Getting the Scoop on Scope Repair

I arrive unfortunately late— both the flight and the cab ride from the airport took longer than expected. By the time I check in, pin on my name tag and pull out my camera and notepad, my group is just rounding the third of several long rows inside the giant factory.

Wearing navy blue polo shirts, Olympus officials whisper in my ear, trying to get me up to speed with what I have missed on the previous 15 minutes of the tour. As I scribble furiously, listening intently to the speaker, Eddie Garces, executive director of endoscopy service, I take a deep breath and try to get my bearings.

Just two hours earlier, I had been waiting in a crowded gaggle of cranky air travelers in Phoenix. With remarkable contrast, now in San Jose, Calif., I stand in a group of happy healthcare professionals, giddy to ask questions and “talk shop.” These 15 people have been discussing the importance of effective endoscopy repair for nearly two days by the time I join their group. I immediately feel like an interloper.

As the tour of the repair facility continues, Garces periodically peers over the shoulders of workers and describes what each precise movement accomplishes in restoring the accuracy of the scope.

“We service over 350 endoscopy models alone,” he says. “We provide services for at least eight years after the purchase of the scope. Our repair process is performed according to factory specifications to eliminate subjectivity.”

If you’ve met Garces, as many endoscopy nurses and technicians have at SGNA annual conferences, you know he is hard to forget. Few people exude passion about their profession. He can’t help it. Garces began working for Olympus 29 years ago, sitting in one of these repair chairs. Through years of hard work, honesty and a friendly demeanor, Garces now sits in the front office as the executive director. But his promotion hasn’t gone to his head. He’ll be the first to say the reason the facility can repair 250 to 300 scopes daily is because of the employees.

“The company is the people, not this beautiful Olympus building. The building without all of these dedicated Olympus employees would be an empty shell.”

His favorite story is about an employee who came to him at the end of a shift the evening before a major holiday. Rightfully so, he and the staff were eager to go on vacation and spend time with their families. The repair technician approached Garces to report an extra separator plate at her station, although she had received the exact number of parts for the number of scopes she needed for repair (this precise parts issuing is also a step in the Olympus quality management system). She knew she had made an error and had forgotten to replace the separator plate during one of many repairs she performed that day. Garces comforted the crying technician and assured her that mistakes happen and they would work together to correct it.

“But,” he says, “I said I hoped she’d understand but I had to make a big deal out of it. We deployed management staff at every exit to notify employees of the mistake. Everyone stayed. Around midnight, in the last endoscope to be checked, we finally found the scope that had the missing part. It is critical [that] employees work in an environment where they feel comfortable acknowledging that a mistake has been made. They feel safe to say, ‘I made a mistake.’ This is key to ensuring the quality built into our product.”

Education and training at Olympus is an ongoing pursuit. Training is conducted by factory engineers resident in the United States and also by sending personnel to receive training at Olympus factories in Japan and Germany.

“We cannot grow any faster than our employees’ growth; it is in our best interest to assist and develop them,” he says. “The quality is built by the people. I can relate to that since I’ve performed this precise technical work myself.”

With that mantra, the repair facility runs like a well-oiled machine. Scopes are received on a large dock starting at six a.m., with different shifts working until 11:30 p.m. and beyond. Scopes are received, aerated and inspected and logged into the computer system. Each scope repaired by the facility has its own file of information that repair technicians can look back on to make new diagnoses. Coincidentally, it is similar to a patient history file.

A unique service order opened on the scope will specify why the instrument needs repair, and Mike Jensen, quality assurance manager at the facility, says “technical evaluation is performed step by step. During this process, a thorough evaluation of the condition of the scope is performed systematically according to factory standards.” Based on this evaluation, the customer is notified of the required repairs and customer approval is obtained. Only original Olympusspecified parts are used during the repair process.

The instrument is directed to the specialized production repair line based on the type of repair required to ensure product safety, quality and reliability. Every step of the repair process is accurately documented and signed by the technician who performed that step. Repair technicians are taught if a repair has not been documented, it has not been done. Each step in the repair process is fully inspected before being passed on to the next technician. This is called a sequential repair system. In addition, every scope undergoes an independent inspection to ensure the functionality of the entire unit prior to shipping it back to the customer.

Scopes that have had the insertion tube unit replaced undergo additional testing such as a “life test,” states Garces. This specialized test is performed with proprietary factory equipment to include a blue Styrofoam form that emulates the human anatomy. This “life test” assures that all the internal elements of the insertion tube are properly aligned and properly function in the environment that mimics how the physician will use the scope. “We used to perform this test by hand,” he says, gently holding a scope.

The minute details that are checked, repaired and tested at each step are nothing short of complicated and amazing. Often, repair stages have their own calibrated proprietary torque wrenches or other tools made specifically for that task.

“If a scope exhibits channel problems,” he says, “the best solution is to replace the entire channel as opposed to just a portion of it.” While this repair may seem more expensive, Garces notes this is because the channel needs to be one continuous piece to ensure the free passage of accessories during procedures, without compromising the efficacy of cleaning and reprocessing. “The Food and Drug Administration (FDA) regulates the original equipment manufacturer (OEM) that provides service and repair,” but does not regulate third-party repair vendors.

It is hard for Garces not to take it personally when Olympus scopes are sent to and modified by other repair vendors. Garces says electrical and plumbing tape, as well as mechanical greases, are often found inside scopes repaired by some other repair facilities. These materials can critically damage the scope, reducing the instrument’s performance capabilities. “Unfortunately, I see scopes needing repair that end up being more expensive than need be because they were not repaired correctly the first time,” he adds.

“It tends to domino,” says Jensen. “It is just a matter of time until the compromises compound themselves.”

No one will argue that it is crucial to find a reputable repair firm, although Garces is understandably in favor of using Olympus facilities exclusively. “Make sure personnel are trained,” he recommends. “It is important that education is ongoing. And, when a product needs repairs, make sure it is repaired by the original manufacturer. Make an investment initially to understand the technical aspects of the scope and how poor repairs will ultimately add to your costs, not reduce them.”

As the tour winds to its conclusion in final inspection, the group watches how an employee removes a repaired scope from a carousel, matching up the carrying case before packing up the scope for shipping. An RN toward the back of the group clears his throat and begins to give a testimony about the importance of proper repair. His contract is currently with another endoscope manufacturer, and he has been researching repair facilities for more than a year because he isn’t happy with the service he is receiving. He’s done tests on this and that scope, trying to figure out how to keep penny pinching administrators and demanding endoscopy teams happy. Finally, he says, he thinks this Olympus facility will satisfy his needs.

Garces says, “The best repair is no repair. Thus, Olympus invests significant resources in educating and training our customers for the prevention of repairs.

“Patient safety,” Garces adds, “cannot be compromised.”

There are 18 Olympus service centers throughout the United States.

For more information, visit: www.olympusamerica.com. For Olympus University training courses visit: www.olympusuniversity.com.

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