Author: Megan Pietura

The Weight of Standardization: The Goal, The Change and The Process

Posted on by Megan Pietura

Standardization. A word widely used in healthcare today to define the goal of consistent and reliable care across the healthcare industry. Having standardized processes, equipment and workflows can lead to greater efficiencies, fewer questions regarding procedures and can open up avenues for “cross-training” of staff to fill in for staffing variances across departments and system wide facilities.

Hospitals go through accreditation processes such as Joint Commission or Nursing Magnet designations to showcase the importance and accountability towards standardized, high-quality care. Sterile processing department’s across the United States reference standards and guidelines, such as ANSI/AAMI and AORN, or manufacturer instructions for use (IFUs) to ensure they are complying with current standard practices and processes to achieve the appropriate and safe outcomes our patients expect.

However, standardization hasn’t come without its fair share of scrutiny and concern including the debate that it can create transactional experiences, discourage autonomy in personalized care and A decontamination technician flushing a flexible endoscope with a syringepotentially lead to adverse outcomes as a result. (Sinsky, et al 2021) There are pitfalls and imperfections within any mode of practice, and humans are at risk of falling into a rhythmic, box checking mode. At the core, a strong standardization program is intended to “create efficiencies that generate the additional time needed for personalized care.” (Sinsky, et al 2021)

  • For example, flushing with syringes can be a standardized approach to manual cleaning. However, this practice has several variabilities that lead to inconsistent outcomes and approaches including: No user does it the same, and sometimes the same user can do it differently at the start of their day as opposed to the end of the day when fatigue sets in.
  • Syringes come in varying sizes
  • Both volume and pressure can’t be finely controlled by technicians, especially in a fast-paced environment

Determining what, how and when in standardization can be a tricky endeavor to navigate. A creative way to ensure that our standardization leads to greater efficiency and opens doors to more personalized approaches can be done by working your considerations backwards. Starting with what you want your team to achieve and tracking back to the place of improvement can help determine action items, and account for needed flexibility to ensure accurate and impactful quality of care.

 

The Goal

Goals are built based on several scenarios or situations. This measure for improvement will originate from things like new standards, identified gaps in practices, or new trends that prove the need for added or updated quality assurance measures.

ANSI/AAMI ST79: 4.3.1 addresses education and standardized work to protect reprocessing professionals from potential hazards, ensures the appropriate education and training are presented to each person, and sets the expectation for safe and appropriate medical device reprocessing.

“Education, training, and standardized work practices decrease the risk of operator error during reprocessing and help ensure that personnel are conversant with the latest data and techniques. Education and training are an important aspect of any program intended to protect employees from a potential safety hazard. Without it, the employee might not recognize unsafe conditions or work practices and might not know how, when, or why to employ protective measures. The health care organization’s policies and procedures are a necessary part of any education and training program, and all personnel should be familiar with and adhere to these policies and procedures. Documentation of education and training is required by accrediting agencies.”

The goal is the desired outcome, such as a determined metric (ie. X number of trays sterilized per day), percentage of accuracy (X% reduction in bioburden findings) or a process upgrade, such as a move from a manual process such as manual flushing, to an automated flushing device.

Setting goals without understanding the nuance of your teams, processes, volumes and current procedures can lead to slow implementation, poor buy-in or work arounds that can impact time and efficiency, at times making more work where the goal was to reduce it.

The Change

Once the goal is determined, it positions change leaders to understand the scope of impact by looking at the reprocessing cycle from start to finish to understand where and what parts of the process will change.

Implementing standardized practices often results in adjusted workflows beyond the single step or process point, or triggers a change in routines, sometimes in start or close-of day routines. For example, if you were to convert to an automated flushing or automated dosing system, it would lead to incremental testing to ensure functionality, which needs to be accounted for in the daily tasks and assignments.

Limiting the view of the goal into a singular process can lead to oversight of time allocation and necessary resources that are required properly integrate standardized processes, losing the opportunity to truly capitalize on its full benefits.

Considering the changes required and being upfront about the adjustments in responsibility are key objectives to address during initial considerations and matching the goal with the proposed standardized practice or product. When these objectives are not analyzed and reviewed against the larger picture of reprocessing as a whole, it can lead to work arounds or gaps either at the front and proceeding steps to follow, resulting in a loss of effectiveness.

The Process

Understanding the goal and the impact it has on the whole of a process from start to finish can pinpoint how to implement the proposed standardization and best prepare for the upcoming changes. This can include understanding learning curves, new resources that will be made available and understanding how it will change the steps in the process.

Processes can look different. For automated flushing, the steps go from individual, single port flushing, to sorting and hooking up multiple lumens and starting the flushing equipment for a pre-determined amount of time and fluid volume. This now changes what happens with the time that was once committed the syringing process.

  • What are some new ways to utilize the time originally spent flushing?
  • How does the daily maintenance impact the start of your mornings?
  • Is there a cost savings? If so, what other opportunities can now be considered with the budget adjustment?

These questions are not punitive, but an opportunity to consider the other side of efficiency which is the additional time and space granted to expand the benefits of standardization.

Standardization, when done correctly, can create autonomy and a personal touch that healthcare calls for where it is most needed. Standardizing work can set appropriate expectations and create opportunities to focus our time, development and energy into the nuanced tasks that require a personal touch and flexibility. Together standardization and personalized care can lead to a more robust quality management system within sterile processing and endoscope reprocessing departments, making processes more intentional and reliable.

Interested in other resources to help you improve your department? Check these out resources out!

 

Education:

The Cost of Cutting Corners Blog: Earn 0.5 Free CE

Luminosity Requirements in Instrument Reprocessing Blog: Earn 0.5 Free CE

Additional Resources:

Ergonomic Audit Checklist

Luminosity Compliance Checklist

References

Sinsky CA, Bavafa H, Roberts RG, Beasley JW. Standardization vs Customization: Finding the Right Balance. Ann Fam Med. 2021 Mar-Apr;19(2):171-177. doi: 10.1370/afm.2654. PMID: 33685879; PMCID: PMC7939702.ANSI/AAMI ST79: 2017

How to Mitigate Productivity Concerns Caused by Inefficient Manual Processes in Decontamination

Posted on by Megan Pietura

Decontamination is a vital and labor-intensive stage in sterile processing departments. While it serves as the first step toward sterilization and safe surgical outcomes, the high volume of tasks involved means that inefficiencies can significantly bog down productivity. Managers often pinpoint decontamination as the key area for productivity boosts, but how can they identify and implement effective solutions? 

In our previous blog, we discussed the productivity pitfalls posed by manual processes in decontamination, including manual cleaning, the manual handling of chemistries, and unassisted visual inspection. These processes contribute to significant productivity drains—slow speeds, inconsistent results, and human error. But what if there were ways to automate and optimize these areas to ensure greater efficiency, consistency, and, ultimately, better patient outcomes? 

