CS CONNECTION
cent in the next 10 years. Historically, the reasons reusable products have converted to disposable are generally the same – lost clinician time, high costs of repair and processing, risk of disease transfer and degrading performance over time. Once a single-use option becomes available that can provide the same performance at a low enough cost, the marketplace conversion is typically 100 percent.” Cripe cites as examples single-use shaver blades in arthroscopy, single-use pressure transducers in cardiac medicine and even syringes, depending on how far back one traces. “The costs associated with repair, processing, sterilization and OR down-
time are some of the key drivers to the rigid endoscopy conversion as well as the performance degradation over time, which is the direct result of processing and steril- ization,” he added.
For Bryan Lord, CEO, Pristine Surgical, the panoramic view forward is quite dis- tinctive.
“In the near term, we see synergies and complemen- tariness between reusable and single-use devices,” Lord noted. “But in the medium and longer term, we believe the market will
Advance SPD to include higher-paid specialist teams
Amid the developing and growing debate about the adoption and implementation of disposable/single-use endoscopes – and just how pervasive the transformation needs to be, Gregg Agoston believes he has a more fundamental solution that must be imple- mented first. Agoston, who serves as Vice President,
Business Development, SPD Transformation Services, SpecialtyCare, argues that Sterile Processing & Distribution (SPD) professionals haven’t progressed enough from the prover- bial Stone – or perhaps Stainless Steel – Age of the 1940s in the context of 21st
century
technology and related techniques. “The bottom line is that the 1940s model
for SPD does not work in today’s advanced surgery environment,” Agoston argued. “The model for SPD must be upgraded to allow for highly trained specialists to reprocess complex instruments. Nurses and surgeons specialize in one or two service lines, [but] SPD must be the master of all. Is this a realistic expectation without some form of specialization? Consider orthopedic instruments used for arthroplasty. The majority of these of these instruments are complex. These instruments can be processed effectively primarily because the manufacturer of the instruments/implants provides their representatives who inspect and assemble the instruments prior to the SPD staff wrapping and sterilizing them. If the representatives were not providing these services, there would be tenfold times the errors. “This model of having a highly trained
technician (vendor rep) perform the critical functions in conjunction with less skilled staff who clean and sterilize the set, works,” he continued. “Companies such as ours offer Specialists for Minimally Invasive Surgery, Orthopedics and flexible endoscopes. Spe- cialization works because of the laser focus
of the Specialist on the assigned complex instruments. Removing the responsibility for complex instruments makes it easier for the hospital to hire and train technicians for the non-complex instruments, effectively making them non-complex instrument specialists.” Agoston scoffs at hospital claims that it cannot afford specialization in SPD. “They do not realize that they are paying a
lot more to staff the department than they re- alize,” he indicated. “The costs associated with high staff turnover, training, errors, delays, disposable instruments, repairs/replacements, surgeon and staff frustration and the potential for [surgical site infections] all need to be calculated. Single-use or limited-use flexible endoscopes (disposables) will not solve the intrinsic problem of non-qualified technicians reprocessing complex instruments. Complex instruments require a higher level of skills for the technician to be successful.” Agoston swipes at the compensation levels
offered to SPD management and staff as not reflecting the complexities and intensities of the job.
“Most SPDs experience high levels of turn-
over (20 percent-plus) due to low pay and the demanding work,” he observed. “Typical starting pay for a non-certified SPD technician is around $12 per hour. Most technicians max out at around $22 per hour. We find that most SPD departments average between 30 percent to 50 percent of their staff having less than one year of experience. This revolving door for staff and management exacerbates the issues. The symptoms of a poor preform- ing SPD are OR delays, missing/broken/con- taminated instruments, demand for single use instruments, high replacement/repair costs, surgeon/nursing frustration, high turnover/ vacant positions/agency staffing, etc. These symptoms result in real cost to the hospital.”
40 November 2020 • HEALTHCARE PURCHASING NEWS •
hpnonline.com Bryan Lord consistently migrate fully to single-use
devices. hen you can combine high-defi- nition visualization without the headaches, expense or risk of reusable endoscopic platforms, once you eperience the benefits, there’s really no reason to go back. Is any- one today begging to go back to 3mm film cameras when we have our high-quality iPhone cameras in our pocket?” ord etols additional benefits single-use models can bring. “Complicated vendor contracts put the risk of obsolescence on the customer,” he indicated. “Pristine urgicals high-definition digital platform is scalable and extendable, eliminating the risk of obsolescence – and the software and hardware can be seamlessly upgraded without further capital expenditure.” Alison Sonstelie, CHL, CRCST, oneSOURCE consultant and Sterile Pro cessing Coordinator at Sanford Health, Fargo, ND, advocates complete conversion for several reasons.
Alison “First, as disposable Sonstelie
products continue to be developed, the cost will become more competitive,” she surmised. “This will impact the price bar- rier that many facilities have and make the product more appealing. Another issue with disposables is picture quality. I think disposable products will continue to evolve and have better picture quality, or have a range of picture quality options with different price points. Another issue to be considered with any disposable item is the environmental impact. Many companies offer recycling programs for various products. If this is feasible with disposable scopes, it would be an enticing option to reduce the environmental impact and decrease prices.”
Sonstelie acknowledges that hybrid mod- els, equipped with disposable components for critical areas of the endoscope, such as distal tips and elevator mechanisms, may offer an alternative to continue operating in the current state. ut she classifies it as more of a transitional role.
“There are too many infections and risks
to patient safety with some current reusable models,” she insisted. “Additionally, we know that some scopes cannot be cleaned effectively, even when following the IFU. If we convert these critical components to disposables, there are still parts of the scope that remain difficult to clean and inspect. For example, the channels can be damaged and harbor bioburden, creating a patient safety risk. I think having disposable components for the most critical areas of the endoscope is only a partial or temporary solution.” HPN
Page 42
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66
