Becker's ASC Review

8 EXECUTIVE BRIEFING EXECUTIVE BRIEFING SPONSORED BY Reducing human error in endoscope reprocessing: The crucial role of innovation as GI procedures shift to ASCs A dvances in minimally invasive surgery have enabled patients to visit outpatient gastrointestinal facilities for procedures rather than hospital operating rooms. Infection prevention is a top priority for ASC leaders, and that focus extends to reprocessing the endoscopes used in many GI procedures. Becker's Hospital Review recently spoke with three experts from Olympus about endoscope reprocessing and how Olympus® technology and training is focused on improving patient safety: • Melinda Benedict, Director of Infection Prevention and Control • Jeff Daniels, Director, Marketing of Infection Prevention Solutions • Carolyn Klimas, Executive Director, Marketing of Infection Prevention Solutions and Strategic Marketing Endoscope reprocessing should eliminate cross-contamination — if each step is performed correctly. Endoscope reprocessing requires multiple steps. From an infection prevention perspective, every step is important for different reasons. For patient safety, the steps of each reprocessing stage must be performed consistently and correctly every time. The pre-cleaning step occurs immediately after a procedure. This removes any significant bioburden, which could dry on the instrument and make subsequent steps less efficient. To detect endoscope damage, which can affect patient safety and scope reprocessing, leak testing must be performed as a next step. Traditionally, leak testing is conducted by pressurizing the scope, placing it in water and looking for bubbles that emerge from the endoscope. The presence of bubbles indicates a breach in the watertightness of the scope, which is often caused by physical damage to the scope itself. "Sometimes, small punctures can be very hard to see," Ms. Benedict said. "Proper leak testing requires sufficient time and a careful eye, and there's room for human error." After leak testing comes manual cleaning, during which technicians use friction to brush the scope's channels. "A lot of the literature suggests that this is one of the most important parts of endoscope reprocessing," Ms. Klimas said. Once manual cleaning of a scope is complete, it can be moved into the high-level disinfection or sterilization step. This process inactivates remaining microorganisms and renders reusable devices safe for use with the next patient. The value of drying and storage can't be overlooked. Literature and peer-reviewed articles published in recent years have underscored the importance of drying flexible endoscopes inside and out before putting them into storage. "A lot of evidence suggests the best practice is to use drying cabinets for storage," Ms. Benedict said. "If an organization doesn't have those, it's a good idea to use a cabinet that circulates HEPA- filtered air around the scopes to maintain their cleanliness." Automated endoscope reprocessing reduces the risk of human error. A common complaint we hear from ASCs and Hospitals is regarding staff turnover. Endoscope reprocessing is often considered an entry-level job and turnover among technicians tends to be high. In addition, endoscope reprocessing has multiple steps, and many people may be involved in the cleaning and disinfection process. "When you combine a high-turnover entry-level job with a process that includes manual steps, you need to remove as many human factors from the process as possible," Ms. Klimas said. "Olympus is focused on automating the maximum amount of scope reprocessing steps and training technicians, so each step is repeatable." Healthcare organizations strive to follow scope reprocessing steps consistently. They also recognize this work demands a lot from employees, as the various processes require them to remember many things. "At larger sites, there are new technicians in training most of the time," Ms. Benedict said. "Organizations are looking for anything they can do to make the new hires' learning experience easier and faster, while still being robust in order to reduce the chance of error." At the core of Olympus' design philosophy is removing human factors and introducing automation that enables machines to do the work. "This allows for better repeatability and consistency in endoscope reprocessing, while allowing technicians to focus more on patient care," Ms. Klimas said. Olympus incorporates smart technology to improve patient safety + operational efficiencies. Olympus is continually listening to customer feedback, while staying abreast of industry trends and best practices identified by professional societies. This information influences the company's approach to designing scope reprocessing equipment. 2

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