1.Ergonomics

Enhance Technician Comfort with Height-Adjustable Sinks

Decontamination sinks that are not height-adjustable force technicians to work in uncomfortable postures, leading to strain and fatigue over long shifts. Height-adjustable sinks allow each technician to customize the sink height to their ergonomic needs, reducing bending and reaching that can cause discomfort or long-term injuries. 

By investing in adjustable sinks, sterile processing and gastroenterology departments can create a more comfortable work environment that enhances efficiency. When technicians and nurses are less fatigued, they can maintain focus and precision in cleaning, leading to better overall reprocessing outcomes. 

Reduce Strain with Wrist Rests

Long hours of scrubbing and handling of instruments in decontamination can place significant strain on technicians’ wrists, increasing the risk of repetitive motion injuries. Wrist rests provide ergonomic support, reducing pressure on the hands and wrists during extended cleaning sessions. 

Incorporating wrist rests at decontamination sinks promotes better posture, reduces fatigue, and helps prevent musculoskeletal disorders (MSDs). By prioritizing technician well-being, SPDs can maintain productivity while ensuring staff comfort and long-term health. 

 

2. Efficiency

Eliminate Syringe Flushing with Automated Flushing Devices

Automated flushing systems provide a solution to the slow, manual process of syringe flushing. By integrating an automated system, technicians ensure consistent and thorough flushing with minimal effort.  

These systems reduce the risk of human error, ensuring each instrument is cleaned to the same standard every time. The automation also speeds up the process, cutting down on the time spent flushing instruments and preventing the need for reprocessing due to inconsistencies in manual flushing. This leads to more efficient manual cleaning, freeing up technicians to focus on other tasks and saving money. 

 

Say Goodbye to Manual Chemical Handling: Automated Dosing Pumps 

Automated dosing pumps eliminate the need for manual measuring and mixing of cleaning chemicals, ensuring that decontamination sinks are consistently supplied with properly concentrated detergents and disinfectants. These systems accurately dispense the exact amount of cleaning solution needed for each task, preventing variations that can occur with manual mixing. 

 

By removing the risk of over- or under-concentrated solutions, automated dosing systems help maintain the effectiveness of cleaning agents while reducing chemical waste. This not only improves cleaning consistency but also enhances technician safety by minimizing direct handling of concentrated chemicals. When integrated into decontamination sinks, these systems streamline workflows, reduce errors, and ensure compliance with manufacturer Instructions for Use (IFUs) and industry standards—ultimately supporting a more efficient and effective cleaning process. 

 

3. Lighting

Enhance Inspections with Technology: Borescopes and Task Lights

Borescopes offer a magnified view of hard-to-reach areas in instruments, enabling technicians to spot debris and contaminants that would otherwise be missed with the naked eye. The high-resolution image provided by borescopes ensures that even the smallest particles are detected, enhancing the thoroughness of inspections and preventing missed contaminants that could lead to reprocessing. 

Implementing borescope inspections in decontamination rather than assembly provides a key advantage: identifying damage or residual debris before instruments progress further in reprocessing. If an instrument enters a washer with unnoticed damage or contamination, the entire cycle may be wasted—costing valuable time and resources.  

Additionally, many instrument manufacturers’ Instructions for Use (IFU) require visual inspection during decontamination. For example, some arthroscopy shaver IFUs specify that inspection must occur before further cleaning or sterilization. ANSI/AAMI ST91 also recommends that visual inspection and cleaning verification be completed before instruments move into an Automated Endoscope Reprocessor or sterilization. By integrating borescopes in decontamination, SPDs can align with IFU and industry guidelines while ensuring instruments are thoroughly inspected early in the process, ultimately preventing delays and improving overall efficiency. 

Additionally, task lighting designed specifically for inspection areas ensures optimal illumination, reducing shadows and improving visibility. With adjustable, bright lighting, technicians can more adequately see contaminants in every corner, making visual inspections more accurate and efficient. 

Maximize Visibility with Light Hood & In-Basin Lighting

Proper illumination in decontamination sinks is critical for ensuring thorough cleaning and inspection. Light hoods provide broad, overhead illumination, reducing shadows and glare in key work areas.  

In-basin lighting enhances visibility during critical decontamination tasks, such as leak testing for flexible endoscopes. Proper illumination within the basin allows technicians to clearly observe air bubbles that indicate leaks, ensuring accurate testing results. Without adequate lighting, small leaks may go unnoticed, potentially compromising patient safety and requiring costly repairs. By integrating in-basin lighting, SPD and GI can improve the precision of leak testing, reduce the risk of missed damage, and enhance overall instrument quality assurance. By incorporating both overhead and in-basin lighting, sterile processing and GI can create a more ergonomic, efficient workspace that supports thorough cleaning, reduces strain on technicians, and improves overall instrument quality before the next stage of reprocessing. 

 

Manual processes in decontamination create inefficiencies that slow down workflows and strain sterile processing teams. The key to overcoming these challenges may lie in technology. By implementing automated solutions for syringe flushing, chemical dispensing, and visual inspection, GI and SPD can eliminate common bottlenecks, reduce errors, and enhance overall efficiency. 

 These improvements not only help departments keep pace with rising reprocessing demands but also contribute to higher-quality outcomes and a safer, more ergonomic work environment. 

 

Investing in smarter, more efficient processes ensures that productivity concerns become a thing of the past. Ready to optimize your SPD?

Contact us today to explore solutions tailored to your team’s needs. 

 

Manual Processes Continue to Bog Down Productivity in Decontamination

Posted on by Megan Pietura

Productivity is a central measurement in sterile processing departments, particularly in decontamination. The potential for bottlenecks in processes and lost productivity is at its highest in decontamination due to the sheer quantity of tasks and manual labor involved. It’s no wonder why managers look to decontamination when it comes time to fuel productivity boosts. Identifying these opportunities, however, can be tough. That is, until you start looking at manual processes.

Manual processes have an inherent ability to bog down productivity due to their very nature: they’re physical labor intensive, done by a range of people with varying experience levels and wide open to potential human error and inconsistency. What manual processes should managers zero-in on when it comes to identifying potential productivity drainers?

