GI societies vote no on ANSI/AAMI revisions on endoscopic processing

AGA, AASLD, ACG, ASCRS, ASGE, SAGES and SGNA are committed to initiatives focused on eliminating health care-associated infections through improved education about evidence-based practices. While our societies appreciated the opportunity to engage in the discussion around the 2021 revision of ST91 Flexible and semi-rigid endoscope processing in health care facilities, the joint GI societies remain concerned and do not support some of the finalized revisions to the standards and therefore voted negative on vote for approval.

Each of our societies has endorsed the Multisociety guideline on reprocessing flexible GI endoscopes and accessories, which provides evidence-based recommendations for the reprocessing of flexible GI endoscopes based on rigorous review and synthesis of the contemporary literature and application of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, included significant input from the endorsing organizations, and achieved consensus through redistribution. The process of revising ST91 and the final output varied significantly from the standards for guideline development expected by our societies, which led to our casting and maintaining negative votes on the final revised version of ST91 Flexible and semi-rigid endoscope processing in health care facilities.

While the GI community awaits the availability of widespread, cost-effective alternative endoscopes and novel reprocessing technologies, it is critical for our patients that the focus of the national dialogue continues for the more salient issues of training, oversight and enhancement of cleaning practices and technologies.

Fundamentally, our societies remain concerned about the inability for health care teams to implement and operationalize this ST91 standard at the practice level due to its length, construction, internal redundancies, disparate definitions, and, at times, conflicting recommendations.