Automated flexible endoscope leak testing drives cost savings, safety

Healthcare Purchasing News, June, 2007 by Jim Daake, Jim Gleich

BJC HealthCare is one of the largest nonprofit healthcare organizations in the United States, with over 145,000 hospital admissions and 386,000 emergency department visits per year at 13 hospitals and multiple community health locations in the greater St. Louis, southern Illinois and mid-Missouri regions. The system contains two top ten nationally-ranked facilities: Barnes-Jewish Hospital and St. Louis Children's Hospital.

BJC has seen flexible endoscope usage grow dramatically. Endoscopic procedures are common at our institutions, occurring in every hospital in our system and in multiple areas within each facility such as gastroenterology, cardio-thoracic, pulmonary medicine, urology, et al. We reprocess our endoscopes after each procedure in either a departmental or central sterile reprocessing facility. Endoscopes are prone to damage that can allow moisture to invade the scope's interior and inflict costly damage. We recognized that moisture removal accounts for a significant portion of our repair costs and that moisture typically entered the scope through undetected leaks.

Leak testing

Leak testing is a critical part of the reprocessing regimen that follows every endoscopic procedure. Leaks are frequent. Detection of leaks immediately upon occurrence allows for inexpensive repair and prevents the invasion of fluid that comprises over 50% of total repair costs. Current leak detection devices are manual, which places the highly challenging leak detection burden on the cleaning technician. Current manual leak testing devices are labor-intensive and often lack precision, resulting in a high incidence of undetected leaks that drive substantial repair costs and elevated infection risk.

Verimetrix creates testing equipment that enhances the life, performance and cost efficiency of complex medical devices. The company's Veriscan Pro V2 endoscope tester is the first automated leak testing and fluid detection system for flexible endoscopes.

Veriscan offered an innovative auto mated solution that features a microprocessor- and sensor-driven technology and mandatory testing protocol to deliver superior leak detection, best practice compliance and a host of other benefits.

To confirm this claim we tested Veriscan in the endoscopy clinic at our Missouri Baptist Medical Center. In baseline testing Veriscan detected leaks in 8.7% of endoscopes not detected by our testing devices. We then used Veriscan on 926 procedures and experienced a 35% reduction in our average repair cost. Our reprocessing team concluded that Veriscan was superior to manual leak testing.

Veriscan replaces human judgment and imprecise manual technology with a microprocessor-driven device and mandatory testing protocol that automatically detects the presence of leaks with far greater precision than current methods. As a result, overall repair costs fall by 30%, on average. The product also captures detailed data for each test, satisfying the high demand for procedure documentation. Over 300 institutions, including leading hospitals and surgery centers, scope manufacturers and national repair companies trust Veriscan to test their endoscopes.

The approach

In spring 2006 Corporate Contracting communicated to all BJC facilities that Veriscan offered the ability to detect endoscope leaks early, which allowed repairs to be done quickly and inexpensively. This advanced, user-friendly solution represented a six-figure cost saving opportunity for our system. We encouraged all facilities to take a serious look at acquiring Veriscan for our scope reprocessing. By the fall of 2006 Veriscan was in use at 90% of the hospitals in our system.

The outcome

Veriscan's promises of superior detection accuracy and the benefits of early leak detection were realized. Across our facilities we have achieved a 27% reduction in scope repair costs in the six months since we began using the product. Importantly, Veriscan was able to test the multitude of endoscope brands and types we use at BJC, with consistent efficacy. The benefits of Veriscan's technology have extended well beyond cost savings.

The product's automated, mandatory testing protocol ensures that we follow a best practice approach and frees our technicians to perform other tasks while the test runs, aiding efficiency. Our Infectious Disease Division lauds the reduction in undetected leaks, which are a topic of concern in potential cross-patient infection. And, the product's ability to store and download test data allows our technicians to comply with documentation requirements and managers to analyze endoscope utilization and repair rates to optimize our investment in these valuable assets.

WHAT WORKS

THE HOSPITAL

BJC HealthCare System

THE PROBLEM

Inconsistent endoscope leak detection during reprocessing driving high repair costs

THE SOLUTION

Introducing an automated leak testing solution to endoscope reprocessing

THE VENDOR

Verimetrix LLC

Jim Daake is manager, corporate contracting and Jim Gleich is director, corporate supply strategy for BJC HealthCare System.