 

Manual Rinsing & Flushing

Rinsing and flushing are key contributors to lost productivity in decontamination. In fact, a Process (previously Communique) analysis, A Glimpse at the True Cost of Reprocessing Endoscopes: Results of a Pilot Project, into endoscopy reprocessing found that the manual cleaning step takes 17.3 minutes1. One area where time is spent: syringe flushing. Syringe flushing leads to diminished productivity for a few reasons:

  1. Time: Syringe flushing is a slow, arduous process that lengthens the time necessary to achieve IFU compliance due to the multiple steps required and limited syringe volume capacity.
  2. Human error: Each technician is unlikely to execute syringe flushing the exact same way. This human error means that some teammates are bound to be less efficient at it than others.
  3. Ergonomics: Syringe flushing is a tiring process, and this is only amplified over the course of an entire shift. As the day goes on, technicians are likely to begin feeling the strain syringe flushing causes, which results in altered syringing methods that can lead to poor flushing performance, and an amplified impact of human error. Inability to achieve IFU compliance towards the end of the day could mean lumened instruments need to be reprocessed a second time later, effectively doubling the time it takes to adequately reprocess them.

 

Manual Measurement, Mixing, and Dispensing of Chemistries

Manually preparing enzymatic detergents and disinfectants for instrument decontamination is a time-consuming and error-prone process that can negatively impact both efficiency and cleaning efficacy. Sources of lost productivity related to these activities include:

  1. Inconsistent dilution ratios: Manually measuring and dispensing these chemicals often leads to over/under-concentrated solutions. This can negatively impact cleaning performance and ultimately the quality of outcomes.
  2. Lost time: Manually filling basins, measuring chemicals and mixing solutions before placing instruments in them present several steps’ worth of wasted time that a technician could be using to conduct other tasks.
  3. Wasted chemistries and restocking: Inaccurately mixed solutions can result in over-use of certain chemistries, not only driving up costs associated with them, but wasting technicians’ time leaving the sink, finding the chemistry, and replacing it. Over time, these actions can add up.
  4. Risk of chemical exposure: While more loosely tied to productivity, it is worth mentioning that the more a team is required to handle and mix chemicals, the more likely it becomes that they experience negative consequences as a result of it. These can include risk of skin exposure, inhalation, and spills, all of which can result in the temporary loss of teammates and potential impacts on productivity for the department.

Unassisted Visual Inspection

The human eye is a marvel, to be sure. But one deficiency it has is an inadequate ability to detect bioburden and other debris without assistance. Visual inspection is a key responsibility for sterile processing technicians before moving them out of decontamination for sterilization. Visual inspection without the assistance of magnification or enhanced illumination can lead to several productivity challenges:

  1. Incomplete detection: Many contaminants, such as dried blood, bone fragments and tissue are particularly difficult to identify under standard lighting conditions. Further, small cracks and crevices in instruments can harbor residue that the human will simply never be able to pinpoint on its own. If these are missed in decontamination, they will need to be sent back and effectively reprocessed twice.
  2. Technician fatigue: Conducting visual inspection without assistance of magnification or enhanced illumination puts a tremendous amount of not only physical strain on technicians’ eyes, but also cognitive strain on the mind from intense focus over long periods of time. Both forms of strain impact the quality of work and the efficiency of it. As these strains grow over the course of a shift, productivity will suffer.

 

Productivity is a measure that managers, directors, and other leadership positions look at to gauge departmental performance. Assessing manual processes that contribute to productivity metrics is a smart way to begin positively changing them.

 

Interested in learning about how to start booting productivity by tackling manual processes? Check out this blog post!

Sources

1 Boston Scientific. (n.d.). Sterilization resource handout. Retrieved [2.13.25], from https://www.bostonscientific.com/content/dam/bostonscientific/uro-wh/portfolio-group/LithoVue/pdfs/Sterilization-Resource-Handout.pdf

The Age of Quality Assurance: A Complete Guide to Quality Assurance in Endoscope Reprocessing

Posted on by Megan Pietura

Albert Einstein once famously said, “Without changing our patterns of thought, we will not be able to solve the problems that we created with our current patterns of thought.” This perspective is fitting for a scientist who revolutionized our understanding of physics and the very fabric of nature. The hallmark of successful scientists, theorists, and professionals across all fields is their unyielding curiosity and willingness to ask new questions. These inquiries are the driving force behind groundbreaking discoveries, innovative methodologies, and lasting advancements.

In the realm of instrument reprocessing, particularly with flexible endoscope reprocessing, there is a constant stream of new questions being posed. Recent discussions have highlighted the convergence of rising adverse events, a rapidly evolving gastroenterology landscape, and an impending surge in colonoscopy procedures. If we fail to adapt and rethink our current practices, we risk becoming entangled in a complex web of challenges.

 

The Important of Quality Assurance in Endoscope Reprocessing

This might be why the industry has embraced quality assurance in recent years. Its ability to ask questions and provide potential answers can help untangle this mess. Quality assurance is a formalized attitude and methodology to embrace safety, data, preventative activities, training, and a commitment to error-free reprocessing, and in endoscope reprocessing, takes on other unique characteristics.

Quality assurance is a patient safety matter, firstly. Any means to prevent patient harm is a binding law. Cori Ofstead and associates also estimated in a 2017 study, that the impact is a financial one, too, with estimates to reprocess a single endoscope from $114.07 to $280.71. Hands-on time further estimated over 76 minutes of a technician or nurses time. The risk to patient, cost and labor all depend on quality.

 

Major Areas of Quality Assurance in Endoscope Reprocessing

Pre-Cleaning

Pre-cleaning outcomes are the foundation to quality endoscope reprocessing outcomes. The Centers for Disease Control starts its Essential Steps for Flexible Endoscope Reprocessing at bedside, for its importance in preventing the formation of biofilm.

Some of the most important investments that improve pre-cleaning quality outcomes is training and measures of accountability. When nurses and technicians have a harmonious relationship, pre-cleaning is often done effectively and consistently, reducing the demand on manual cleaning. The stronger the foundation, the stronger the building.

Delays in the journey from pre-cleaning to manual cleaning also increase the risk of biofilm formation, lowering quality outcomes. Methods to ensure items move quickly from pre-cleaning to manual cleaning may include timers, trackers, and others means to ensure pre-cleaning happens within 60 minutes of the procedure. Tags and written reminders can also be a helpful, visual cue without compromising transport containers or bags.

 

Leak Testing

For endoscopes which require leak testing, this critical step ensures damage is caught before time is spent on further reprocessing, or further damage can be extended to the scope. ANSI/AAMI ST91:2021 offers a couple recommendations to ensure quality leak testing outcomes:

“Automated leak testers should be placed on a calibration schedule to verify the leak tester is producing the correct pressure. Manual handheld leak testers and leak tester tubing should be inspected for damage, leakage, and pressure output (kPa). Pressure verification should be performed for each type of leak tester in the facility each day that endoscopes are used; calibration ensures that an endoscope will be challenged with the proper pressure each time when being tested for leaks. Documentation of testing results should be recorded. The manufacturer’s written IFU for testing each type of leak tester (manual or mechanical) used in the facility should be followed to ensure they are properly functioning.” 7.4.1 Leak Testing, ANSI/AAMI ST91:2021

Leak testing can be complicated in areas with poor lighting, particularly during wet leak testing. Investing in underwater lighting can enhance the ability to see small damages to endoscopes, and pull scopes for repair early, before damage gets worse. Investing in basins the right size for endoscopes is also important; over-coiling can hide holes, and result in false passes.

