Office Based Biopsy Clinic

Ben Whittaker
Ben Whittaker • 8 December 2023

SusQI project completed as part of the Cwm Taf Morgannwg University Health Board (CTM UHB) and Centre for Sustainable Healthcare Intensive Sustainable Innovation Group Scholar Programme. 

Team Members:

Mr S. Rao Pasunuru, Mr U. Chalishazar and Miss. A.Morris

Setting/Patient Group: ENT Department

Issue to be Addressed:

Operating theatres are high resource settings with a considerable carbon footprint. The development of lean pathways such as moving throat biopsies to a clinic setting under local anesthesia will reduce bed occupancy, reduce pressures on operating theatres and improve convenience for patients.


  • Design and implementation of a novel pathways enabling patients seen in outpatient clinic to be allocated for an office-based biopsy (micro-laryngoscopy and biopsy) clinic with same day discharge



  • Reduced waiting time for patients requiring biopsy
  • Reduced bed occupancy and better utilisation of theatre time
  • Better patient satisfaction


  • Reduced number of journeys for patient/relatives in novel pathway compared to conventional pathway resulting in avoided lose of wages, travel expenses and time required.


  • Estimated carbon savings of biopsy on novel pathway compared to conventional pathway of 154.15kgCO2e per biopsy (nearly halved)
  • Clinical waste was reduced by 93% in the novel pathway compared to conventional pathway


  • Estimated cost saving of ¬£547 per biopsy on novel pathways compared to conventional

Key Learning Point:

System change fueled by COVID-19 has resulted in significant social, financial, and environmental savings with positive outcomes for patients and staff alike.

Full case study report includes more information about measurement, results/impact, next steps and learning points.

Resource author(s)
Rao Pasunuru, S.
Resource publishing organisation(s) or journal
Centre for Sustainable Healthcare
Resource publication date
July 2023

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