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Pulmonary Procedures |

A Novel Intervention to Reduce Bronchoscopy Laboratory Costs

Kevin Kane; Christopher Gilbert; Jennifer Toth; Michael Reed
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Penn State Milton S. Hershey Medical Center, Hershey, PA


Chest. 2014;146(4_MeetingAbstracts):731A. doi:10.1378/chest.1993730
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Abstract

SESSION TITLE: Bronchoscopy Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Advancing bronchoscope technology has improved the diagnostic approach to diseases of the thorax with improved endoscopic processing, visualization and ultrasonic images. These newer bronchoscopes may be prone to damage and increased repair costs. Several studies have documented high costs associated with bronchoscopy but few describe interventions to reduce expenses. We report our expenditures before and after an instructional site visit with scope manufacturer support representatives.

METHODS: Equipment repair costs in early fiscal year 2013 exceeded $34,000. In an attempt to maintain an efficient, cost effective bronchoscopy program, an intervention was performed. Scope manufacturer endoscopy support specialists were invited to observe all practices performed in a standard day within our bronchoscopy suite and operating room. Clinicians, nurses, technicians, and cleaning/processing staff were observed and the report included detailed descriptions of their respective involvement in bronchoscopic handling. Endoscopy support specialists provided feedback for all staff within 24 hours of the visit, delivered in a lecture format.

RESULTS: A total of 10 hours of direct observation related to bronchoscopy setup, performance, cleaning, processing and storage was performed. Bronchoscopic damages were identified relating to scope handling, scope storage, and scope use. Damage costs varied from outer sheath laceration ($275) to ultrasound probe damage (over $4000). Results and proposed mechanisms of damage were discussed in a formal presentation followed by open discussion. After recommendations from the scope manufacturer team our endoscopy team embarked on a campaign of “tip awareness” for all involved in bronchoscope handling. Over the next nine months repairs fell to under $2400; a 93% reduction in repair costs.

CONCLUSIONS: Maintenance of bronchoscopic equipment can be costly. Experienced bronchoscopy suites may be unaware of the best practices in the upkeep and care of these devices. Our intervention demonstrates that product specialists can be utilized to help reduce costs related to bronchoscope damages. Further study is needed to help define the sustainability of these interventions and ultimate cost savings.

CLINICAL IMPLICATIONS: Third party consultation may identify previously neglected areas of bronchoscope processing and allow for better scope handling with improved repair costs.

DISCLOSURE: The following authors have nothing to disclose: Kevin Kane, Christopher Gilbert, Jennifer Toth, Michael Reed

No Product/Research Disclosure Information


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