Colonoscope Reprocessing at Multispecialty Community-Based Outpatient Clinics

The VA Office of Inspector General (OIG) conducted a national review to evaluate specific elements of colonoscope reprocessing at 10 multispecialty community-based outpatient clinics (CBOCs). The OIG reviewed training oversight and documentation, colonoscope reprocessing, and environmental monitoring in sterile processing areas. Colonoscopy carries some risk with the possibility of infection acquired from improperly cleaned medical devices. The Veterans Health Administration (VHA) requires specific training during initial orientation with monthly continuing education for Sterile Processing Services (SPS) staff to maintain technical knowledge. Facility SPS chiefs are responsible for oversight of staff training. The OIG determined that CBOC SPS staff reprocessed and tracked colonoscopes and monitored the environment according to VHA requirements. The OIG identified deficiencies in training and oversight of SPS staff. The OIG found that 50 percent of SPS employees who were required to complete initial training within 90 days did not complete it in the required time frame. Service chiefs at 70 percent of the CBOCs did not ensure that training documentation was complete. The OIG determined that SPS supervisors did not ensure that SPS staff received continuing education at 20 percent of the CBOCs. The OIG made two recommendations to the Under Secretary for Health related to initial SPS training and continuing education.