In response to the impact of healthcare reform, a re-engineering of problem areas within the University of Maryland's Medical System needed to be initiated. A critical issue to be addressed, within the perioperative areas of the hospital, was the delay in service because of the unavailability of functional fiberoptic endoscopes. This resulted in spiraling operating costs and compromised quality of care of patients. Analysis of the situation using fiberscope inventory data revealed unreliable quality-controlled reprocessing systems and lack of knowledge by the staff in handling and caring for the fiberscopes. A number of actions were taken to improve staff patterns of performance. Graphs, spreadsheets, and diagrams were used to pinpoint the problem areas for each perioperative area and were presented to the staff. These data were updated monthly to inform staff and inspire further improvements in performance. This re-engineering of the fiberoptic scope delivery system resulted in economic, operational, customer, and quality of care benefits. Fiberoptic endoscopes are increasingly used in surgical fields outside of the traditional endoscopy unit. Endoscopic nurses need to share expertise to improve the quality of performance in all areas of the hospital where fiberoptic scopes are used.