S659 Reducing Delays in Colonoscopy and EGD Access Through Real-Time Virtual Scheduling: A Quality Improvement Initiative

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Introduction: Timely endoscopic access is critical for preventing colorectal cancer. However, scheduling inefficiencies persist as a significant barrier and contribute to prolonged wait times. At our institution, patients were scheduled for endoscopy through telephone calls, often resulting in miscommunication, or no-shows. To address this, we implemented a quality improvement intervention using a virtual scheduler embedded in the gastroenterology clinic. This study evaluated its impact on procedure completion rates. Methods: Pre-Intervention: We performed a retrospective chart review of all patients who were scheduled for a colonoscopy or esophagogastroduodenoscopy (EGD) between February and May, 2024 at an underserved tertiary care center. During this period, standard scheduling procedures were used without the aid of a real-time scheduler. Post-Intervention: Beginning August 5, 2024, a virtual scheduler was introduced at the clinic to assist patients in booking their colonoscopy or EGD appointments prior to leaving the office. All patients scheduled were prospectively followed. Results: A total of 658 patients were evenly divided between the pre- and post-intervention groups (328 vs 330). While demographic characteristics such as sex, race, and language were similar across groups, there were statistically significant differences in age and income. Implementation of the virtual scheduler significantly reduced time from procedure scheduling to completion (mean: 65.9 vs 55.8 days, P = 0.018) and time from procedure ordering to completion (mean: 79.3 vs 56.1 days, P < 0.001). Despite improvements in timeliness, overall procedure completion rates remained comparable between the pre- and post-intervention groups (69.8% vs 70.9%, P = 0.759). Although contact rates and willingness to complete follow-up surveys were comparable (P = 0.127 and P = 0.744), post-intervention patients reported more barriers, including life demands (29.0% vs 10.4%, P = 0.001), health-related concerns (18.0% vs 3.1%, P = 0.001), time constraints for bowel preparation (P = 0.007), and cost-related barriers (23.2% vs 11.1%, P = 0.028). Conclusion: The implementation of a virtual scheduler significantly reduced delays in scheduling and overall time to procedure, highlighting its effectiveness as a patient navigation tool. However, social and financial barriers persist, underscoring the need for multi-level interventions to further enhance procedure completion in vulnerable populations.

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