Establishment of a IP unit under the publicprivate partnership

ABSTRACT

Introduction: Development of a new interventional bronchoscopy (IP) unit is a challenge due to requirement of equipment and skilled staff. Organising this in a public-private model was not well explored. Methods: Our IP unit at Northern Beaches Hospital (NBH) was established in August 2020. This audit was from August 2020 to Sept 2021. All equipment required were obtained through research funding. The number of procedures, types and complications analysed. The staff training sessions and ongoing training noted. Results: During the 12-month period 129 flexible bronchoscopies, 77 Linear-Endobronchial Ultrasound Guided Biopsies (EBUS), 30 Radial-EBUS, 10 cryo-biopsy for lung nodules, 10 rigid-bronchoscopies, 7 de-bulking and two tracheal dilatations and one stent placements were performed. There was one unplanned admission for hypoxia and one patient developed a vocal cord polyp following a Radial/ cryo-rigid procedure. No pneumothorax or significant bleeding. Staff had staged introduction to multiple procedures and ongoing training during sessions. One nurse specialist and one interventional bronchoscopist with IP fellowship training conducted the sessions. With 12-month data it was easy to convince management of the workload and revenue, enabling purchase of a full fleet of two EBUS scopes, EMU 2 processor, Radial-EBUS probe driver, one ultra-thin scope, Cryobiopsy machine and Rigid equipment. Nursing staff turnover was high and required multiple training sessions. COVID-19 resulted in 3-month closure. Conclusion: The new IP unit at NBH was accomplished with full fleet of equipment including rigid-cryo capability in a short time with reasonable case numbers during COVID-19 lockdown. Being a private hospital, demonstrating revenue with grant funded equipment resulted in funding approval. Having a partnership enabled both public an private list to be combined to maximise usage of equipment. Staff turnover was high and needed constant education.