Managing Sterile Processing Departments : R . E . S . T . to Ensure Success
By Mary Olivera , MHA , CRCST , CHL , FCS
If you have ever felt like throwing in the towel at the beginning of your sterile processing department ( SPD ) shift , you are not alone . Let me paint the all-too-common picture . As soon as you begin your shift , you are met with disorder . The prep-and-pack area is in disarray and there are stacks of instruments waiting to be assembled . There are also unfinished dirty carts in decontamination with paper filters and indicators strewn across the floor . Amid all this , you get a phone call from the operating room ( OR ) looking for a tray , and by the time you hang up , the night team has disappeared into oblivion . Not long after , you receive another phone call from the OR director following up about the missing tray . Exasperated , you tell them you ’ re working on it , only to hang up and think , “ I want to run and never look back .”
To make matters worse , you are also likely dealing with staffing issues , such as numerous resignations and difficulties recruiting new technicians . Furthermore , the equipment that you need to do your job — including the washers and sterilization equipment — keeps malfunctioning as it nears the end of its useful life .
Unfortunately , this scenario is not far from reality in most sterile processing departments across the nation . Perhaps reading this may even remind you of your own SPD . However , this doesn ’ t have to be the norm . What are some ways that we can prevent the negative chain of events described above ? What solutions can we put in place to resolve the many problems in this scenario ? To help us address these questions , we will employ the acronym R . E . S . T .
● Retrace your steps – It is critical to carefully assess the root of the problem . What happens early on to prevent tasks from being completed and what can we do to prevent that ? Here are some examples to consider : o Communication :
• It is important for the SPD to know which trays are needed for today for tomorrow ’ s cases . In fact , reviewing the OR schedule and assessing tray needs ahead of time is critical for success . Does your SPD have daily meetings with the OR to determine the tray / loaner needs ? If not , establish a huddle time with the charge nurse and explain the reason for the meeting . Also , incorporate a separate huddle time in the SPD and use a white board to track important information . Keep the white board visible so that the incoming shift has access to relevant information to ensure their success .
• Integrate a prioritization process by using tags to alert technicians ( both in the decontamination area and in pack and prep ) which the trays should be done first . Organize the trays using color-coded tags : red tags for first-case trays , and yellow tags for second-case trays . These tags are a helpful way to keep technicians focused on which trays are needed first , rather than which trays are the easiest to assemble .
• Establish consistent communication during shift changes . Each outgoing shift should inform the incoming shift about completed and outstanding tasks .
• Unscheduled time off should be communicated directly to the SPD supervisor or manager . In order to ensure coverage can be obtained in a timely manner , this should be done well ahead of the start of the scheduled shift . o Training :
• Learning to read the OR schedule can enhance the technicians ’ skills and give them confidence to perform their jobs . The sterile processing technician manual has a helpful chapter on medical terminology that is most frequently used in the SPD . This , coupled with flash cards featuring medical terminology and definitions , can be helpful learning tools . You can also print a skeleton diagram and label major bones to help technicians remember the names of bones .
• Surgical procedure observations are extremely helpful . They allow technicians to see how the instruments they process are used in the OR . Techs should be able to see the scrub technicians opening packages , doing the count , and brainstorming for alternatives when items do not pass the quality test .
• Remember to make learning fun ! The more knowledgeable technicians are , the more confident they will feel . This , in turn , will boost their productivity . o Supervision of staff :
• Management by walking around ( MBWA ) is a management style where the manager or supervisor randomly checks employees ’ workloads while wandering through the department . To be effective , these checks should be unplanned , and constantly change in frequency and time performed . The MBWA can greatly improve staff morale and increase productivity . While conducting random checks , the manager should use errors as training and learning opportunities for the team .
• Set performance improvement goals for each technician by creating knowledge levels . For instance ,