Improving access to surgical care through a high-volume, OR-based hysteroscopy program: A transitional model towards...

Outpatient hysteroscopy offers a potential solution to improve access to gynecological surgical care; however, its widespread adoption remains limited in Canada. This quality improvement study aims to assess safety and efficiency outcomes of a dedicated high-volume OR-based transitional hysteroscopy program.

A retrospective observational study of patients who underwent elective hysteroscopy at a single tertiary care centre in Toronto, Canada, between April 3, 2023 and May 9, 2024 was performed. The pre-implementation group (n = 251) comprised patients who underwent hysteroscopy in the 6 months prior to the introduction of a monthly high-volume OR-based hysteroscopy program. The post-implementation group (n = 70) included those who underwent surgery in the 9 months following the program's introduction.

Compared to the pre-implementation group, the post-implementation group demonstrated significant reductions in median total OR time (52 [42 - 65] vs. 36 [31 - 39.75] minutes, P < 0.01), procedure length (19 [14 - 29] vs. 14 [10.25 - 18.75] minutes, P < 0.01), and recovery time (136 [112.5 - 172.5] vs. 114 [99.25 - 137.75] minutes, P < 0.01). Surgical wait times did not differ significantly between groups (95 [50 - 182.5] vs. 92 [54.25 - 124.75] days, P = 0.30). There was no statistically significant difference in complication rates.

Implementation of a high-volume, OR-based hysteroscopy program improved procedural efficiency without increasing complication or readmission rates. This model represents a feasible transitional approach for institutions aiming to expand toward a fully outpatient hysteroscopy service while maintaining patient safety and optimizing existing OR resources.