Introduction Endoscopic procedures can be subject to large variability due to patient factors. The turnaround time (TAT) between patients offers a more predictable sequence of events, amenable to a sustainable reduction in time through implemented changes.
Our primary aim was to reduce TAT at St.Mary’s Hospital (SM). Our secondary aim was to identify and compare factors leading to TAT delay at SMH and Charing Cross Hospital (CC), both tertiary centres based in London.
Methods Clinical observers were used to record TAT and reasons for delay during endoscopy lists at both sites. A TAT was defined as from the point of scope removal from the previous patient to insertion of scope for the next.
Results 28 TAT were measured at SM during June 2014, with an average TAT of 25 minutes 14 seconds. Nurse-led cannulation was identified as a factor to reduce TAT and partially implemented at SM and CC. From March to May 2015, 44 TAT were recorded at SM (average 20 minutes 49 seconds) and 43 at CC (average 20 minutes 8 seconds), demonstrating a reduction in TAT at SM. Analysis demonstrated significantly more nurse led cannulations in the fastest 20 TAT compared to the slowest 20 TAT (p = 0.01). Endoscopist interruption from non-procedural staff during the TAT also occurred in 25% of TAT across both sites.
Conclusion Changes in TAT procedure offer sustainable ways to reduce endoscopy list length. Sources of delay are multifactorial, however nurse-led cannulation has been shown to contribute to faster TAT.
Disclosure of Interest None Declared
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