C56-28 Delays in Critical Care Bronchoscopy: An Analysis of Contributing Factors and Opportunities for Improvement

Abstract Rationale Single-use bronchoscopes have recently emerged as a popular and valuable tool in the critical care setting due to their sterility and availability advantages over reusable bronchoscopes. Despite this, some hospitals still utilize reusables for critical care cases and are subject to potential procedural delays which can have far-reaching impacts on daily workflow and patient care. The purpose of this study was to understand the prevalence and reasons for critical care bronchoscopy delays. Methods A survey was distributed to healthcare professionals who assist in critical care bronchoscopy cases in the United States via a third-party agency. Survey questions were related to their experiences, preferences, and ideas on how to improve the critical care setting. “Assist in” was defined as completing one or more of the following: preparing endoscopes, assisting in procedures, endoscope reprocessing, scheduling, and/or purchasing equipment. Averages and proportions were calculated. Results 94 responses were collected from individuals who currently assist in critical care bronchoscopy cases, with 93 regularly working with reusables. Of those who work with reusables, 78% (n = 73) of the respondents reported experiencing delays in performing critical care bronchoscopy procedures in last 24 months with the main reasons being waiting for anesthesia team (62%, n = 45), scope in use in another case (51%, n = 37), delay in transporting scope to ICU (42%, n = 31), scope being repaired (29%, n = 21), scope being reprocessed (25%, n = 18), and staffing shortages (21%, n = 15). Of the respondents who reported experiencing delays, 38% were pulmonology endoscopy nurses, 32% were respiratory therapists, 38% worked in community urban hospitals, 26% worked in private hospitals, 21% worked in community rural hospitals, and 14% worked in academic medical centers. 83% agreed that single-use bronchoscopes would help improve workflow efficiency and reduce delays with the main reasons being reducing time required for preparation (78%, n = 60), ensuring a scope is always available (65%, n = 50), eliminating reprocessing (61%, n = 47), eliminating transportation (45%, n = 35), and reducing risk of scope malfunction (45%, n = 35). Conclusions Workflow delays are a common issue that continues to plague the critical care setting at hospitals in the United States. By adopting single-use bronchoscopes, critical care departments may be able to avoid costly delays caused by the availability issues that only reusables are subject to such as repairs, reprocessing, and concurrent usage. Single-use bronchoscopes may also help increase patient outcomes by reducing the time required to prepare for critical care bronchoscopic procedures. This abstract is funded by: Ambu USA