Presented by: Robert Medairos MD
Duke University Medical Center

Introduction

Outpatient cystoscopy is one of the most commonly performed procedures, which is traditionally performed with reusable equipment. Cleaning, maintaining, and preparing reusable cystoscopes can use a lot of clinical staff time. The single-use cystoscope recently developed by Ambu (Ballerup, Denmark) has come to market, and the impact on clinical workflow has yet to be explored. Our aim was to evaluate the change in overall clinical encounter time and clinical capacity after transitioning to single-use cystoscopes in an outpatient urology setting.

Materials

A single-institution prospective study comparing two full outpatient urology procedure clinic days was performed. Discrete categories for each portion of nursing care responsibilities were defined, and time spent during each category was recorded. Two separate clinic days, one where reusable cystoscopes were exclusively used and one after the transition to single use cystoscopes had occurred were analyzed. Overall clinical encounter time and the number of procedures per clinic day before and after the transition to single-use cystoscopy clinics were compared.

Results

,

A total number of 24 outpatient Urology procedures were performed, producing the same number of cystoscopy procedures on both the reusable and single-use cystoscopy clinic days. Preliminary cystoscope cleaning and transportation tasks by nursing staff were eliminated when utilizing single-use cystoscopes (Table 1). Average total encounter time decreased from 66 to 44 minutes, resulting in a 34% reduction in clinical encounter time.  The average number of flexible cystoscopy procedures increased after the transition (single-use cystoscope clinic average 13.6 ± 3.7 vs re-usable cystoscope clinic average 8.8 ± 4.0 p=<0.03).

Conclusion

Transition to a completely single-use cystoscopy outpatient procedure clinic improved clinical efficiency, which allowed for increased the clinical patient volume from 12 to 21 patients per clinic day.

Funding

N/A

Lead Authors

Robert Medairos, MD
Duke University Medical Center

Co-Authors

Francois Soto-Palou, MD
Duke University Medical Center

Zachary Dionise, MD
Duke University Medical Center

Rachel Locascio, MSN, RN
Duke University Medical Center

Jodi Antonelli, MD
Duke University Medical Center

Glenn Preminger, MD
Duke University Medical Center

Michael Lipkin, MD
Duke University Medical Center