JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 27

Abstracts

P2-9: Table 1. (Continued)
Clinical Outcome
Patient satisfaction

Discharged
68.5%
Very Happy

Re-book VC
16.1%
Happy

Costs

68.3%
VC

22.2%
Face-to-face clinic
opportunity cost
£27 403
Avoided CF
(mtCO2e)

Environment

£8250
Avoided Travel
Distance
(miles)
4623

0.35 - 1.45

P2-10 Cost benefit analysis of a disposable
flexible cystoscope for ureteric stent removal
Donato P1, Honore M1, Rukin N1, Bowes W1,
Pokorny M1
1Redcliffe Hospital, Queensland, Australia

Introduction: Ureteric stent removal is a common procedure, requiring endoscopy theatre time, a reusable
flexible cystoscope and stent grasper. We evaluate the
costs and benefits of Isiris™ (Coloplast, Denmark), a
mobile, single use flexible cystoscope with a built in stent
grasper.
Methods: A prospectively collected database was
reviewed to define procedural outcomes for Isiris™ ureteric stent removal. Variables assessed included stent
duration and location of removal. A cost assessment was
performed evaluating the impact on costs, funding and
facility utilization.
Results: 93 procedures were performed using Isiris™
between April and September 2017. The median (interquartile range) and mean time of delay was 0 (0-2) and 2
days. The procedures were performed in clinic (81.7%),
emergency (2.2%), ward (6.5%), day procedure unit (3.2%)
and the endoscopy suite (6.5%). 83 elective cystoscopy
appointments were made available as a result of implementation. The hospital's remuneration for stent removal
is £875, with disposable costs of £230 per case, resulting
in a surplus £59,985 for 93 procedures. Over the previous
12 months, scope repairs/replacement cost on average
£2850 per month. In the six months following implementation of Isiris™, only one scope was damaged (£3220),
resulting in a surplus of £13,880 on repairs/replacements.
Isiris™ implementation resulted in a net financial benefit
of £73,865.
Conclusions: Isiris™ flexible stent removal offers our
patients a rapid stent removal service, with low rates of
removal delay. Savings have been made in scope repair
costs, sterilisation and scope maintenance, as well as optimisation of theatre and procedure room space.

Face-to-face clinic
13%
Neither happy of
unhappy
6.7%
Cost savings
£19,153
Projected 12-month
avoided CF
(mtCO2e)
1.05 - 4.35

MDT discussion
2.4%
Unhappy
1.1%
Projected 12-month
cost saving
£57,459

Very unhappy
1.7%

P2-11 A one-stop prostate cancer diagnostic
clinic incorporating same-day multiparametric
MRI and prostate biopsies; assessment of
sustainability over a one-year period
Reid J1, McCarthy F1, Goode A1, Marcus A1, Train M1,
Grant L1, Volanis D1, Smith G1, Singh P1, Roy A1
1The Royal Free Hospital, London, United Kingdom

Introduction: Incorporating pre-biopsy multi-parametric MRI (mpMRI) to prostate cancer diagnostics may
impact 31/62 day cancer target compliance. We introduced a same day service with clinical assessment, mpMRI
and appropriate prostate biopsy. Initial results were positive, reducing time to diagnosis from 28 to 16 days; we aim
to review whether these effects are sustainable.
Methods: We retrospectively reviewed all referrals to the
prostate cancer diagnostic clinic from a period after implementation of the new service (June-November 2016) and
after 1 year (June-November 2017). Clinical and MDT outcomes were used to establish; the proportion of patients
undergoing same day mpMRI, subsequent biopsy (same day or
delayed due to patient choice or template biopsy), and cancer
diagnosis in both cohorts.The time from referral to diagnosis
and proportion of patients referred for surgical management
before day 38 of the 62 day pathway was also compared.
Results: Clinic attendance increased from 143 to 241
patients over the time intervals.The proportion of patients
undergoing same day MRI was similar (89% vs 80%) though
all scans were reported and reviewed on the same day in
the latter cohort.The proportion of patients biopsied was
unchanged (37% vs 36%) but more patients were discharged/started PSA surveillance in the second cohort
(28% vs 57%). The time to diagnosis was similar but the
proportion of patients referred for surgery before day 38
was higher in second group (70% vs 93%).
Conclusion: The same day prostate diagnostic service
has improved 31/62 day target compliance. This effect is
sustainable and continues to improve despite an increase
in patient volume.

Table of Contents for the Digital Edition of JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018