Quality Improvement Project to Reduce Wait Time for Pediatric Gastrointestinal Procedures.

Abstract

Introduction: Delays in care can lead to poor health outcomes and suboptimal patient and family experiences. We aimed to reduce the average wait time for gastrointestinal endoscopic procedures (procedure request to procedure completion) from 145 to 15 days (a 90% reduction) within 4 months (November 2023 to March 2024).

Methods: A3 problem-solving methodology was used. The primary intervention was a multiday, multidisciplinary improvement workshop. Outcome measures included (1) procedure request date to procedure completion date, and (2) favorable patient satisfaction score for timeliness of access to care. Process measures included (1) procedure request date to date procedure scheduled by staff, and (2) date procedure scheduled by staff to procedure completion date. The balancing measure was the number of procedures scheduled per weekday. Control charts assessed the impact of interventions.

Results: Following the primary intervention (October 2023), special cause improvement was seen for all but the balancing measure. Outcome measure 1 achieved a sustained reduction in mean monthly wait time from 145 to 26.4 days (an 82% reduction), whereas outcome measure 2 achieved sustained improvement in patient satisfaction from 39.7% to 50.2% (a 26.4% relative improvement). Process measures 1 and 2 had sustained reductions from 56.5 to 14.7 days (a 74% reduction) and 89.1 to 20.7 days (a 77% reduction), respectively. The balancing measure also remained unchanged at a monthly average of 11.7 procedures scheduled per weekday.

Conclusions: Using A3 problem-solving methodology, we achieved an 82% sustained reduction in endoscopic procedure wait times with a concurrent 26.4% improvement in patient satisfaction. Procedures are now routinely completed within 1 month of the request date.