healthcare value analysis
By Barbara Strain , AM , SM ( ASCP ), CVAHP , and Gloria Graham , DNP , RN , CVAHP
Moving the SPD During a Pandemic : Keeping Value Analysis Dialed In
Our need for criticalcare beds and cardiothoracic procedure rooms was growing , as well as new services for high-risk fetal care deliveries and eventually for mothers with potential highrisk pregnancies presented the opportunity to build an SPD to support the new efforts as well as service all OR needs .”
Barbara Strain , AM , SM ( ASCP ), CVAHP , founding member and strategic board liaison of the Association of Healthcare Value Analysis Professionals ( AHVAP ), caught up with Gloria Graham , DNP , RN , CVAHP , clinical value analyst For Cincinnati Children ’ s Hospital and AHVAP past president , to ask her about the opening of a new critical care tower and the move of their entire sterile processing department to a new expanded space .
Barbara Strain ( BS ): What was the impetus for moving SPD ?
Gloria Graham ( GG ): No surprise to the readers but the sterile processing department ( SPD ) was in the basement of an existing building which served all operating room ( OR ) cases at base campus . Like other hospitals and healthcare systems , the need for expanded or new services was realized over the past 10 years which necessitated renovations or net new space construction ; Cincinnati Children ’ s was no stranger to these phenomena . Our need for critical-care beds and cardiothoracic procedure rooms was growing , as well as new services for high-risk fetal care deliveries and eventually for mothers with potential high-risk pregnancies presented the opportunity to build an SPD to support the new efforts as well as service all OR needs . Plans including a connector from the new critical care tower to the existing building with the remaining operating rooms and expanding the SPD footprint to accommodate the latest technology and practices have been several years in the making .
BS : Describe the process steps that kicked off identification of the supply needs for the new SPD ?
GG : A gap analysis between the supplies used in the current SPD space and those that would be required in the new space was key . We started with a purchase history report for an agreed upon time frame for the current SPD and assembled a team of internal subject matter experts consisting of a supply chain sourcing specialist , co-chair of the OR value analysis team , base hospital clinical value analyst and SPD leaders to review . One of the overarching criteria for the review was to clean up the list based on low-use or never-used supplies and supplies for equipment that would no longer be in use post-move . The review group found that the list contained some of the same or similar products from a
variety of manufacturers and agreed that one of the key goals was to standardize and reduce variation through this process . Once the list was reviewed a report was generated for all locations that may be using any of the supplies that were suggested to be deleted as well as those that were to continue to be used .
BS : You must have found some aha and winwin moments during this process .
GG : There were many learnings using a process like this . We found some departments in and outside of the base hospital and at our neighborhood locations were using some of these products . We reached out to them to describe the process we were going through and made standardization recommendations where possible . One great opportunity that emerged through this process was the discovery of the root cause of issues related to dry bioburden when scopes were returned to SPD for cleaning and processing . A process improvement project was conducted to look at key steps in the process to determine why this was occurring . Even though the same brand spray was used , when the outside locations used the spray immediately as directed , the scopes would sit for long periods of time before a courier picked up them up . Depending on which end of the courier route , the scopes may continue to sit for an even longer period before reaching SPD at the Base hospital for processing . The optimal process occurred for scopes used at the Base hospital where the interval the scopes sat post spray was short before arriving in SPD for complete processing . Upon discovery of this difference , value analysis assisted in finding a new spray for the outlying areas that was put through a test of change ; one of the use areas the furthest away from the base hospital was chosen to try the spray and put through the usual courier process . They saw an immediate improvement with the scopes remaining wet upon arrival at the base hospital SPD . Another outcome of this project was using up of the existing spray prior to converting to the new spray in all areas to reduce waste and costs . The neighborhood locations converted first where the issue needed to be resolved quickly . The base and “ liberty ” location , which also had their own SPD area , used up the existing spray before converting to the new enzymatic spray .