Single-Use Flexible Endoscopy for Short-Staffed Facilities

It didn’t take long for Dr. Austin Rose to make a cost-benefit argument for single-use rhinolaryngoscopes at the University of North Carolina in Chapel Hill. 

Between inpatient consults, emergency department visits, and intensive care unit procedures by the pediatric ear, nose and throat specialist, completing multiple patient procedures per day was more streamlined without having to reserve access to limited reusable rhinolaryngoscopes or imaging equipment on the hospital floor.

A sterile from the package single-use endoscope option — complete with portable high-definition monitor for imaging — allows for quick setup, use, and disposal of the instrument at the point of care, he said. Rose could easily show how costs associated with disinfection, maintenance and repair of this type of flexible endoscope could be significantly reduced. 

Flexible endoscopies, like those performed with a rhinolaryngoscope for ENT diagnostic and therapeutic care, account for roughly 40 million medical procedures annually in the U.S. Flexible endoscopes are used for bronchoscopy, colonoscopy, cystoscopy, ureteroscopy and other specialties and may take up to two hours to clean and disinfect between uses. These delicate instruments require large amounts of staff time and resources to operate and maintain.

Benefits also translated to the outpatient clinics, Rose said, particularly when it came to staffing.  

“We’ve had a lot of staff issues,” Rose said in recent webinar hosted by Becker’s of one of the medical center’s satellite clinics, especially due to recent surges in COVID-19 variants. “Staffing is a day-to-day process.” 

There is no guarantee available employees are versed in how to properly sterilize and handle flexible endoscopes between procedures, he added. This makes a disposable option very attractive.  

“Stocking single-use scopes really helped us in that kind of pinch,” Rose said. 

Inflation, supply chain issues, and lingering effects of the COVID-19 pandemic are having a profound impact on healthcare. Too many healthcare workers are leaving the field, whether being let go in light of severe budget cuts or stepping back voluntarily after more than two years of pandemic-related challenges.  

But, as when staffing was limited during the height of the pandemic, an innovative way to keep procedures and patient throughput moving is by adopting single-use technology. 

 

Workers at the breaking point 

Future healthcare staffing shortages were predicted long before the emergence of COVID-19. A recent Mercer analysis based on 2017 data from the U.S. Bureau of Labor Statistics forecasted that healthcare worker demand would outpace supply by 2025, largely due to the number of aging baby boomers. Similarly, the American Association of Medical Colleges has predicted a physician shortage of up to 122,000 by 2032. 

Now, thanks to COVID-19, the number of healthcare workers — particularly physicians — eyeing an early exit from the industry could cause an even greater supply-and-demand problem. 

A recent survey conducted by the Mayo Clinic found that one in five physicians surveyed has plans to leave the industry in the next two years. One in three doctors and others in healthcare plan to significantly reduce time at work in the next year. Contributing factors include burnout, workload, fear of infection and depression. 

Pandemic effects were not only felt by physicians: The U.S. Bureau of Labor Statistics reports as many as 400,000 healthcare workers have left their positions since early 2020. 

For endoscopy, where care ranges from preventative to potentially lifesaving, that means not only are there fewer providers to perform the procedures, but there is also less support staff to assist bedside and properly disinfect scopes. This not only impacts patient wait time, but patient safety. Flexible endoscopes require a complex cleaning process of more than 100 steps and have been traced back to more hospital-acquired infections than any other medical device. 

 

Disposing of inefficiencies 

Adopting single-use endoscopes was one way to address hospital staffing shortages during the height of the pandemic, and the practice could be just as helpful today. Studies show an adoption of single-use bronchoscopes for use on COVID-19-positive patients reduced the number of staff needed to perform procedures and the subsequent risk to reprocessing personnel.

Healthcare personnel involved with endoscopy use encompasses the physicians who use the instruments as well as clinical technicians, nurses, reprocessing transporters, surgical services technicians, reprocessing technicians — a wide swath of important roles illustrating how single-use can help solve a hospital-wide issue. 

A switch to single-use endoscopy during the pandemic helped showcase how single-use endoscopes help hospitals meet increased demand with less-than-ideal staffing. They are easy to set up and deploy and do not require reprocessing, creating a more efficient environment, both in inpatient and outpatient settings. 

With a growing portfolio of single-use endoscopes, device manufacturers such as Ambu are well positioned to provide hospital systems with the technology they need to tackle today’s labor challenges head on. Ambu is the world’s leading single-use endoscope provider and currently provides close to 2 million scopes worldwide every year, including duodenoscopes, gastroscopes, rhinolaryngoscopes, bronchoscopes, and cystoscopes.

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