EFFICIENCY IN AN ENDOSCOPY UNIT IN A TEACHING HOSPITAL - DELAYS, PROLONGED PROCEDURES AND INPATIENT WAITING TIMES
Bibliographic record
Abstract
Purpose: The need to improve efficiency in endoscopy units is receiving attention because of increased demand for screening colonoscopy. One solution is to increase the volume of endosocpic services available by efficiently utilizing existing resources. The purpose of this study was to assess efficiency in the endoscopy unit of a large tertiary care teaching hospital. Methods: A research assistant collected data prospectively over 3 months in the endoscopy unit of a 650 bed acute-care teaching hospital. The data collected on inpatient and outpatient procedures included time intervals between endoscopic procedures and procedure durations. Procedure delays (defined as time interval between procedures of >15 minutes) were determined and the reasons for them recorded. For inpatients, the number of additional days spent waiting in hosptial for endoscopic procedures was also recorded. Results: From May 16-September 5, 2003, 675 endoscopic procedures were observed in 625 patients of whom 207 (33%) were inpatients. The most common procedure performed was colonoscopy (42.1%) followed by esophagogastroduodenoscopy (36%). Overall, in 193/625 patients (30.9%), the procedures were delayed (>15 minutes between procedures). Of these, the time interval between procedures was >30 minutes in 24.4%. The delays were physician-related in 54.4% (physician was not available to start the procedure). Procedure duration was prolonged in 22% of procedures. 86/207 (41.5%) inpatients waited at least one day in hospital for their procedures. Conclusions: Procedure delays were considerable and physician unavailability contributed to these delays. Strategies to reduce procedure delays could have a favorable impact on the volume of procedures performed in the unit, thereby improving utilization of existing resources. The generalizability of these findings is not known although it is widely perceived that the delivery of endoscopic services in large tertiary care teaching hospitals may not be as efficient as in other settings. Our results support this observation. We encourage other groups to assess the efficiency in their endoscopy units.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".