BIAS AND ENDOSCOPY TURNOVER TIME IN A TERTIARY REFERRAL ACADEMIC CENTER ENDOSCOPY UNIT

ABSTRACT

Introduction: Room turnover time (TOT) is a measurement of endoscopy unit efficiency and delays in procedures lead to wasted health care expenditures. Several factors have been identified to influence turnover time including communication, staffing, case complexity, and specific surgeon. Previous research has indicated stereotypes about perceptions of physicians based on their gender or experience. For instance, women in surgical subspecialties endure gender discrimination from conscious and unconscious bias, that produce obstacles to career development and lead to burnout. It is unclear if these biases affect work flow in an endoscopy unit. Here, we sought to evaluate if endoscopists gender or academic experience affected their endoscopy room turnover time. Methods: We evaluated 2,917 inpatient and outpatient endoscopic procedures performed at our large academic tertiary care center between July 2019 and July 2021. TOT was calculated by taking the difference between a prior patient “out of room time” and the next patient “in room time”. TOT was averaged for each endoscopist and T-tests were used to evaluate for any statistical difference between groups. Academic experience was differentiated by having £5 years or >5 years since completing GI fellowship, or holding a leadership position. Results: The average room TOT was 3128 minutes amongst 26 different gastroenterology providers. There was no statistically significant difference in TOT by gender (p=0.99), serving in a leadership position (p=0.46), or being >5 years since completing fellowship (p=0.63). TOT was longest for advanced endoscopic procedures (p=0.025). TOT increased and case volume decreased in April and May 2020, following the onset of the COVID-19 pandemic. Conclusion: Neither gender or years of academic experience were associated with differences in endoscopic room TOT. More research is needed in gender or professional bias as related to work flow in medicine. Our other future directions include identification and analysis of other endoscopy efficiency metrics for endoscopy suite quality improvement. References Day, L.W et al. Quality and Efficiency in Gastrointestinal Endoscopy Units. 2018, Springer International Publishing. p. 587- 601. Stephens EH et al. The Current Status of Women in Surgery How to Affect the Future. JAMA Surg. 2020 Sep.