With all the business and clinical challenges that managers of outpatient surgery facilities face, the issue of proper sterilization seems bland and mundane - something that should be able to be taken for granted. Unfortunately, the reverse is actually true:

- Instruments are growing ever more complex and harder to sterilize and/or disinfect. There's still no strong consensus on the best way to care for an endoscope, for instance;

- Thanks to dropping reimbursements, the pressure is on everywhere for quicker OR turnaround, placing increasing pressure on sterilizing instruments quickly; and

- Many freestanding outpatient surgery centers are managed by people who have lots of experience with running ORs, but little to no experience with sterilization.

As a result, a proverbial accident may be waiting to happen. No one knows how many nosocomial infections occur in outpatient surgery facilities each year, but there are indications that the number is relatively significant. Last fall, the FDA and the Centers for Disease Control issued a joint statement warning that endoscopes were being improperly processed and were making patients sick. Just a few months ago, the Association for Professionals in Infection Control and Epidemiology made a point of recommending that several measures be taken in "out-of-hospital" settings. The recommendations included consolidating the responsibility for infection control into the hands of one well-trained person, encouraging surgeons and other providers to report infections that occurred at such facilities, and developing written, scientifically based guidelines outlining each staff member's responsibilities with respect to infection control.

Here at Outpatient Surgery, we feel it's our responsibility to help readers deal with the challenges and opportunities that are before them. That's why I'm so happy to report that Dan Mayworm has agreed to author a new monthly column on Infection Control.

Dan, who was retired until we begged him to go back to work, has a surfeit of credentials for the job. In a former life, he was president of Tower Products, a manufacturer of packaging materials for single-use, disposable medical devices, paper/plastic peel pouches and dust covers. After Dan sold that business to American Hospital Supply, he started the journal that ultimately became Infection Control & Sterilization Technology, the most respected publication of its kind until Dan sold it and retired.

I myself am looking forward to learning what I can about infection control from Dan in the months and years to come. If you'd like to join me, please turn to page 55.