Problem: A mid-sized community hospital endoscopy center was cited for lack of adherence to intraoperative timeouts on internal review. Identified factors contributing to nonadherence were “distractions” and “personnel engaged in other activities”. Lack of time out adherence reduced endoscopy patient safety, as evidenced by a near miss event involving a difficult airway, and impacted system reputation through potential loss of Joint Commission on Accreditation of Healthcare Organization (JCAHO) recognition. Preventable patient harm and JCAHO accreditation loss impose direct costs on the hospital through legal fees, potential fines, and tarnished reputation. Purpose: The purpose of this quality improvement project was to increase time out adherence amongst providers administering anesthesia in the endoscopy center. The project implemented an evidenced-based, research supported practice change by instituting an anesthesia time out policy with fixed, efficient, interdependent workflows aimed at practice standardization amongst endoscopy staff, and measured time out compliance. Methods: The initiative was implemented over a 15-week period in the Fall of 2024, impacting on average 10 patients per day, 68 patients per week, and 272 patients per month. The project structure goal comprised the creation of a standardized time out policy. The project’s process goals involved education on policy implementation and adherence to endoscopy time outs. Adherence to endoscopy time outs was measured weekly using the Endoscopy Time Out Adherence Measurement Tool. Results: Pre-intervention endoscopy time out adherence recorded a median of 62.5%, while post-intervention endoscopy time out adherence recorded a median of 100%. Conclusions: Intraoperative time out adherence amongst endoscopy anesthesia providers is attainable. A 100% time out adherence rate was achieved in eight out of 15 weeks. Consistent fulfilment of this goal rests on reliable workflow execution and resolution of evolving barriers.