CS CONNECTION
Looking ahead at endoscope reprocessing quality performance
The coming decade, initiated by a global pandemic, promises to bring considerable changes to the sterile processing profession and how the Sterile Processing & Distribution (SPD) department services its customers, the Operating Room (OR). For the third consecutive year, Healthcare
Purchasing News surveyed more than a dozen sterile processing subject matter experts on seven potential – but likely scenarios – that may direct and redirect how SPD navigates the 2020s. HPN asked the executives from device manufacturers and reprocessing product com- panies to rank the seven strategies (1 being the most important or influential; 7 being the least important or influential). To show the trends year over year, HPN
publishes the aggregate respondent data from 2019 and 2018 as well. One noteworthy result is that the top two
strategies this year represent a transposition of the same two last year. And while Big Brother continues to languish at the bottom, the Bullwhip curiously moves up two notches above major device shifts. 1. Thoroughly educating, training, vetting and certifying SPD staffers on proper and effective cleaning techniques 2020 average score: 2.43 2019 average score: 2.5 2018 average score: 1.5 2. Demanding, receiving and following vali- dated instructions for use (IFUs) 2020 average score: 2.64 2019 average score: 1.9 2018 average score: 2.5 3. Switching to endoscopes that contain dis- posable/single-use-only components that can be swapped out (if available) 2020 average score: 3.62 2019 average score: 4.1 2018 average score: n/a 4. Holding staffers accountable/responsible for endoscope cleaning “violations” 2020 average score: 4.23 2019 average score: 4.8 2018 average score: 2.8 5. Switching to disposable/single-use-only endoscopic devices for selected endo- scopic procedures only (e.g., bronchos- copy, etc.) 2020 average score: 4.46 2019 average score: 4.3 2018 average score: n/a 6. Switching to disposable/single-use-only endoscopic devices for all endoscopic procedures
2020 average score: 4.77 2019 average score: 6.1 2018 average score: 4.8 7. Comprehensively monitoring and tracking all steps in the process with sensors and video technology 2020 average score: 4.85 2019 average score: 4.7 2018 average score: 3.4 HPN invited respondents to explain their perspectives and even offer alternatives. Here’s what they shared. “Endoscopes are difficult to clean and
therefore to reprocess,” said Betty McGinty, RN, CGRN, CER, Fellow, Clinical Education Services, Boston Scientific Corp. “From an infection prevention standpoint, the single-use application for endoscopes and accessories is favorable to take the medical devices out of the equation for contributing to cross- contamination due to ineffective reprocessing. This can’t happen overnight, and therefore, prioritization for use for such high- risk pro- cedures as endoscopic retrograde cholangio- pancreatography and bronchoscopy, allows an opportunity to move in the direction of the single-use concept.” “A second factor to consider in the prioriti- zation involves consideration of the patient’s comorbidities,” McGinty continued. “A third factor to consider is for the high-risk proce- dures performed ‘after hours’ to eliminate the need for reprocessing by staff who may have less opportunity to prove competency. In the meantime, high-quality reprocessing requires education, competency, attention to reprocessing steps (validated by tracking), possession of and following of validated, ‘doable’ instructions for use, and certainly accountability by the staff performing the processes.” Seth Hendee, CRCST, CIS, CHL, CER, CSPDT, CFER, Clinical Education Coordinator, SPD, Healthmark Industries Co., encourages SPDs to apply a resource management mindset to the process. “Setting and adhering to a realistic expec- tation for the number of procedures that are able to be performed in a day/shift [is key, as well as] factoring in the number of endoscopes and the actual time it takes to follow all processing steps correctly,” he said.
What do you think about any of these find- ings and opinions? Drop us a line at editor@
hpnonline.com or share your opinions at HPN Online (
www.hpnonline.com).
30 November 2020 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
WILL surpass the use of fully reusable models.
Yes, SPD, there is a future Starting with observations from more of the fringe elements, none of the executives believe that healthcare providers will con- tinue using reusable models exclusively. But that doesn’t mean the sterile pro-
cessing function is doomed – at least for endoscopy. Why? Because reactions are mixed as to how much the use of dispos- able/single-use models or components will overtake the use of reusables. In fact, half the executive respondents feel hybrids are the answer while the other half supports disposable/single-use models. This translates into the notion that repro- cessing won’t be dead after all, but also that it has not quite reached the “Houston, we have a problem” stage either.
Make sway for the hybrids More than a third (35.7 percent) feel that hybrid models – reusable endoscopes that contain disposable/single-use components – will occupy a minority segment of the market.
Marcia Frieze, CEO, Case Medical, keeps her fingers on the pulse of the market, particularly among SPD departments, anticipating a reserved shift.
“Two factors limit the
broad adoption of par- tially or fully disposable endoscopes: Psychology and economics,” Frieze
Marcia Frieze
explained. “Endoscope manufacturers and others are in early stages of developing disposable components, and clinicians are even earlier in the awareness and accep- tance of these new options. Understand- ably, new product adoption can be slow in the perioperative sphere due to risk aversion. Moreover, in this case, clinicians weren’t seeking these changes; rather, they are being forced upon them by circum- stances and fallout from disease outbreaks tied to eible endoscopes.
But Frieze observes an inherent econom- ics issue lingers, particularly exacerbated by the pandemic.
“The economic challenge is twofold: Disposables and single-use devices are an added cost, and hospitals have been dealing with narrow margins for years, even before the disruption of the COVID-19 pandemic,” she continued. “For many decision makers, any program that adds cost (or uncertainty) will be put on the backburner considering the immediacy of managing through this public health emergency.”
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