The beginning of the end or the end of the beginning…

By Steve MacArthur, Hospital Safety Consultant

As we slide from the 8th month to the 9th, I’m hoping that you have/had the opportunity to take some time over the Labor Day weekend for some rest and relaxation. While it is certain that exhaustion is almost the baseline of the moment when it comes to healthcare, I am hopeful that we’re in the final stages of the constant barrage of external factors (there will be a barrage, no doubt, but I am hoping for a reduction to something less than constant), but as I’ve been reading in a lot of different places, hope is not a plan. I guess we’ll just have to keep following this story.

So on to other things…

In looking through the metaphorical mailbag (AKA the draft folder in my email), I found this news item that had been languishing since March: . I guess in the world of competing priorities, etc., this one seemed somehow less pressing, but there are elements of medical equipment and utility systems management that would tend to make me throw a little spotlight on the topic now that the fullness of time has almost passed us by.

Certainly, the cleaning of endoscopes has been a fair focus during accreditation surveys, particularly as a function of further contamination (or re-contamination) of the scopes during the cleaning process ( ). And with the updated guidance document from ANSI/AAMI ( , there’s a much clearer picture of how the process should be managed (including water testing of scope re-processors) to ensure that there is minimal potential for infections as the result of the re-processing of these devices.

And, since we know that more eyes than ever will be glued to the outpatient arena, it is probably only a matter of time before the expectations for processing are identical to those inside the hospital (i.e.—no more manual disinfection). I know automation has spread pretty quickly for high-level disinfection processes in outpatient imaging/radiology settings, so I guess it comes down to making sure that any manual re-processing that’s occurring in your organization is very closely monitored until such time as automation can find its way to those locations.

Infection prevention and the physical environment are another example of those inextricably entwined pursuits; we know the accreditors are looking at any related process and preparedness is really all that can be done. Every step of every process has to be in place and hardwired into everyday practice; while humans are sometimes less that perfect, process perfection must always be the goal and the expectation. The next outbreak of whatever could be as close as an incompletely disinfected device—who wants to be downstream of that?

And while you’re pondering the enormity of that little screed, you might find some useful, thought-provoking content here: This is another late-bloomer from the mailbag, but I think it dovetails nicely with this week’s topic of conversation. I don’t think it’s possible to stress enough the importance of collaboration on this front; seemingly, there is much to do – and much ado about a lot of things.

I can’t say that the focus has shifted as much as it has widened to encompass every nook and cranny of the healthcare environment. I suppose it’s where it always should have been, but the confluence with the diminishing availability of resources (skilled or otherwise) makes for yet another challenge. So, rest up while you can!

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at