Badge Sign-in Plus Report Cards Increased First Case On-time Starts
Douglas K. Rex, MD, MASGE, reviewing Hiroshige K, et al. Endosc Int Open 2022 Jun 10.
At a single U.S. academic center with 20 endoscopists, including 13 academic and 7 voluntary, there were initial baseline measurements of first case on-time starts (FCOTS), followed by a timed badge sign-in requirement (period 2) and then badge sign-in plus monthly report cards (period 3).
The first case start (FCS) time delay was 21 minutes during baseline observation. During the badge sign-in period, procedures started 5 ± 18 minutes earlier (P=.03). With badge sign-in plus report cards, procedures started 8 ± 17 minutes earlier than start times during the initial observation period (P=.0006). The academic faculty improved more than the voluntary faculty. Overall FCOTS increased 14% with badge sign-in alone and 17% with badge sign-in plus report cards. When report cards were initiated, sign-in compliance increased from 58% to 68% among the academic faculty members (P=.004), but among the voluntary faculty, the increase was 24% to 31% (P=.16). On-time sign-ins increased to 53% with report cards for both the academic and voluntary faculty (P<.0001). FCS time was delayed about 20 minutes when physicians did not sign in with a badge versus only a 3- to 4-minute delay when they signed in on time with a badge.
COMMENTIn my experience, if you start 15 minutes late, you’ll be 15 minutes late all day long. I’m surprised that average baseline delays of this magnitude would be acceptable because they would have a significant negative impact on patient satisfaction and are costly to the endoscopy unit. This important study highlights the problem and identifies two mechanisms to improve performance.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Hiroshige K, Ferrer A, Chi S, et al. Badge sign-in and report cards improve first case start times in gastrointestinal endoscopy: a prospective quality improvement study. Endosc Int Open 2022;10:E769-E775. (https://doi.org/10.1055/a-1804-0094)
