Reusable Flexible Bronchoscope Setup and Reprocessing: A Multicenter Prospective Study

OBJECTIVES: Identifying resource constraints and process bottlenecks has become more important than ever for healthcare facilities. Despite reusable flexible bronchoscopes (RFB) having been in use for over fifty years, limited research currently exists on the time required to properly setup, remove and reprocess them. The purpose of this study was to measure the active time required to properly set up and reprocess RFBs.

METHODS: Fourteen bronchoscopic procedures utilizing 21 RFBs were followed from setup through reprocessing at three university hospitals in the United States. Time increments were captured for each stage of bronchoscope preparation and reprocessing. Delays, when applicable, were also recorded. The actual hangtime in a drying cabinet was not captured.

RESULTS: The average active time to set up and reprocess RFBs, not including procedure time, time in a drying cabinet, or delays was found to be 48’56”. The following are the average times for each time increment captured: preparation = 2’07”, precleaning = 2’31”, transport to reprocessing = 1’18”, leak testing = 3’12”, manual cleaning = 10’27”, microbial testing = 1’27”, transport to HLD = 1’48”, AER runtime = 27’28”, removal from AER = 1’05”, and endoscope wipe down = 1’19”. The average time for delays sustained throughout the process was 23’56”.

CONCLUSIONS: The average active time to set up and reprocess a RFB was 48’56”. This would be 58’56” with the recommended 10 minutes of forced air drying. The total reprocessing time may be as high as 82’52” when considering both delays and forced air drying, which is consistent with the 76 minutes cited in literature. Further comparative studies are needed to better understand whether other technologies, such as single-use bronchoscopes, can improve efficiency in large volume procedure suites.