ST91 also recommends manual dry leak testing for at least 30 seconds, and manual wet leak testing for 60 seconds. Rushing leak testing can result in lower quality outcomes.

Manual Cleaning

Manual cleaning should follow immediately after leak testing to further prevent biofilm formation, and the drying of soil.

Three C’s form the backbone of effective manual cleaning outcomes:

  1. Copious amounts of fluid
  2. Contact time & correct use of detergents
  3. Correct brushing technique, prioritizing single-use brushes, when possible

Endoscopy and sterile processing departments should consider investing in technologies, training, and improvements which focus on these 3 key areas. For example, investments in automated cleaning solutions which flush, leak test, or dispense detergent can be great for busy departments, so long as departments write in policies to verify equipment performance, and hence, quality outcomes.

Brushing with tools that are validated to provide high-quality outcomes is a great potential enhancement. Brush technology and design varies widely. Try sourcing brush technologies that have validated performance from independent sources, and which fit the endoscope inventory. Quality begins with preventing lapses, not finding them.

Other quality assurance measures include biochemical cleaning verification tests to ensure detergent is being dosed appropriately, with temperature gauges to ensure they operate within proper ranges.

 

Visual Inspection

In a 2024 Ofstead and Associates study, it was estimated that visual inspection was one driving reason for a facility to reduce repair costs from $1.2M per annum to $724k, and cut the average cost per repair in half. It’s one helpful argument to help departments prioritize spending on inspection technologies.

Borescopes and task lights both have a place here. ANSI/AAMI ST91 references the following regarding visual inspection:

“Flexible endoscopes, accessories, and associated equipment should be visually inspected for cleanliness, integrity, and function before use, during the procedure, after the procedure, after cleaning, and before disinfection or sterilization (AORN, 2018e [39]).” 7.8.2 Visual Inspection

“The internal channels of a flexible endoscope that are accessible can be inspected by a borescope or other appropriate inspection method.” – 7.8.3 Borescopic Inspection, ANSI/AAMI ST91:2021

Investing in borescope technology is just one means to ensure quality outcomes in endoscope reprocessing. While its not enough to determine soil levels, it can identify residual water and poor drying technique, brush fibers and failing brush quality, or damage, potentially resulting in negative patient outcomes.

PureClear™ Visualization Station

Determining where and how to inspect using borescope technology is also important. ST91 offers multiple recommendations for when

in the process borescopes can be helpful. Creating a clinical team of stakeholders to do a risk assessment can help make this decision clearer for your team. Regardless of where, investing in the power requirements and organizational tools to get borescope stations ready is key. Borescopes can either sit cluttered and messy in a corner, or be fully integrated into stations with other quality assurance tools such as ATP testing.

ANSI/AAMI further recommends testing duodenoscopes with a 10x magnifier. Elevator channels continue to present cleaning risks. Be prepared to address this recommendation with enhanced visualization technology.

 

Cleaning Verification Testing

With the 2021 update for ST91, a new category emerged; high-risk endoscopes:

“High-risk endoscopes…and/or those that are of complex design (e.g., duodenoscopes, linear ultrasound (EUS) endoscopes, bronchoscopes, endobronchial ultrasound (EBUS) endoscopes, ureteroscopes, cystoscopes and as determined by the facility) shall be monitored with cleaning verification tests after each cleaning. Manual cleaning of flexible endoscopes that are not determined to be high-risk should be verified using cleaning verification tests when new endoscopes are purchased and at established intervals (e.g., at a statistically significant frequency based on the number of procedures performed).” 7.8.4 Cleaning Verification, ANSI/AAMI ST91:2021

Visual inspection alone is not enough to ensure high-risk endoscopes have undergone quality cleaning practices. Organic soil and microbial contamination lead to biofilm formations on and within endoscopes. Regular use of technologies such as protein testing, adenosine triphosphate tests (ATP) and others help test that minimum benchmarks of contamination are controlled. They can also provide trending data over time, to show if cleaning outcomes are improving.

Departments also need to verify that testing equipment is working and effective. Having this step written in department SOP’s is critical.

High-level Disinfection / Sterilization

Whether liquid chemical high-level disinfection (HLD) or low-temperature sterilization practices are in effect, both require monitoring.  Have all valves and caps underwent consistent HLD processes? Is there a spill kit plan in case of accident? Is the process for using solution test strips or chemical monitoring systems well trained, effective, and accurate?

Drying

Endoscopes should never be stored wet. Biofilm and microorganisms thrive in dark, damp and undisturbed environments, leading to potential infection hazards. Ensuring pressure-related instrument air or HEPA-filtered air are used according to IFU is critical here. When storing, methods that circulate filtered air through channels are preferred.

 

Taking the Next Steps in Quality Assurance Improvements

There is no shortage of questions to ask when it comes to improving quality cleaning outcomes in endoscope reprocessing. Where to start? How much to invest? Who can I count on to believe in the changes I want to make?

Putting together a group of stakeholders who might be impacted by quality assurance programs is a great place to start. Identify needs, opportunities and the implications of certain QA program components.

Measure and assess data points to identify where in the endoscope reprocessing cycle QA improvements will have the biggest impact. Starting with the most impactful change can be powerful to earn additional resources for other QA initiatives. Starting small is another approach, particularly if departments are anxious about additional steps or new technologies.

Putting together means to measure the quality outcomes before and after QA initiates are implemented is also essential. Don’t enter the journey without the end destination in mind. Set goals with stakeholders and revisit them often to ensure the compass’ needle hasn’t moved.

 

The foundation of great answers lies in the power of asking great questions, and quality assurance programs provide a prime platform to do just that:

  • Where is this quality issue arising?
  • Could additional training in this area enhance cleaning outcomes?
  • How can quality assurance programs empower and support my team in achieving their goals?

There are numerous starting points for this journey, but the most crucial step is choosing to begin. Leverage available resources, consult with experts, engage stakeholders, and collaborate with peers to navigate this path to success. By fostering a culture of inquiry and continuous improvement, you’ll be well-equipped to elevate your practices and achieve outstanding results.

Looking to explore more topics related to endoscope reprocessing? Explore all our Reprocessing Reports related to GI, here!

