title: Utilization of resource leveling to optimize ERCP efficiency.
abstract: BACKGROUND
  Optimizing endoscopy efficiency is becoming increasingly important. This study profiled ERCP availability and assessed resource leveling as a strategy to enhance efficiency.
  
  
  METHODS
  All ERCPs performed at an academic teaching hospital between January 2007 and December 2008 were reviewed. Procedure timeliness (time between admission and ERCP) and demand were analyzed to assess resource utilization.
  
  
  RESULTS
  Data were recorded for 393 ERCPs. Profiling identified an unequal distribution of waiting times from admission to procedure due to restricted ERCP availability. Use of resource leveling methodology demonstrated that a small increase in procedure availability (one additional half day per week) would significantly reduce the hospital stay of ERCP patients.
  
  
  CONCLUSIONS
  Resource leveling can be applied to balance procedure provision with demand to cope with fluctuations in demand. The impact of resource leveling can be truly measured only by implementing these changes and prospectively studying the effect.
authors.affiliation: University College Dublin School of Medicine, Dublin, Ireland.
authors.forename: L M
authors.initials: LM
authors.lastname: Hendrick
authors.forename: G C
authors.initials: GC
authors.lastname: Harewood
authors.forename: S E
authors.initials: SE
authors.lastname: Patchett
authors.forename: F E
authors.initials: FE
authors.lastname: Murray
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D007494:Ireland; D007902:Length of Stay; D040841:Resource Allocation; D012189:Retrospective Studies