This is part of a series of interviews being held with professionals who have deep expertise in the requirements and protocols around endoscope reprocessing in hospitals. The goal is to learn about and educate on existing and emerging best practices in endoscope reprocessing.
I had a chance to sit down with Jhmeid Billingslea, the Director of Surgical Support Services at Children’s Healthcare of Atlanta (CHOA). We walked through the set up and the endoscope reprocessing protocols across the multiple CHOA campuses that he oversees.
Jhmeid has over a decade of experience in surgical services at CHOA, and has been a subject matter expert for IAHCSMM. He started out as a military surgical tech and has also been a college professor in health sciences. His deep knowledge of CHOA’s surgical services and previous experience as a professor and subject matter expert make Mr. Billingslea uniquely qualified to give us useful insights into his scope operations.
Following are some highlights from our discussion:
How many scopes does your department manage the reprocessing of?
We manage 147 scopes across Children’s Atlanta. I know that number by heart because scope inventory is one of the biggest things that we’re trying to manage. We have such a large inventory that sometimes resources aren’t available when we need them. We’re trying to integrate all of the areas across our campuses, and so far we’ve standardized our cleaning processes across the organization.
What brand(s) of scopes do you use at your facility?
We mainly use Olympus, followed by Karl Storz, and a couple of Pentax and Fujis.
What EMR are you on?
We have Epic OpTime. And we use Provation Medical for GI. And they’re integrated.
How many AERs do you have?
We have 7 Medivators Advantage AERs spread across our facilities. We’re doing a construction project now and we’ll be bringing in another type of Medivators reprocessor.
Where are the scopes stored after reprocessing?
Scopes are dispensed out to the area where they’ll be used. The OR scopes are kept in house and there’s a separate special procedures area where the GI scopes go. The scopes for Anesthesia and others like ENT are distributed to where they’re used.
We actually are sterilizing about half of our scopes each time they’re reprocessed, and these ones we keep coiled in the container. The other half of our scopes hang freely in storage and we sterilize those every 3 months.
What is your scope hang-time/end-of-life limit?
We stick to a 7-day hang-time limit.
How do you track the scopes to make sure they don’t surpass the hang-time limit?
We have a color coding system that we monitor with visual inspection. We have a different color for each day of the week, so we know which scope needs to be pulled based on the tag color and the day of the week.
We’re looking forward to our instrument tracking system from SPM Microsystems being expanded to cover more of our scope information. Things like hang-time we’re planning to track through there.
How do you know when a scope is ready to be picked up after use?
The personnel in the room transports them to the dirty room downstairs, or to the endoscope reprocessing area. They’ll send us an alert when they’ve put them on the elevator down to SPD.
How do you track who is washing which scopes and make sure that all steps along the way are completed and documented?
The Medivators Advantage system stores that info for us. We don’t have an interface to monitor it, but we’re able to pull it out as needed.
How do you track which scopes were used on which patients?
With Epic and Provation being integrated, we have a good view into which scopes were used on which patients.
How do you track which employee took out which scope from clean storage?
Clinical staff is documenting who took the scopes out for the most part, but we don’t really have a way to track who is taking them out. At one of our campuses, we have a manual log that they use to log scopes in and out, but our other campuses don’t have a log. We’re actually trying to get rid of that log because the compliance rate with people filling it out is so low. You’re better off having no log than one that can’t be relied on.