Flexible endoscopes such as bronchoscopes and sigmoidoscopes are extremely expensive (10k-50k a piece) to purchase and to maintain. Specificalized equipment must be purchased to properly high-level disinfect these scopes to meet regulatory standards. Additionally, the individuals who process these scopes must have significant training in order to perform the tasks properly. Proper cleaning of flexible endoscopes is complicated and, if not done correctly, can put a patient at serious risk of infection.

Currently, UCSF has no method of overseeing the purchases of these scopes, therefore we tend to purchase from a wide variety a vendors and there is little opportunity to work towards volumn discounts for purchasing or maintenance. Additionally, because processing requirements vary by vendor and scope, the more vendors and models we use, the more equipement and specialized education we need to properly process this equipment.

Finally, with standardization, there may be opportunity for scope exchange systems which would reduce the amount of on-site high-level disinfection performed. Because high-level disinfection of scopes is such a high-risk procedure and requires specific training, and is subject to signifcant regulatory over site, the more we can centralize it the better, allowing only the truly expert staff to process these scopes.

In a nutshell, I propose that we aggressively work towards the standardization of flexible endoscopes throughout the organization.