Optimizing Endoscope Reprocessing Resources Via Process Flow Queuing Analysis

Abstract

The Massachusetts General Hospital (MGH) is merging its older endoscope processing facilities into a single new facility that will enable high-level disinfection of endoscopes for both the ORs and Endoscopy Suite, leveraging economies of scale for improved patient care and optimal use of resources. Finalized resource planning was necessary for the merging of facilities to optimize staffing and make final equipment selections to support the nearly 33,000 annual endoscopy cases. To accomplish this, we employed operations management methodologies, analyzing the physical process flow of scopes throughout the existing Endoscopy Suite and ORs and mapping the future state capacity of the new reprocessing facility. Further, our analysis required the incorporation of historical case and reprocessing volumes in a multi-server queuing model to identify any potential wait times as a result of the new reprocessing cycle. We also performed sensitivity analysis to understand the impact of future case volume growth. We found that our future-state reprocessing facility, given planned capital expenditures for automated endoscope reprocessors (AERs) and pre-processing sinks, could easily accommodate current scope volume well within the necessary pre-cleaning-to-sink reprocessing time limit recommended by manufacturers. Further, in its current planned state, our model suggested that the future endoscope reprocessing suite at MGH could support an increase in volume of at least 90% over the next several years. Our work suggests that with simple mathematical analysis of historic case data, significant changes to a complex perioperative environment can be made with ease while keeping patient safety as the top priority.

Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5‐year experience in an endoscopy center

“…A wide variety of devices continually require reprocessing in the endoscopy unit, and technicians need to identify each type, brand, and model of endoscope and apply appropriate reprocessing procedure. Furthermore, complete reprocessing of each endoscope takes up to 40 minutes, 33 and the technician may speed up the process due to high‐volume loads, which may lead to an increased reprocessing error 26,34 . Memory violation due to too many reprocessing steps, a lack of real‐time feedback, and visibility violation were the most causes of human errors during endoscopy reprocessing 32,35,36 .…”

Monthly endoscopy surveillance culture facilitates detection of breaches in the scope reprocessing procedure: 5 year-experience in an endoscopy center

“…A wide variety of devices continually require reprocessing in the endoscopy unit, and technicians need to identify each type, brand, and model of endoscope and apply appropriate reprocessing procedure. Furthermore, complete reprocessing of each endoscope takes up to 40 min [33], and the technician may speed up the process due to high-volume loads, which may lead to an increased reprocessing error [26,34]. Memory violation due to too many reprocessing steps, a lack of real-time feedback, and visibility violation were the most causes of human errors during endoscopy reprocessing [32,35,36].…”