Works Cited

  1. Essential Elements of a Reprocessing Program for Flexible Endoscopes – Recommendations of the Healthcare Infection Control Practices Advisory Committee
  2. A Glimpse at the True Cost of Reprocessing Endoscopes: Results of A Pilot Project
  3. ANSI/AAMI ST91:2021

Hidden Dangers and High Stakes: The Lurking Endoscopy Crisis

Posted on by Megan Pietura

“I went to get a routine colonoscopy and because of that I am going to be in turmoil mentally,” said one patient. “It’s sleepless nights, near panic attacks at times….” For healthcare administrators, this reads like a stake to the heart. Due to suspected lapses in endoscopy procedures at one Eastern U.S. facility, someone did find themselves facing these heartbreaking comments after routine colonoscopies went wrong.

There might be a few questions that come from reading reports like these:

  • “Could I have been involved in one of these events as a patient, provider, or as a loved one?”
  • “How many events aren’t being reported?”
  • “How many other people might have been affected?”
  • “What did we do wrong here?”
  • “What’s going to get this to change?”

Rising Adverse Events as Reported by the FDA

It’s shocking but true that adverse events within gastroenterology continue to be reported at all-time highs. The United States Food and Drug Administration considers an adverse event as any undesirable experience associated with the use of a medical product in a patient, or when there is concern about a product’s quality, authenticity, performance or safety.

A 2022 report released by Lawrence Muscarella, PhD and President of LFM Healthcare Solutions reported more than 10,000 adverse events related to contaminated flexible endoscopes between 2014 and 2021. As of Q4 2024, the FDA posted 8,903 adverse events in just three months, a 14% increase over the same time period from 2023 (you can find frequent updates from Cori Ofstead on quarterly findings like these in social posts, here).

The reason for each adverse event seems to be limitless. Reasons range from distal endcaps falling off in patients, balloon catheters being stuck inside biopsy channels, or clogged channels from insufficient reprocessing. Lapses often occur during manual processes, such as point-of-use cleaning, flushing, brushing, or visual inspection. Even the most well-trained reprocessing departments are likely to have lapses; tools can be insufficient, processes can be rushed, or nurses and technicians can get interrupted in their work. Regardless of the why, the trend in rising adverse reported events to the FDA is alarming.

The hardest part of this equation to define are the costs associated with adverse events. Adverse events are broad and cover a large array of issues, and studies to get firm financial data associated with these events are rare. As adverse events continue to climb, it’s likely that their financial impact will come into clearer focus as well.

 

Rising Demand – the Future of Colonoscopies

If adverse events are not addressed, the issue will grow. By evaluating colonoscopy procedures alone, the United States can expect to see growing surgical volume. It is estimated that roughly 15 million people receive a routine colonoscopy procedure each year. By the American Cancer Society’s estimate, over 1 in 3 adults over the age of 45 are not receiving regular colonoscopies. This indicates that nearly 30 million people are routinely skipping colonoscopy screening. Imagine the burden of an estimated 45 million annual colonoscopy procedures on the United States healthcare system!

The Weldon Cooper Center for Public Service, a part of the University of Virgina, published expected population projects for the United States through 2050. While the United States’ population growth rate is slowing, it is quickly aging. This can be expected to further add demand and strain on routine colonoscopies over the next 30 years. It is expected that by 2030, more than 20% of the population will be over the age of 65 and nearly half the United States’ population will be in their 40s or older.

Can the gastroenterology industry solve two problems at once: a rising trend of adverse, negative events, and an influx of demand on its hospitals and ambulatory surgery centers, all within the next 5 years?

US Historic Census Counts and Projections

Image credit belongs to the University of Virginia Weldon Cooper Center for Public Services, 2024. The direct use of this graph can be found, here. 

Shifting Sands – How Endoscope Reprocessing is Changing

Among rising adverse events and patient demand, the sand under many GI professionals’ feet is shifting. New endoscope technologies are popping up faster than can be adapted to. The discussion between reusable and single-use gets more complex during each round of discussion. Further, staffing shortages, exacerbated by COVID-19, continue to impact productivity.

According to the 2024 GI Reprocessing Landscape Report, over 28.42% of participants cited that the most important area to focus efforts on in 2024 was IFU compliance. Together with Training & Certification and Cleaning Verification, over 67% of reported responses indicated a focus on improving competencies with reprocessing, quality assurance, and efforts to overachieve IFU requirements were most important. When asked what the most important problem to solve was, Processes led responses with 19.88%, shortly followed by compliance at 19.30%. It’s clear these challenges led GI and sterile processing professionals to seek improved processes that provide guardrails and security around quality.

The endoscope reprocessing environment will continue to evolve in many exciting, positive ways. It’s fun to speculate on what’s on the horizon for gastroenterology, and some developments are sure to surprise! When participants were asked what they see when they look ahead, 33.29% in the 2024 survey cited compliance, guidelines, and IFU requirements to be one of the most challenging opportunities moving forward for the industry. With what the industry has reported, it’s easy to understand why this is top of mind.

 

Endoscope processing is at the heart of debate, conversation, and change. What’s most important to keep in mind is that endoscopy procedures generally result in positive outcomes and are a routine, safe practice that catch early signs of cancer. However, any lapse in patient safety requires thorough investigation; what can be done more effectively for a patient’s safety, should be.

Following adverse events in endoscope reprocessing is not pessimism, it is awareness. Identifying areas for improvement by seeing where lapses occur can help sterile processing and gastroenterology professionals take control over their own quality outcomes. Awareness is the start to identifying, and ultimately, making lasting change.

 

Looking for more information about endoscopy reprocessing outcomes? Download our free, GI Landscape Report, where hundreds of gastroenterology professionals share their insights from the floor of the patient room, and we turn them into actionable insights!

 

Works Cited

  1. Vanderbilt endoscopy patients at risk of contracting HIV or hepatitis after reported issue
  2. Product Problems | FDA
  3. https://www.ormanagement.net/Infection-Control/Article/09-22/Reports-of-Endoscope-Contamination-Rose-Significantly-Since-2014-New-Analysis-Says/68366
  4. https://www.linkedin.com/posts/activity-7282446227445559296-IyMC?utm_source=share&utm_medium=member_desktop
  5. How well do colonoscopies prevent colorectal cancer? What you need to know – Harvard Health
  6. Data and Progress – American Cancer Society National Colorectal Cancer Roundtable
  7. National 50-state population projections: 2030, 2040, 2050 | Cooper Center
  8. US hospitals pass on most of the costs of errors – PMC

Staffing Challenges: How to Build a Candidate Funnel for your Department

Posted on by Megan Pietura

In December 2024, Pure Processing’s Voice of the Customer Committee met to discuss a topic that’s never out of style in sterile processing: staffing and staffing challenges. Our VOC members discussed many facets of staffing and retention, from how to train new employees, to how to enhance culture and boost retention, and lots in-between. One topic caught the attention of every VOC member; something that a vast majority sterile processing department in the country would benefit from: creating a funnel of candidates to fill their open positions.

