● Motion . Have you ever worked in a decontam or prep area where any tool you needed was just out of reach and required a few extra ( literal ) steps ? That ’ s a whole lot of motion waste . Excess movement within a workstation can contribute to delays in reprocessing trays . Use a spaghetti chart analyze the workflow and redundancies in your current setup . This is a visual representation of every location the technician must motion to complete the task can help identify opportunities for improvement
● Transporting . Moving contaminated or sterile instrument trays to the end user can be incredibly challenging for SPDs that do not have a case cart dumbwaiter , and unattended workstations during peak hours , different buildings , and long rounds can complicate matters . Identify opportunities to do the job better and find the right people to do it
● Waiting . It ’ s not uncommon for the washer decontaminator or sterilizer to break during peak hours when no one is around to fix it ; we ’ ve all been there . Regular , proper maintenance of all machinery can help you avoid major issues that don ’ t have immediate fixes . ( Take note , most repair contracts are written with clauses for a 24-48 hour response time .) Maintenance can also take care of smaller , less costly issues before they bigger , more expensive ones . Most equipment IFUs contain a table for scheduled maintenance . Follow it .
➋ Keep inventory low . Keep your finance department happy and excess spending in check by practicing inventory control principles that are in line with organizational goals .
● Replacement instrumentation . Though keeping inventory low is a priority , be sure that you have enough inventory of the right kinds of instruments that may be needed in an emergency . Are there tools or instruments that break most often ? Get replacement items in place . Are certain instruments the ones most commonly left off the tray ? Shore up your system for adding a missing instrument label to the tray and make sure all critical instruments are accounted for on the count sheet . To eliminate any doubt , stock every workstation with replacement basic instrumentation and place it within hand ’ s reach to minimize motion and improve productivity .
➌ Embrace technology . The use of new technology in the SPD has improved processes and increased throughput , and most SPDs now use reprocessing equipment like higher-capacity washer decontaminators that reduce water consumption while still cleaning vigorously and effectively . Robotic technology can aid movement and tray loading in the decontaminators and tracking systems can locate and identify instrument trays using a barcode and scanning systems . Robots are even assembling instrument sets . Embrace the introduction of new technology and you can reduce labor , enhance processes , and increase efficiency and safety in the SPD .
➍ Value employees and develop people . Human resources are the most valuable asset of an organization . A lot of time and finances is invested in training employees , so creating a culture of safety and quality is vital to the success of the organization . Instead of creating processes without the feedback of the technicians , collaborate . Make time for brainstorming sessions in which everyone provides their ideas for how to complete a task . Evaluate the suggestions as a team and value the contribution everyone is giving . During this brainstorming process , consider that every answer is right ( or at least valuable ) and put it forward for further analysis to determine which solution aligns with established regulatory standards and is the best one for the problem . Develop your team ’ s skills through continuous education . An educated technician is confident , and a confident technician is happy , and a happy technician is productive and committed to process quality .
➎ Continually improve focus on root causes .
● The Institute of Medicine defines quality as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge ( Source : Committee to Design a Strategy for Quality Review and Assurance in Medicare , Institute of Medicine . Medicare : A Strategy for Quality Assurance , Vol . 1 . Lohr KN , ed . Washington , D . C .: The National Academies Press , 1990 .) We must continuously improve the quality of care we offer our patients ; it ’ s the only thing that will increase the chances of them getting better . When a problem occurs , we must focus on solving the problem by performing a root cause analysis , prepare an action plan , and immediately implement corrective action .
The similarities between manufacturing a product and the process for assembly and sterilization of surgical instrument trays are many . We must raise the bar in our departments , enhance the knowledge and skills of our technicians , and continuously aim for assembling trays that are 100 percent cleaned , 100 percent completed , 100 percent of the time . And while we do , let ’ s remember the words of Taiichi Ohno : “ Progress cannot be generated when we are satisfied with existing situations .”
Mary Olivera , MHA , CRCST , CHL , FCS , has actively participated in the monitoring , surveying and training interdepartmental staff in the proper cleaning , decontamination and sterilization practices and has been highly committed to the standardization of interdepartmental processes . Currently , she is the president and CEO for OSPECS Consulting , LLC . a company dedicated to facilitating process re-engineering in healthcare organizations .