Risk Prevention : Implementing a Quality Improvement Program
By Mary Olivera , MHA , CRCST , CHL , FCS
People who need surgery do not think about the surgical instruments or supplies that are going to be used during their procedure . They are concerned about choosing the best surgeon and perhaps go to a medical facility with advanced technology . They are most likely unaware that for the physician to perform the surgical procedure he / she will need specialized equipment and surgical instruments that require intricate processing before it can be used . Patients trust the surgeon , the organization , the process and the people in charge of their care .
As sterile processing professionals , it is our responsibility to ensure that the processes we have established in our
Media reports have highlighted defects in cleaning , disinfection , and sterilization and suggests that healthcare organizations mitigate these deficiencies and potential deaths by taking a proactive approach to ensure processes , staffing , equipment , and engineering systems are all in compliance and undergo regular surveillance and maintenance . department are worth earning the trust our patients bestow on us . But the reality is that in many places the quality of the products produced presents a risk and put in danger the lives of those who need to have a surgical procedure . Media reports have highlighted defects in cleaning , disinfection , and sterilization and suggests that healthcare organizations mitigate these deficiencies and potential deaths by taking a proactive approach to ensure processes , staffing , equipment , and engineering systems are all in compliance and undergo regular surveillance and maintenance . Why did it had to come this far and have many people exposed to these mishaps in process ? Are these events so far out of control that there is no eminent fix to the problem ? Can organizations continue to try to do more with less when it refers to surgical instrument reprocessing ? The answer revolves around improving the “ quality ” of the product and the processes to produce an error free instrument tray . But how can we accomplish this goal ?
In the 1940s W . Edwards Deming developed a quality improvement approach that consisted in managing the process , removing inconsistencies and becoming sharply focused on customer satisfaction . The Japanese automotive industry adopted these concepts and process ideas and as a result became one of the largest economy in the world . Quality process management has been used in many industries and most recently healthcare organizations have engaged in process management and implementation of quality systems very similar to those used in manufacturing industries . Quality management is not a new concept , in fact device manufacturers practice this concept and nothing leaves their manufacturing plants unless they have passed quality inspections .
The question that remains to be answered is do these manufacturing quality processes work in our daily routines of a sterile processing department ( SPD )? Can sterile processing become a high performing department ? Yes ! Sterile processing manufactures – makes trays -- out of prime materials . We break down those instrument trays , clean , package and sterilize them before the tray can be used again for a surgical procedure . The business dictionary defines manufacturing as “ the process of converting raw materials , components , or parts into finished good that meet a customer ’ s expectations or specifications .”
Therefore , the SPD instrument reprocessing falls under this definition . How can we begin to improve our processes to meet the customer expectations without errors in the trays ? Organizations must begin to adopt a risk prevention approach and invest in the necessary components to improve the process . Sterile processing departments must begin to implement quality management processes and use it as a preventive tool .
Let ’ s focus on the steps we should follow to begin the journey of the continuous quality improvement ( CQI ) process .
1 . Prepare a plan outlining the actions to be taken to address the risks and opportunities the identified . Plan your project objectives , your methodology and the processes you are going to be auditing . Here are some examples : a . Opportunities : i . Reduce assembled tray errors by ___ % ii . Achieve 100 % accuracy in trays assembled . iii . Cultivate a Transparent Culture and continuously reinforce the concepts iv . Empowered technicians to provide feedback on how to improve the process . Engaging employees helps them take ownership of the process and take pride of the work they do . This translates in greater productivity , reliability and accountability . b . Methodology : i . Storyboarding technique – use a board , add colors and pictures to outline the current and future state of the department . Some adults learn and understand faster if they have a visual picture of what they are supposed to do . ii . Tray process audits iii . Observations iv . Tracers v . Establish a performance improvement committee . The members should not just be the leadership ; to achieve greater success , include members of the OR and SPD . Use this venue to share audit outcomes and solicit ideas for improvement .