 

Creating Cohorts

The key to creating a constant funnel of candidates for sterile processing departments is to create cohorts; groups of people that will train and learn together. By creating cohorts, you can deliver uniform information and training to all of them at once, reducing cost and efforts associated with individual training.

The VOC members identified two primary ways to create a cohort.

1: Local schools

High schools are often looking for ways to get their students more experience and exposure to various professions. SPD Managers can reach out to counselors and career centers at local schools to identify when career events might be held. Managers can attend these events to begin recruiting students that might be interested in working in a hospital.

However, SPD Managers may not have the time, means, or authority to initiate a program like this in their own. Approaching the human resources department can begin opening doors and getting SPD Managers assistance in the creation of a program.

There are certainly other positions that need to be filled throughout the facility, so having HR help you approach school counselors and career centers with a facility-wide approach can help demonstrate the benefits to both the facility and the school much more clearly.

What do these high school student cohorts look like?

One VOC member partnered with a co-op option for seniors at their school. These co-ops allowed the students to attend classes in the morning and spend the afternoons working in an occupational setting. Students would spend about 20 hours per week working in the facility. Over the course of the semester, they would learn valuable skills and processes associated with SPD. If they enjoyed the work, many would end up increasing their hours over the summer following their senior year, setting them up for full-time employment down the road.

There are some things to consider, however. Another VOC member noted that there are certain OSHA guidelines that may restrict how and where students are able to work. It’s important to familiarize yourself with this information and ensure they’re doing work they’re legally able to. One VOC member expressed this thought regarding the limited scope of work students could do:

“Sure, maybe they can’t work in decontamination; they might be a runner, or work in prep & pack. The important thing is that they’re getting exposure to instruments, exposure to processes. Exposure to sterile processing.”

2: Building your own cohort

Other VOC members noted that you don’t need to partner with a high school in order to start building cohorts to create your candidate funnel. In fact, you don’t need to go further than your current facility! One VOC member currently operating an in-house cohort program explained his approach:

“ I always start in the facility. Valets, dietary, maintenance staff, doesn’t matter. If I see someone in the hospital hustling and doing their current job well, I walk right up to them and ask them if they’re interested in making a change.”

Another explained that they’re open to anyone, stating:

“Start training people from Jiffy Lube!”

It’s clear that these VOC members have confidence in their ability to mold people into excellent SPD candidates, but where does that confidence come from? Creating a great educational program for cohorts to participate in and “graduate” from. Here’s the general outline of one VOC member’s cohort training program:

  • 24 weeks total
  • 18 weeks with classes
    • Three days in class
    • Two days in clinicals in the area of the department they’re currently studying
  • Six weeks getting their hours to sit for the exam

Over the course of 24 weeks, this VOC member’s program can take someone that doesn’t have experience with sterile processing and get them through the CRCST handbook, well-versed in department processes, and the required of hours they need to sit for the CRCST exam.

After those 24 weeks, a new cohort begins the program.

 

Benefits of cohort-style recruiting

One VOC member made an interesting observation on sterile processing career trends:

“You’re not going to see this generation working 30 years in SPD anymore. You’re just not. Some will, but many will spend 4-6 years in SPD and then likely move on, either to another part of the hospital or into a different industry. That’s okay!”

He explained that the key is for sterile processing departments to evolve with the needs and trends of the people they’re trying to hire. That means adapting and finding new ways to bring them in.

Another member pointed out:

“Right now there are managers across the country that just want to hire someone and throw them in decon. That’s the current model, and that’s not working.”

It’s important to view new hires that lack sterile processing experience like students, rather than bodies contributing to productivity metrics. You may take a productivity hit on the front end, while spending the time getting cohorts of candidates off the ground, but putting this initial effort in helps avoid lost productivity associated with high turnover rates and distractions for experienced, high-performing team members.

 

Tips from the Voice of the Customer Committee:

  1. Work with school counselors and career centers
  2. Recruit from within your facility
  3. Be aware of OSHA guidelines associated with younger employees
  4. Get HR in the loop and advocating for you
  5. Demonstrate the organizational benefits of cohort programs to admin to get buy-in
  6. Treat cohorts as students, not productivity robots
  7. Have a clear, enticing career ladder
  8. Recognize that you’re going to lose great teammates, it’s important to be able to find another one.

While there are certainly other means of finding candidates, our VOC members swore by their cohort programs and the impact that they have. A well-oiled program can expect to produce 3-5 solid FTE candidates per rotation. Some cohort members will decide the work isn’t for them, and that’s okay! The members that decide to stick with it and go for a full time position in the department will be well-versed, well-trained, and ready to begin contributing.

Interested in other VOC content? Click here to dig into other insights from the VOC!

 

About: Voice of the Customer Committee

The Voice of the Customer Committee is a panel of healthcare and instrument reprocessing professionals who have graciously donated their time to share their expertise and guidance on current challenges faced by the instrument reprocessing community. Through sharing their insights, experiences, and best practices, we have been given the opportunity to share these findings with our readership. We’d like to thank our VOC members for their outstanding input and insights, as well as their time! Thank you for your continued partnership, and all you do.

Staffing Challenges: Best Practices for Getting New Teammates Up & Running

Posted on by Megan Pietura

In December 2024, Pure Processing’s Voice of the Customer Committee met to discuss a topic that’s never out of style in sterile processing:staffing & retention challenges. Jessica Hatch, Sterile Processing Manager at Confluence Health’s Central and Marus Campuses and VOC Member, agreed to extend the VOC conversation with us to dive deeper into effective ways to get new teammates off the ground and contributing to the department’s goals. Having onboarded eight new teammates over the last year, she has faced and overcome a number challenges regarding onboarding and training. She’s identified a number of best practices to help growing departments make the most of a new employee’s training.

Assessing New Teammates

Hatch explained that earlier in her career, it was customary to assess new hires with a survey about one month into their training. These assessments are essentially check-ins designed to gauge how people were feeling in their role and whether on pace with learning objectives.

When Hatch opted to move the first of these check-ins to one week into training rather than after 30 days, she discovered something surprising. New hires weren’t feeling confident in their learning objectives and needed more guidance in their initial first week of training. She explained:

“And then I started [an assessment] at the first week and the feedback that I got is they were massively overwhelmed.”

By checking in on new hires earlier in the training process, Hatch found that she could modify training programs and pacing to better meet their needs and offer clarity.

 

Existing Teammates Are Critical

Hatch also found that getting current teammates on board with training strategies is a critical component to their success. Your existing team

will likely play an important role in the training of new teammates, so ensuring they understand newly introduced training policies, pacing, and methods will help them assist and train new hires in a way that’s aligned with your goals.

Failing to fill them in or not getting their buy-in related to training practices can cause them to inadvertently undermine your training objectives for new teammates. They may teach them ‘old’ ways of doing things and potentially cause confusion as to how certain tasks need to be executed to ensure positive outcomes.

