The Hidden Burden of Equipment Failure in Endoscopy: Uncovered and Improved With Digital Technology

Cureus. 2022 Nov 19;14(11):e31664. doi: 10.7759/cureus.31664. eCollection 2022 Nov.


Objective A growing and ageing population combined with severe disruptions across endoscopy services throughout the United Kingdom (UK) during the recent pandemic has accelerated the backlog of patients awaiting endoscopic procedures. This places increased pressure to improve service efficiencies in an attempt to reduce this growing burden. Moreover, beyond repair costs, the full impact of faulty endoscopes on services is not well documented. This study aimed to outline tasks performed to traditionally report a broken endoscope; measure the impact on staff time, efficiency costs and staff morale; and report outcomes of staff experience and productivity when replacing traditional reporting with a digital reporting tool. Methods This study was conducted over six months at three endoscopy units. Cognitive-task analysis (CTA) and a time-motion study (TMS) were performed to process map all traditional tasks when an endoscope breaks, and again after a digital reporting tool was implemented. Two staff surveys were conducted. Data was aggregated to determine the overall impact and model efficiency costs. Results With traditional processes, on average one faulty endoscope generated 54 tasks, consuming 8 hours 53 minutes of staff time or £325 in efficiency costs, with 60% of staff reporting a negative effect on morale. In comparison, digital reporting generated 41 tasks, consuming 4 hours 31 minutes of time or £147 in efficiency costs, resulting in £45,468 saved annually. Furthermore, 95% of staff said their morale improved, and environmentally all paper-based processes were removed. Conclusion This study demonstrated the immense hidden burden of faulty endoscopes. Given the current challenges to endoscopy recovery, digital reporting tools may present an attractive means to minimise disruption to endoscopy services driven through improved equipment maintenance.

Keywords: cognitive task analysis; digital reporting tool; efficiency costs; endoscopy; time motion study.

Grants and funding

This project is supported through Mid and South Essex NHS Foundation Trust’s Innovation Fellowship, awarded to Ashish Kalraiya in 2019. Ashish Kalraiya helped deliver the technical solution in this study. This study was conducted by staff working across the Mid and South Essex NHS Foundation Trust without any additional financial support.