S3016 Physician Time Spent Triaging Interventional GI Patient Referrals

Introduction: Triaging interventional gastroenterology (GI) referrals improves care efficiency but is associated with large amount of uncompensated work done outside of normal work hours. The purpose of this study was to assess the physician time spent triaging interventional GI procedure and clinic referrals. Methods: Prospective observational study from March 2024 to March 2025 involving an academic medical center with 7 interventional GI endoscopists who share triage referral responsibilities each week they are on call. Physicians performed additional daily triage of referrals directly referred to them. To systematically capture triage work performed by interventional endoscopists, an electronic medical record “smart phrase” was created to track the following variables: Diagnosis/Reason for Triage, Triaging Physician, Triage Disposition, Procedure Ordered, Type of Anesthesia, Time Frame, Requested Provider, Triage Comments. Time spent performing triage work was calculated from the EMR’s user access log. Results: 3009 triages were captured, averaging 57 triages per week (range 14-87). Physicians spent an average of 4.2 minutes in each triage note. The physicians varied in time spent per triage from 2.5 minutes to 5.3 minutes. The on-call attending of the week performed 44% triages. Sixty-nine percent of referrals were triaged directly to procedures, 23% to clinic, and 8% to other (e.g. oncology or surgery or to get more information). Thirty-eight percent of patients were triaged to have urgent (<4 weeks) procedures/visits (5% within 1 week, 12% within 2 weeks, 21% within 4 weeks). The mean amount of time per week spent by the on-call physician doing triage was 98 minutes. The mean amount of time per week spent by the other 6 non-on-call physicians doing triage was 29 minutes. Forty-eight percent of triages were done after hours (5 pm to 7 am) or on weekends/holidays. Conclusion: Half of all referrals triaging by interventional GI endoscopy physicians takes place on night/weekends/holidays. There were 57 triages per week which took an average of 4.2 minutes per triage. The on-call physician spent 98 minutes per week doing triages, while the not on-call physicians each spent 29 minutes doing triages. Although physician triaging referrals improves clinical operations efficiency and patient care by getting the right patient to the right care at the right time, it may decrease physician wellness and compensation.