Increasing emphasis on quality of care, as well as performance-based reimbursement have placed the spotlight on improving healthcare efficiency. As demand for GI procedures continues to increase, resources like physical space and personnel remain unchanged. Despite this, the literature is sparse with regard to improving efficiency in the endoscopy unit. First-case start delay is a known endoscopy efficiency metric. In our study, we look at the impact of implementing a patient check-in protocol on first-case start delays in our hospital-based endoscopy unit.