Transitioning to Office-based Transperineal Prostate Biopsy-A Case Study From a Regional New Zealand Hospital in...

To explore the effects of the transition to office-based transperineal prostate biopsy (TPPB) on the interconnected domains of profit, planet, and people. Sustainability, encompassing environmental, social, and economic dimensions, is increasingly significant in health care. Urology, as a surgical specialty, presents unique opportunities to implement sustainable practices. This article outlines a case study detailing the transition of TPPB from the operating theater to an office-based setting.

This study utilized a multi-phase approach, integrating retrospective and prospective data analyses. Changes in clinical workflows, financial savings, environmental impacts, and accessibility to care were assessed. Life cycle analysis evaluated carbon emissions associated with TPPB, while clinical outcomes, including infection rates and procedural efficiency, were monitored. Patient satisfaction and equity in health care access were explored through geographic accessibility studies and procedural adaptations.

Transitioning TPPB to an office-based setting resulted in: 1. Profit: Annual cost reductions of $302,000 NZD, increased procedural capacity, and elimination of hospital admissions due to transrectal ultrasound-guided-related sepsis. 2. Planet: Reduction in greenhouse gas emissions to 70 kgCO2e per biopsy, with significant contributions from reusable equipment packs and virtual consultations. 3. People: Enhanced patient comfort through fewer biopsy cores, reduced health care worker burden, and improved access for Māori populations via proposed mobile biopsy units.

This case study underscores the potential for sustainable innovations in urology to achieve cost-effective, environmentally responsible, and socially equitable health care delivery. It serves as a model for integrating sustainability into clinical practice, reinforcing the need for data-driven decision-making and collaborative leadership in the medical field.