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more intensive surface cleaning that's needed to safely care for patients dur- ing the pandemic. These factors have helped them maintain overall efficien- cies as the center continues to get back up to speed: • Standardized turnovers. Two designated staff members float throughout the day to turn over proce- dure rooms. "One floater wipes down the endoscope tower and starts clean- ing the room from right to left," says Wendy Wellott, RN, an endoscopy nurse at the facility. "The other starts working on the left side of the room, and they meet in the middle." Endoscope reprocessing techs who work procedures wipe down the exte- rior of scopes to prevent gross debris from drying on the surfaces and flush their internal channels with enzymatic cleaner before transporting the instruments to the decontamination area. The scope tech returns to the procedure room with a clean scope, and the floater sets it up for the next case while the scope tech inputs the next patient's information into the bedside computer. "Storage drawers placed conveniently in proce- dure rooms house needed supplies, including packs containing suction tubing and small sponges used during the bedside cleanings of scopes," says Ms. Wellott. "The tech who works procedures sets up supplies for the next case." The coordinated efforts result in rooms being turned over in about six minutes. • Streamlined scope care. Three techs work in the center's decontamination room: Two on the dirty side to manually clean scopes and run them through an automatic endoscope reprocessor (AER); one on the clean side to make sure reprocessed scopes are ready for the next case and delivered to a procedure room. The facility has four automatic endoscope reprocessors (AERs), each with the capacity to high-level disinfect two scopes in independently operated bays. Techs use the units' barcode scanning technology to automatically document scope model numbers, the case scopes were used in, and the disinfecting chemicals and detergents used during reprocessing cycles. "There's no paperwork to fill out," says Paula McGee, an endoscope reprocessing tech at the cen- ter. "Barcode scanning is a user-friendly feature that keeps us accountable and simplifies the scope reprocessing process. It's a huge time-saver." It takes a couple minutes to clean scopes at the bedside, five to eight minutes to perform manual cleaning at one of two sinks in the reprocessing rooms and about 40 minutes to complete AER cycles. All told, scopes can be high-level disinfected in about an hour, and the reprocessing techs handle up to 60 scopes each day. "Our department is a well-oiled machine," says Ms. McGee. "We're work- ing constantly, but have the manpower and technol- ogy to keep things flowing." • Short-acting sedation. The effective use of anesthesia in a high-volume GI center is critically important, according to Dan Vasend, MS, CRNA, chief anesthetist at Innovative Anesthesia and a provider at The Oregon Clinic. He says anesthesia professionals can expedite the beginning of the patient evaluation and exam for the gastro- 5 8 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • D E C E M B E R 2 0 2 0 Wendy Wellott LIGHT TOUCH Propofol is the gold standard for patient comfort, recovery and safety, according to Dan Vasend, MS, CRNA, seen here preparing the drug for administration.