It is virtually impossible for us to evaluate anything in a vacuum. Almost every element of our personal and professional lives are thought about in comparative terms—especially in a world measured in faster, further, bigger, smarter and more efficient increments. Learning from others can help guide us in our decision making and lets us know where we can improve. The healthcare industry is no different with its attention focused on pay-for-performance, best practices, evidence-based outcomes and similar measurements of success.

Therefore, it isn’t any surprise that the scope care questions I’m peppered with most often revolve around my experiences with other hospitals, EASCs and office endoscopy practices. What’s the average age of GI scopes at other facilities? Is there a typical AER-to-procedure-room formula? What liquid chemical germicide is favored in the industry? They’re encouraging questions because they serve as the foundation for improvement. What’s more, these inquiries are the best kind because they come with an easy answer. Benchmarking.

Whether you’re talking about scope repair and reprocessing or any other clinical, financial or operational aspect of your GI business, benchmarking allows you to compare your facility’s operation against others in the industry as well as best practice models. The results obtained through GI-specific benchmarking data can prove highly beneficial when evaluating your day-to-day operational activities or making strategic business and financial decisions.

Grading your operation

The opportunity to compare your data against peer facilities enables you to convert mere numbers into meaningful information for more effective management of your GI lab. To illustrate, let me give you a few examples culled from our 2006 benchmarking data.1 In keeping with the nature of this HPN Scope Service Guide, I’ll limit the discussion here to some sample reprocessing and repair finding.

Scope Mix: This is one of those oft-voiced and important issues—too many scopes and you’ve locked up excessive capital, too few and your scopes become over utilized and your procedural volume compromised. The trend we’ve seen in the past year is a migration toward increasing the number of workhorse scopes per procedure room (2.6 upper scopes in 2006, up from 2 in 2005; 3.5 lower scopes in 2006, up from 3) while the specialty scopes numbers stayed static (specialty upper at .4 and lower at .9). These numbers will continue to change over time, but this type of data can help you evaluate your own scope mix, ensuring you’re getting the most mileage out of your capital equipment budget.

Life Expectancy: This is another timeless question. Hang on to a scope too long and repair expenditures start to climb while your technology edge plummets. In our 2006 comparative data, the replacement timeframe for workhorse scopes varied from 5.5 years (colonoscopes) to 6.5 years (ERCP scopes). And the average age of all scopes combined within a facility was 3.4 years. So if the data for your facility showed the average age of your scopes was 7 years, for example, we’d want to look at how your repair expenditures and procedural volumes stacked up to your peer group to determine what impact your extended scope aging had on other aspects of your operation.

Acquisition Strategy: A subtler benefit of benchmarking data is that it may challenge you to rethink some of your preexisting assumptions. Perhaps you’ve always thought that only a small number of GI facilities actually lease their equipment, or vice versa. In fact, it is split almost down the middle with about 54% of 2006 respondents purchasing their endoscopes and the balance acquiring them under some sort of leasing arrangement. Additionally, 55% acquired their equipment used. Each strategy obviously has its pros and cons, so peer-level data like this can encourage you to look at each strategy without bias.

Chemicals: With the bevy of liquid chemical germicide (LCG) options out there, one of the interesting findings from the 2006 data was the way participants ranked their reasons for choosing a particular LCG type, with soak time and safety clearly the most important (37% and 29%, respectively) and compatibility/price/infection control each grabbing a ranking of 10% or less. So, if you’re feeling pressured to tighten reprocessing times, these findings indicate you’re not alone.

Reprocessing Time: When all is said and done, reprocessing takes time. An average of 42.7 minutes to be precise, with 2.1 endoscopes waiting 17.6 minutes for reprocessing during peak times. If your reprocessing times leaned to the long side of this benchmark, for example, we would want to explore other metrics in your reprocessing protocols to determine where your process deviated from the norm to hopefully identify opportunities for improved reprocessing efficiency.

Repair Costs: To talk about this topic generically can be a bit risky since there are a lot of variables that can impact repair expenditures and the usable life of the equipment—scope utilization and aging, repair durability, reprocessing protocols, number of handlers, to name a few. A couple of key points repeatedly emerge, however, relative to repair expenditures. Facilities with repair contracts consistently had lower average repair costs per case (5% or better) than those without a repair contract. So if your repair expenditures seemed skewed to the high side, we’d take a look at the age of your scopes, your repair arrangement and your reprocessing protocols, among other things, to determine what might be driving your cost in excess of your peer-group benchmark.

Repair Culprits: In our 2006 data, three types of repairs emerged as the most common: bending section repairs or replacements, angulations repairs and refurbishments. These three repairs also represented the highest percentage of total annual repair expenditures. Data like this can be beneficial when you’re analyzing your scopes’ repair histories. If another type of repair is uniquely consuming your repair dollars—say for example, a bevy of CCD chip replacements—the anomaly can alert you to a problem in your scope care protocols so that you can investigate where in the transport/use/reprocessing/storage procedural chain the damage is occurring.

As I mentioned earlier, considerable time and resources are required on your part to implement a successful benchmarking program. However, the resulting data can provide your facility with a wealth of information on everything from reprocessing and repair as discussed here, to variables like staffing, mortality rates and supply costs per procedure. In an industry forced to focus on its bottom line, accurate comparative and historical data can help you set realistic goals and monitor progress towards improvement within your area or specialty. Ultimately, benchmarking is the best way to litmus test the efficiency and effectiveness of your operation and identify opportunities for improvement, all while serving the needs of your patients. HPN