TIME IS MONEY: OPERATING ROOM VS ENDOSCOPY FOR INTERVENTIONAL PULMONARY PROCEDURES

Abstract

SESSION TITLE: Interventions to Advance Patient Care SESSION TYPE: Original Investigations PRESENTED ON: 10/08/2018 04:30 pm - 05:30 pm PURPOSE: Interventional pulmonary (IP) procedures are fast becoming more accessible and a cornerstone in the management of multiple pulmonary diseases. They can be performed in the operating room (OR) vs Endoscopy suite (ES) depending on the center and availability. To our knowledge, there is no data comparing the delay in initiating the procedure between the 2 locations. We present a single center retrospective analysis comparing the time delay from scheduled procedure time in the OR vs the ES using the same staff. METHODS: A single center retrospective study at a major metropolitan hospital with expertise in IP was performed for a time duration of 11 weeks in each location. The same nursing staff were used to process and transport the patient in the OR and the ES. A two-sided Mann-Whitney test with a 0.05 significance level was used to compare the mean delay times at the 2 locations. Time delayed was calculated as the difference between the scheduled procedure time to the start time. Start time was defined as the time of insertion of a bronchoscope or a needle for pleural procedures. RESULTS: Between 9/8/2017 and 11/21/2017 a total of 74 IP procedures were performed in ES and between 11/28/2017 and 2/13/2018 a total of 72 IP procedures were performed in the OR. Linear EBUS with a transbronchial needle aspiration was the most common procedure in the ES (45%) and the OR (50%). The median delay time in the O.R. was significantly larger compared to the median delay time in the ES (median=60min vs. 40min, respectively; p=0.02, using a two-sided Mann-Whitney test). The most common reason for delay in ES was patient processing (49.2%) while it was room turnover (54.6%) in the OR. CONCLUSIONS: The time delayed was significantly less in the ES in comparison to the OR at our hospital by a mean of 20mins. Increased utilization of the OR time due to this delay invariably leads to more utilization of resources and increases cost in comparison to the ES. We hope that our experience can help those institutions setting up an IP program and are debating where to perform their procedures. Being a retrospective study there is an inherent selection bias which acts as one of the limitations of the study. More studies are needed to confirm our results. Another limitation is that the results are based on the interior design and architecture of our ES and OR. Other institutions may have different results based on their interior design. CLINICAL IMPLICATIONS: Our study can help future programs in determining a location for performing their procedures. Performing these procedures in the ES can potentially be faster and save valuable resources and money. DISCLOSURES: No relevant relationships by Erica Altschul, source=Web Response No relevant relationships by Habtamu Belete, source=Web Response No relevant relationships by Khalid Gafoor, source=Web Response No relevant relationships by Bryan Husta, source=Web Response No relevant relationships by Maly Oron, source=Web Response No relevant relationships by Shalin Patel, source=Web Response No relevant relationships by Varun Shah, source=Web Response