 

Structure Leads to Success

Structure is a key to success in most circumstances, and that is certainly the case in sterile processing departments. Creating a well-structured training program that clearly outlines weekly training objectives and how to complete them gives a new teammate a clear understanding of their manager’s expectations, as well as sets personal expectations and what they can anticipate working on and learning in a given week.

A well-structured training regimen also helps new teammates determine how their learning material relates to their key competencies, and how it will factor into their day-to-day work within the department.

Structure isn’t only critical in your training program. A clear structure within your department’s organizational hierarchy is also crucial. New hires will undoubtedly have many questions throughout the first few months. Knowing who they can go to for clarity and answers ensures that they overcome hurdles in an efficient, effective way. It can also keep you out of the weeds! When a manager is out of the office, knowing who to go to with questions helps a new teammate immensely.

 

Create Department Champions

Training within sterile processing departments covers a lot of different topics, tasks, methods, and information, often more than one person can adequately cover with a new hire while still doing their job effectively. Giving one teammate the job of training a new hire can lead to them losing effectiveness in their role and burning out trying to cover everything their teammate needs to know.

Hatch has overcome this challenge with an idea that came about in the December VOC call: creating department champions. As Hatch explained:

“I’ve been creating champions on specific topics by approaching my Tech 3’s and asking them to identify what topic they are most knowledgeable on and having them become the champion of that topic in the department.”

These are not champions in an arena; these are topical champions, people that are tasked with knowing all the ins and outs of specific tasks and processes within a department. Having dedicated teammates associated with specific aspects of a department allows a new hire to get in-depth, practical guidance from their teammates while maintaining the same level of enthusiasm and practical guidance throughout.

Having new hires learn from a variety of existing teammates also has the added benefit of introducing them to the rest of the team in an organic way, improving their integration into the team.

 

Communication is Key

Effective communication and the clarity it facilitates is key to a new hire’s success. Clarity through communication not only helps a new teammate understand what’s expected of them, but also what they can expect of their teammates and manager. Open lines of communication and openness to regular, candid exchanges between teammates and their managers help new hires overcome hurdles and challenges as they arise, rather than waiting until the ‘appropriate’ time, potentially wasting valuable training time.

Communication needs to go both ways, though. Hatch explained that it’s important for managers to be reflective and communicative about their shortcomings and acknowledge when they make mistakes. Demonstrating that it’s alright to make mistakes in your department, so long as you own them, encourages teammates to share when they’ve made mistakes, or ask for clarity before a mistake might be made.

 

Conclusion

When it comes to staffing, there are plenty of moving parts that add complexity and difficulty. Finding candidates is one challenge, but getting new hires off the ground and contributing to the success of your department is different challenge entirely.

Using the best practices identified by Hatch can help you streamline your onboarding and training processes, while simultaneously making those processes more effective for your team and continuing to refine them. The sooner teammates begin contributing to the department’s success, the better off the whole team is!

Interested in other VOC content? Click here to see all of our VOC blogs and content!

 

About: Voice of the Customer Committee

The Voice of the Customer Committee is a panel of healthcare and instrument reprocessing professionals who have graciously donated their time to share their expertise and guidance on current challenges faced by the instrument reprocessing community. Through sharing their insights, experiences, and best practices, we have been given the opportunity to share these findings with our readership. We’d like to thank our VOC members for their outstanding input and insights, as well as their time! Thank you for your continued partnership, and all you do.

Staffing Challenges: Four Tips on Improving Culture to Retain Great Teammates

Posted on by Megan Pietura

Debra McGinnis-Peterson

In December 2024, Pure Processing’s Voice of the Customer Committee met to discuss a topic that’s never out of style in sterile processing: staffing and staffing challenges. Debra McGinnis-Peterson, Sterile Processing Manager at Children’s Wisconsin, spent some additional time with Pure Processing following the VOC conversation to elaborate on her journey working to enhance culture and build morale to improve retention rates in her sterile processing department. On this journey, she learned some valuable lessons that can help other SPD managers embarking on a similar journey towards improvement.

 

Tip One: Be Reflective About Your Leadership Style

McGinnis-Peterson led with something she considered critically important to fostering a culture that retains great teams: a manager’s openness to self-reflection and introspection. She explained, “There have been times I’ve needed to think about and change my approach to leadership.”

Adjusting your leadership style can come in a variety of ways, a few expressed by McGinnis-Peterson included:

  • Develop your soft skills: This includes things like a manager’s adaptability, openness to new ideas, communication, etc. McGinnis-Peterson took advantage of various online courses to get insights on how further develop her own soft skills.
  • Assume positive intent: It can be easy for a manager to fall into the habit of thinking that certain actions, such as not following a specific process or SOP, are malicious or deliberate. McGinnis-Peterson explained the importance of always assuming your team has positive intent and tactfully exploring what the root cause of actions or mistakes might be.
  • Be persistent: Changing your approach to your leadership style is likely to feel a bit odd at first and it’s easy to fall back into your old ways. Being deliberate and persistent about the changes you make to your leadership style will help those changes become the norm, and something your teammates can come to expect and appreciate about you.

 

Tip Two: Find Ways to Show Gratitude

In sterile processing, there’s often something worth stressing over, whether it’s increased volume, a certain piece of equipment going down, or a teammate unexpectedly calling out for the day. This chaos and stress can create an environment solely focused on conquering the next task or problem, with the people involved being put on the backburner. McGinnis-Peterson put it succinctly:

“Everyone remembers the bad things. They rarely remember or acknowledge the good things.”

McGinnis-Peterson explained that going out of your way to demonstrate gratitude and appreciation for the work and efforts of your team is a key component to maintaining morale and fostering a culture that retains great employees. She found several ways the whole team can show appreciation, including a gratitude board, callouts at team huddles, in-the-moment comments while working, encouraging teammates to express appreciation to each other, as well as using Pure Processing’s Citations for Being Awesome as a fun way to acknowledge success of her team.

These small changes can have a considerable impact on your team and morale in your department, ultimately helping you retain great teammates.

 

Tip 3: Listen To Your Team

McGinnis-Peterson put an emphasis on a specific question she tries to ask often: “What can I do for you?”

Retaining a great team requires listening to them and understanding their needs. Managers need to make sure that they know what their team needs to be successful and deliver it for them. And they’re not all material; they include having a sense of belonging, understanding their role, feeling heard, a sense of team, etc.

A few questions to help managers gauge whether their team feels their needs are being met might include:

  • Do you feel like your opinion matters?
  • Do you have a sense of purpose in your role?
  • Do people acknowledge your good work?
  • Do you have the materials you need to do your job?
  • Do you know what’s expected of you in your role?
  • Do you feel like you have the opportunity to learn and grow?

