It takes time to rectify sometimes decades of neglect ; however , as this case study proves , a strong leadership and a team of skilled consultants to help steer the process can lead to significant improvements in a matter of months . employees had worked in that facility ’ s SPD for more than four decades , yet no records were found in the department or with human resources ( HR ). The new folders allowed employees to take ownership in the process and they were asked to bring in copies of their certifications , continuing education participation , and more . As part of the ongoing assessment , training and mentorship , employees with strong skills were recognized and recommended for new service lead positions . In all , four of these new positions were created to accommodate day , evening , overnight and weekend shifts .
The educator began the process of validating the of skills of each employee , reeducating , as necessary . A new , on-the-job training program was developed to ensure current and new / incoming employees are trained to the same standard to meet current best practice standards . Competency checklists were created for each area of the SPD ; all employees went through each task and their skills were evaluated . As a result , an action plan was created which helped generate ongoing education and in-service planning as well as the development of a formalized didactic training program that allowed employees to prepare for the certification exam .
Traveling technicians were also a part of the improvement plan . Because the SPDs at each campus had significant FTE vacancies , 10 traveling technicians were hired temporarily to fill in the gaps , each with their start dates staggered over several weeks . As a result , OR technicians who previously assisted with the workload in the SPD , despite being inexperienced in SP functions , were no longer needed .
To build a stronger bridge between the SPD and the OR , the interim management team began attending the OR ’ s morning huddle , which allowed the SPD team to hear firsthand any issues the OR was experiencing — and to be able to act on those issues in real time . Initially , the OR team seemed reluctant to have the SPD participate in their huddles , but they soon came to appreciate their presence . Over time , all SPD staff were brought to the OR to participate in the huddles . This helped them understand what occurred in the OR , while also allowing those in the OR to better know their partners in surgery from the SPD .
After each OR huddle , the SP professionals in attendance would round on every surgical suite to ensure each room had the necessary instrumentation to start their cases . When instrumentation was missing , the SP staff would search for those instruments , so the OR staff could continue opening their cases . This not only helped reduce frustration within the OR , but also helped those in the SPD uncover root causes to problems and more quickly work to remedy them .
The interdisciplinary huddles led to the following discoveries that were then addressed :
● Preference cards were out of date and did not represent the needs of the OR
● Lack of instrumentation for the number of same / similar cases scheduled for the day
● OR staff hoarding or hiding individual instruments and instrument sets because of mistrust
● Misuse of emergency carts , leaving them bare and not reporting their deficiencies to those in the SPD
● Using the majority of single-use peel packed instruments as user preference instead of adding necessary items to instrument sets
The need to find qualified SP candidates to permanently fill the vacancies was a top priority for the management team . Over several weeks , the leadership team interviewed candidates but were unsuccessful . To widen the pool for potential candidates , a plan was implemented to set up a job fair in a bordering state . The organization ’ s leadership knew it would need permanent , skilled SP professionals in order to make the process improvement changes sustainable . To entice the best candidates , they were offered paid relocation , a hiring bonus , a fair compensation package , and paid housing for 90 days after the agreed start date . Along with the compensation package , the hospital also agreed to provide a comprehensive training and education package and committed to pay for the employees ’ certification .
The efforts paid off in spades . During the 12-hour job fair , 120 candidates were interviewed and 60 were offered a second interview . After the second round of interviews , 18 candidates were offered positions and 13 accepted . Upon completion of the employees ’ orientation and training , 10 remained on the job and 100 percent became certified .
The six-month consulting project uncovered numerous issues and challenges that needed to be promptly addressed for the healthcare organization to continue meeting its patient care and service demands . This project also helped the organization ’ s administration see firsthand the hard work , skill sets , tenacity and vital contributions the SP professionals demonstrate each day .
It can be challenging to predict the wide range of situations a well-supported SPD will be able to support over time . Knowing the issues is the first step , but it is also important to understand that new issues will surface and need to be proactively addressed over time . It takes time to rectify sometimes decades of neglect ; however , as this case study proves , a strong leadership and a team of skilled consultants to help steer the process can lead to significant improvements in a matter of months .
David L . Taylor III , MSN , RN , CNOR , is an independent hospital and ambulatory surgery center consultant and principal of Resolute Advisory Group LLC in San Antonio , Texas . He has been serving as an IAHCSMM author since 2019 . He may be reached at david @ resoluteadvisorygroup . com .