenbaum, MD¹, Jonathan Weng, MD¹, Abdulrahman A. Alhajahjeh, ², Harmony Allison, MD¹. P2384 - Multifactorial Determinants of On-Time Starts for Outpatient Endoscopy: An Institutional Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.