Beyond questions about fulfillment in their role and the physical materials needed to do their job, it’s also important for managers to ask for input from their teams. This can include something unrelated to the work in the department, such as ways to improve the break room or lounge, or something directly related to SPD, such as what kind of training and education the team thinks would be beneficial.

Creating accessible ways to share basic department needs is also very helpful, McGinnis-Peterson explained. She put up two “wish list” whiteboards in her department; one in the break room, and one out in the department (what additional instruments are needed). These give her team the ability to share what they need easily, while also allowing her to keep a running list of what the department needs. She’s then able to prioritize and begin finding ways to fulfill the requests. These boards also provide a way for visitors to the department to get a brief look at all of the items required to keep the department operating smoothly.

 

Tip Four: Be Patient

Cultural and management style adjustments can provide long-term benefits, McGinnis-Peterson explained. To fully realize positive, sustained cultural change in a department, you need to keep at it. It took a little over a year and a half for her to see cultural changes she wanted to make in her department take hold and become habit. It took nearly three years to get the culture and morale of her department to the gold standard she was aiming to achieve. “It’s all about how much you put into it”, she explained.

There are some things that just take time to iron out on a journey to retool a departments culture; that there might be some staff members that aren’t interested in cultural changes and are inhibiting the team. It might also take a team some time to feel empowered enough to begin offering feedback and helping to build a new culture in your department. These hurdles take time but are worth it.

 

Conclusion

A great culture is a fundamental aspect of retaining a great team. While some aspects of cultural change can be difficult (and require a manager to be critical of themselves on occasion!), others can be very gratifying. Creating an atmosphere where your team proactively acknowledges wins and support each other through challenges brings benefits that a manager couldn’t achieve on their own. Further, tapping into your team’s industry knowledge and departmental needs can help you prepare them, and the department, for continued success and growth as your facility’s needs evolve.

You’ve spent the time finding and training great people, spending the time and effort to keep them is well worth it.

Interested in other VOC blogs and content? Click here to explore them!

 

About: Voice of the Customer Committee

The Voice of the Customer Committee is a panel of healthcare and instrument reprocessing professionals who have graciously donated their time to share their expertise and guidance on current challenges faced by the instrument reprocessing community. Through sharing their insights, experiences, and best practices, we have been given the opportunity to share these findings with our readership. We’d like to thank our VOC members for their outstanding input and insights, as well as their time! Thank you for your continued partnership, and all you do.

GI Volume Continues to Grow – Keeping Up Can Be Difficult

Posted on by Megan Pietura

Did you know that gastroenterologists perform approximately 15 million colonoscopies a year? Colonoscopies account for up to 24% of ASC volume each year.1

In a previous blog post, Navigating Rising Demand: GI’s Response to Rising Colon Cancer Screening & Reprocessing Volume, we learned that with the recommended age for colon screening going from 50 down to 45, there was a predicted colonoscopy volume increase of up to 56%. For GI reprocessing professionals, this number is no small consideration.

This is just one factor increasing GI case volumes, resulting in reprocessing challenges that can impact quality and throughput. Nurses, technicians, scheduling teams, doctors and more will all feel the strain of this increasing case volume, and the negative impacts when reprocessing outcomes struggle to keep up.

So, what aspects of our technician’s workdays can experience the impact of increasing volume?

 

Compliance & Cleaning Efficacy

67% of 2024 GI Landscape report participants indicated that their department’s focus that year needed to be rooted in patient safety, including factors like IFU compliance, training & education, cleaning verification, and manual cleaning processes.

Furthermore, Ofstead & Associated recently released the 2024 Q4 data on adverse events reported to the FDA related to flexible endoscopes, demonstrating a 14% increase in 2024 compared to 2023. The continued uptick of reported events has been attributed to improved transparency and heightened awareness around flexible endoscope reprocessing. Many of the events were attributed to poor cleaning outcomes and insufficient visual inspection; factors that can be impacted by increased volume if adequate resources, such as staff and time, aren’t available.

Visual inspection can also be the source of bottlenecking as volume increases. One or two borescopes may have been sufficient before, but an increase in volume might mean another borescope is required, or that an additional technician or nurse is needed to provide dedicated visual inspection. Without appropriate visual inspection and cleaning verification tools, cleaning inadequacies can slip through the cracks and go undetected until it negatively impacts outcomes. If a department is currently seeing negative outcomes, they will only increase as volume does.

 

Organization

Organization takes time, diligence and consistency to maintain, and as volume increases in departments already pressed for time, maintaining organization can start to feel untenable.

Disorganization can lead to lost or misplaced supplies, as well as multiple workflows crossing over one another. Some steps may be missed entirely due to their placement in a workflow. Lack of organization, especially on a process-level can lead to confusion, oversight, and mistakes.

Overcrowded workspaces, and the disorganization that can arise within them, can also become a source of lost time, as teams spend more time looking for missing supplies, back tracking processes and maneuvering around people and obstacles.

All of these organizational challenges become amplified as volume increases. A poorly organized workflow, process, or department will become artificially bottlenecked when it’s required to do more in one shift than before.

 

Time Management

From the 2024 GI Landscape Report, 47.03% of participants enjoyed the fast-paced nature of GI, which may signal that increased volume is a welcomed challenge. However, with the short duration of routine GI procedures relative to other ASC activities, GI volume is already consid

Of 2024 GI Survey participants enjoy the fast-paced environment of a GI department.

erably higher than that of other procedure types. Widening the purview of preventative care can add to an already fast-paced environment and, if not well planned, can lead to skipped reprocessing steps. Cutting corners to manage limited time can result in adverse outcomes.

Has there been a time when an in-service was cancelled for postponed due to procedural volumes? It’s a natural reaction to prioritize non-immediate activities and reduce task requirements for the day when workload starts to exceed what a team is capable of.

 

Gastroenterology procedures are continuing to grow in volume across the United States with good reason: many GI procedures, such as colonoscopies, provide life-saving identification of cancers and other diseases earlier than ever before, helping patients and the doctors start the fight against them.

This increase in volume does have a cost, however. GI reprocessing departments, and the nurses and technicians working within them, may not have the capacity to keep up with growing volume while maintaining positive outcomes. Time management, organization, and compliance can all take a hit if departments aren’t prepared for increased volume as their healthcare facility begins scheduling more gastroenterology procedures.


 

Interested in exploring what GI nurses and technicians from around the country are experiencing?

Download the 2024 GI Reprocessing Landscape Report today!

 

Resources:

2024 GI Landscape Report

https://www.linkedin.com/posts/ofstead-%26-associates-inc%2E_here-are-the-q4-numbers-for-2024-fda-posted-activity-7282447741207621632-hG8h?utm_source=share&utm_medium=member_desktop

1 https://www.aorn.org/outpatient-surgery/article/running-a-high-volume-gi-center