Children's Hospitals Today - Spring 2023 - 25

IMPROVEMENT / FEATURE
THE GI ENDOSCOPY LAB
ON TIME, EVERY TIME
THE GASTROINTESTINAL
(GI) Endoscopy Lab had been
running behind schedule for
years. Each patient's procedure
started, on average, 25 minutes
late. Over the course of the day,
these delays compounded and
resulted in the last patient's
care typically being delayed by
more than two hours. The GI
team was finishing its routine
days well into the evening,
resulting in staff burnout,
high staff turnover, and high
overtime costs.
The anesthesiology fellow
Rachel Feldman, M.D., and
GI fellow Irina Gorbounova,
M.D., began an improvement
process, working backwards
from a desired endpoint:
increase GI lab efficiency and
finish caseload during daytime
hours. To achieve that, the
GI lab needed to start all the
cases on time and decrease
recovery room delays with
patients who took longer to
wake up after their procedure.
Feldman and Gorbounova
used historical data to find
outlier physicians who
consistently outperformed
their peer group from two
perspectives: Who was on
service when all the cases
ran on schedule? Who was
on service when patients
cleared recovery in less than
55 minutes (versus the group
average of 75 minutes)?
They discovered one doctor
whose patients consistently
met these criteria. Feldman
and Gorbounova identified
his technique, choice of
medication, sequence of
medication administration and
dosage that were different.
They documented his drug
protocol and created a macro
in the EMR so any other
anesthesia provider could
recreate it.
By leveraging these
actionable insights and
scaling them across the
GI lab, their case volume
increased by 25%, all case
on-time starts improved
by 36%, and recovery time
decreased from a mean of
78.8 minutes to 66.9 minutes.
The GI Endoscopy Lab
revenue increased by 25%
(independent of the charges
per procedure), representing
an increase of more than $2
million in annual revenue.
BY THE NUMBERS
25%
increase in
case volume
36%
improvement
in on-time starts
$2 million
revenue increase
CHILDREN'S HOSPITALS TODAY Spring 2023
25

Children's Hospitals Today - Spring 2023

Table of Contents for the Digital Edition of Children's Hospitals Today - Spring 2023

Contents
Children's Hospitals Today - Spring 2023 - Cover1
Children's Hospitals Today - Spring 2023 - Cover2
Children's Hospitals Today - Spring 2023 - Contents
Children's Hospitals Today - Spring 2023 - 2
Children's Hospitals Today - Spring 2023 - 3
Children's Hospitals Today - Spring 2023 - 4
Children's Hospitals Today - Spring 2023 - 5
Children's Hospitals Today - Spring 2023 - 6
Children's Hospitals Today - Spring 2023 - 7
Children's Hospitals Today - Spring 2023 - 8
Children's Hospitals Today - Spring 2023 - 9
Children's Hospitals Today - Spring 2023 - 10
Children's Hospitals Today - Spring 2023 - 11
Children's Hospitals Today - Spring 2023 - 12
Children's Hospitals Today - Spring 2023 - 13
Children's Hospitals Today - Spring 2023 - 14
Children's Hospitals Today - Spring 2023 - 15
Children's Hospitals Today - Spring 2023 - 16
Children's Hospitals Today - Spring 2023 - 17
Children's Hospitals Today - Spring 2023 - 18
Children's Hospitals Today - Spring 2023 - 19
Children's Hospitals Today - Spring 2023 - 20
Children's Hospitals Today - Spring 2023 - 21
Children's Hospitals Today - Spring 2023 - 22
Children's Hospitals Today - Spring 2023 - 23
Children's Hospitals Today - Spring 2023 - 24
Children's Hospitals Today - Spring 2023 - 25
Children's Hospitals Today - Spring 2023 - 26
Children's Hospitals Today - Spring 2023 - 27
Children's Hospitals Today - Spring 2023 - 28
Children's Hospitals Today - Spring 2023 - 29
Children's Hospitals Today - Spring 2023 - 30
Children's Hospitals Today - Spring 2023 - 31
Children's Hospitals Today - Spring 2023 - 32
Children's Hospitals Today - Spring 2023 - Cover3
Children's Hospitals Today - Spring 2023 - Cover4
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