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Archive December 2020 XXI, No. 12

Bringing Colonoscopies Back Up to Speed

Efficient patient care and streamlined endoscope reprocessing are needed to reach pre-pandemic procedure volumes.

Daniel Cook

Daniel Cook, Editor-in-Chief


Wendy Wellott
BRUSH BY Paula McGee cleans a scope before placing it in one of her facility's four automated endoscope reprocessors.

The Oregon Clinic Gastroenterology East at Gateway in Portland shut down in March for nearly two months when the pandemic's initial wave hit the west coast hard. The center's physicians recently worked through the backlog of patients who had their colonoscopy screenings postponed during the nationwide shutdown of elective procedures, and now the facility is chipping away at a waitlist of new patients. The overwhelming demand for colonoscopies is a good problem to have, but it makes for long and busy days.

On a typical morning, the first patient arrives at 6:30 a.m., the first case begins a half-hour later and the last screening typically starts around 4:30 p.m. The nine-and-a-half hours in between are a bustle of activity as patients are moved through procedure rooms and endoscopes are pushed through the reprocessing area. Each physician in the facility performs 10 to 14 procedures, which translates into 40 to 50 colonoscopies per day. Four of the facility's six procedure rooms are up and running, with a fifth expected to reopen soon.

All patients are required to be tested for COVID-19 within 72 hours of their scheduled procedures —members of the facility's scheduling staff contact patients before procedures to inform them of the closest testing site. Patients who test negative are asked to self-quarantine at home until their procedures. Most patients arrive with completed test results, but the facility has reserved a single procedure room for cases involving the small percentage of patients whose results were not returned in time. Staff clean the room thoroughly after procedures and wait 16 minutes for a complete air exchange to occur before bringing in the next patient.

It's been a lot for the staff to manage, especially with new requirements such as social distancing —chairs in the facility's waiting area are spaced to ensure patients remain six feet apart —and the more intensive surface cleaning that's needed to safely care for patients during the pandemic. These factors have helped them maintain overall efficiencies as the center continues to get back up to speed:

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