Special Edition on Sterile Processing Imperatives Special Edition- Sterile Processing Imperatives | Page 4

from the editor h ealthcarehygienemagazine Leveraging Human Factors, Lean Methodology to Improve Sterile Processing Performance In this special edition focusing on sterile processing, we hear from experts who describe some of the breaches in protocols they see and ways to address shortcomings and barriers to performance. The impact of human factors-thinking on sterile processing is intriguing, and it calls to mind the importance of incorporating Lean quality improvement techniques to cultivate better results. Lean is a set of production improvement tools that manufacturers have used to increase customer value by eliminating waste and creating flow throughout the value stream. Some years ago, Virginia Mason Medical Center in Seattle incorporated quality improvement interventions in the surgical instrument sterilization process based on adoption of a specific set of Lean production improvement methods called the Virginia Mason Production System (VMPS). The system used VMPS to improve surgical sterile instrument processing in its 24 operating rooms where approximately 18,000 operative procedures were performed annually. One of the core components of the successful program was a tool called the “daily defect sheet,” which helped to identify and categorize errors in sterile instrument processing. The healthcare organization used Lean methods to reduce risks in sterile pro- cessing of surgical instruments by creating separate steps of defined work related to assembling and packaging the instruments and by rearranging the physically confined sterile processing workspace to accommodate the new work processes. The center also developed a brief checklist and other processes to mistake-proof sterilization, created an instrument sterilization certification training program for staff, and sought continuous feedback on the sterilization processes. The daily defect sheet was used to track errors, discover the causes of mistakes, foster accountability, and communicate across departments and disciplines. For example, OR staff’s discovery of multiple errors in functionality of the same instrument type led sterile processing staff to initiate a discussion, which revealed that the OR team was using laparoscopic tissue forceps to pull on a drain in a manner beyond its load tolerance, leading to frequent failures. With the implementation of the Lean-based strategies, healthcare professionals at Virginia Mason reported that the instrument sterilization error rate decreased 50 percent, from 3.0 per 100 surgical procedures at baseline to 1.5 in the final sustainability period. Improvements were observed in multiple categories of error types, particularly assembly errors in packaging (from 0.66 to 0.24 errors per 100 cases) and foreign objects such as pens and paper clips (0.17 to 0.02 errors per 100 cases). Although process reviewers at Virginia Mason were unable to directly measure and attribute specific clinical outcomes to the surgical instrument processing interventions, reviewers anticipate the improved processes will contribute to lower infection rates, fewer surgical errors, and reduced costs. Lean methodology can trigger concerns that efficiencies are traded for quality, but sterile processing leaders can take the best global strategies that quality improvement methodologies offer, and apply them to local scenarios to help boost performance, instill confidence, and drive patient-centric outcomes.  Until next month, bust those bugs! Kelly M. Pyrek Editor & Publisher [email protected] Kelly M. Pyrek editor & publisher [email protected] A.G. Hettinger, CPA president & CFO Patti Valdez art director Mary Johnson sales and marketing specialist [email protected] Linda Lybert business development consultant J. Christine Phillips customer service manager Send inquiries to: [email protected] Healthcare Hygiene magazine is published monthly by Keystone Media Inc. 8925 Ridgeline Boulevard, suite 106, Highlands Ranch, CO 80129. Free digital subscriptions available at www.healthcarehygienemagazine.com for U.S., Canada and other foreign subscribers. Copyright © 2019 Keystone Media Inc. All rights reserved. The publisher reserves the right to accept or reject any advertising or editorial material. Advertisers, and/or their agents, assume the responsibility for all content of published advertisements and assume responsibility for any claims against the publisher based on the advertisement. Editorial contributors assume responsibility for their published works and assume responsibility for any claims against the publisher based on the published work. All items submitted to Healthcare Hygiene magazine become the sole property of Keystone Media Inc. Editorial content may not necessarily reflect the views of the publisher. No part of this publication may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher. Reference: Blackmore CC, Bishop R, Luker S, Williams BL. Applying Lean Methods to improve quality and safety in surgical sterile instrument processing. Jt Comm J Qual Patient Saf. 2013;39(3):99. 4 Sterile Processing Imperatives 2020 • www.healthcarehygienemagazine.com