Los Angeles County Department of Health Services (LAC-DHS) is a huge organization comprised of multiple large complex facilities with their own unique culture, leadership, policies, and procedures. It can be extremely difficult to implement a system-wide operational approach within the organization due to this landscape, especially in a time limited capacity. Early in the pandemic, LAC-DHS shut down all outpatient GI procedures for six months. This created a huge GI procedure backlog and delay in diagnostic care.