Hospitals that disinfect and reuse bronchoscopes pay anywhere from 21 percent to 155 percent more per instrument than if they had purchased a sterile, single-use bronchoscope, and that cost is driven up by a host of factors that impact the hospital personnel charged with reprocessing the instruments.

That’s according to a new study that shows a wide range in the time it takes to turn around a reprocessed bronchoscope: anywhere from 41 minutes to nearly two hours. Time is money, and hourly rates for reprocessing personnel varied substantially between the four sites—accredited hospitals diverse in size and location—included in the study.

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The distance between procedure rooms and reprocessing areas were among the factors that influenced the time needed to complete the reprocessing steps. Institutional policies and practices also affected efficiency, according to the study. Technicians at one site, for example, did not do visual inspections and also didn’t dry bronchoscopes thoroughly.

The study, “Managing Bronchoscope Quality and Cost: Results of a real-world study,” was conducted by Cori L. Ofstead, MSPH; Krystina M. Hopkins, MPH; John E. Eiland, RN, MS; Harry P. Wetzler, MD, MSPH. It focused on four accredited hospitals diverse in size and location.

The study builds on a related study last year, published in Chest Journal, that examined the effectiveness of the cleaning processes for reusable bronchoscopes.

Bronchoscopes, a type of endoscope, are delicate instruments that enable practitioners to see the airways to the lungs and perform interventions such as lung biopsies or removing pus and tumors. Reusable bronchoscopes also pose a high risk of cross-contamination. Sterile, single-use bronchoscopes can combat the spread of antibiotic-resistant bacteria.

The total reprocessing time at one of the hospitals was more than double the time at another site, but that wasn’t entirely due to an emphasis on quality. The study coordinator, rather, reported problems with water flow, which meant sinks filled very slowly and increased the time needed for leak tests and manual cleaning.

Ofstead and her team examined acquisition, maintenance and repair costs as well as expenses incurred for cleaning and other consumable reprocessing supplies. And those figures, according to the study, likely underestimate the total because costs associated with essential equipment such as leak testers, irrigation systems, automated endoscope reprocessors and drying cabinets were not included.