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Improving St. Mary’s Hospital Endoscopy Unit Efficiency by Improving Holding Room Turnover Promptness

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1. Project Title: Improving St. Mary’s Hospital Endoscopy Unit Efficiency by Improving Holding Room Turnover Promptness

2. Background and Rationale: During my 30+ years as an endoscopic physician at St. Mary’s Hospital I have observed that while, generally speaking, endoscopic procedures themselves do not now require more time.  However, non-procedure related activities in the unit like inefficient holding room turnover, have slowed our pace. The slowing has resulted in frustration amongst physicians and staff.  More importantly, delays in patient procedures is one of the most frequent negative marks we receive on our patient satisfaction surveys. Because our endoscopy unit is tasked with providing efficient, effective, and timely care, eliminating long wait times in between procedures is a necessary improvement in order to make sure St. Mary’s is meeting the needs of our customers (patients) to the best of our abilities. Reducing holding room turnover times will help us meet this goal.

3. AIM/Improvement Goal: The aim is to improve promptness of holding room turnover. The improvement goal is to reduce by 5% the endoscopy unit holding room turnover time at St. Mary’s Hospital by March 1, 2023.

4. Project Setting, Team, Stakeholders: SSM Health St. Mary’s Hospital, St. Louis, MO, is a 683 bed community hospital in suburban St. Louis. The endoscopy unit has 9 beds, 9 holding rooms, and is staffed by myself (Director of the Division of Gastroenterology, St. Mary’s Hospital), the Head Nurse, 9 endoscopic physicians, and 22 nurses. The improvement project team is comprised of myself, the Head Nurse, plus all of the unit nurses and physicians. The executive stakeholders and sponsors of the project are my supervisor (St. Mary’s Chief of Staff), the St. Mary’s Director of Nursing, and our hospital president. Our project leaders will be myself and the Head Nurse. Other key stakeholder groups include our patients, and our competing endoscopy units both free-standing at other SSM facilities in St. Louis.

5. Measurement System: The KQC to be measured is: Promptness of holding room turnover time. The operational definition of holding room turnover time is the time at which the patient is greeted by the nurse and escorted to the holding room to undress, until the patient is gowned and in bed, ready to be seen by anesthesia. Baseline data will be collected by the nursing staff over a five day period. Holding times will be timed and recorded for each endoscopy visit over the 30 day study. Sampling will not be performed for the baseline data collection.

 

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