sterile processing
sterile processing
By Marie Brewer , CST , CRCT , CIS , CHL , CER , GTS , CLSSBB
HROs and Just Culture : Core Concepts for SPD Quality
The goal is for awareness and acceptance to replace reactivity and judgement .
When applied to sterile processing departments ( SPDs ), HRO concepts encourage frontline technicians to look for and report concerns or unsafe situations before they present a significant hazard .”
Systems thinking , quality , patient safety , and high-reliability principles lead to sustainable process improvements because they help teams avoid serious safety events and continually improve patient and employee safety . Specifically , high reliability organization ( HRO ) concepts and “ just culture ” can serve as a strong basis for sterile processing ( SP ) programs and quality improvement and patient safety initiatives .
HROs effectively complete assignments in the face of high risk and complexity and use intricate procedures to manage their work and avoid failure or errors . HROs successfully handle near misses and address errors by implementing a mix of error-reduction methods that nurtures a safety-conscious environment .
Five key principles
HROs rely on the following five principles in daily operations , which lead to improved quality , safety and outcomes :
➊ Sensitive to operations : Understanding conditions in real time , regardless of intentions , designs or plans . This promotes a heightened awareness of how systems and processes are performing and encourages frontline staff members to report a situation in real time .
➋ Reluctant to simplify : Recognizing that work is multifaceted and refusing to dismiss or excuse failures without further investigation .
➌ Preoccupied with failure : Actively searching for potential errors and exploring all failures . HROs proactively work toward identifying possible failures and developing mitigation strategies .
➍ Deference to expertise : When patient safety is at risk , expertise is more important than the organizational hierarchy . HROs recognize that those who know the most about a subject should be entrusted to make the decisions .
➎ Commitment to resiliency : HROs value the ability to recognize concerns and create effective solutions . They react swiftly to a problem to mitigate its negative impact .
The foundation of an HRO lies in its philosophy of collective mindfulness — a non-judgmental consciousness of a group ’ s purpose , dynamics and mission . When a healthcare organization is collectively aware , the unified team works to collectively achieve their mission , vision and values . SP teams that practice mindfulness see improve team dynamics and increasing productivity and morale . The goal is for awareness and acceptance to replace reactivity and judgement . When applied to sterile processing departments ( SPDs ), HRO concepts encourage frontline technicians to look for and report concerns or unsafe situations before they present a significant hazard .
Accountability comes from the top ; therefore , high-reliability concepts must be endorsed by the top leaders of the organization . A culture rooted in safety and process improvement is vital for supporting collective mindfulness and beneficial behaviors . It is essential that SP leaders reflect on their organization ’ s past and future endeavors and have a clear understanding of how the team promotes and supports HRO concepts . Leaders should ask the following :
● Do I round with employees directly ? Rounding offers a direct line of sight to frontline staff concerns and allows time to share ideas with staff .
● How often do I review safety data , including the frequency of bioburden found on sterilized devices , missing indicators , etc .? Safety reviews help reinforce the team ’ s commitment to resiliency .
● Do I lead and participate in safety huddles to share concerns and communicate error mitigation strategies ? Doing so helps ensure that the team defers to expertise and remains focused on preventing errors proactively .
HROs emphasize the need to follow standard operating procedures ( SOPs ), written instructions that detail a step-by-step process that must be followed to ensure a routine activity is performed properly and consistently , even during times of high stress . HROs make fewer mistakes ; however , when errors do occur , critical information is disseminated to alert staff to the mistake and allow the team to fix the error ( s ) more effectively efficiently . Further , these organizations learn from mistakes by instituting just culture , which discourages penalties for reporting an honest mistake . What ’ s more , HROs rely on strong communication and problem-solving skills and realize that technical expertise alone is not enough . SP leaders must be able to communicate in a manner that earns trust and support .
Just culture promotes safety , collaboration , education , communication and teamwork , which means mistakes can be viewed as learning opportunities . All team members should be involved in the process and participate in after-action reviews ( AARs ); these are
20 may 2023 • www . healthcarehygienemagazine . com