The old cliché in the sterile processing consulting world is: “If you’ve seen one sterile processing department…you’ve seen one sterile processing department.” The point of that statement is that these departments—even though they have similar missions, machines, and team members—are often quite distinct from each other in myriad ways. When an experienced sterile processing department (SPD) consultant shows up at your department door, they have this knowledge ever present in the back of their minds, and they will seek to support your team with that reality in the background.
However, you don’t necessarily need an outside consultant to capture a similar perspective on your department. In fact, it’s common after a large consulting project to hear the SPD leaders say something to the effect of, “Yes, I’ve been saying the same things for years, but no one has listened to me.” Nearly all the “opportunities for improvement” that an outside consultant may find can just as easily be identified by existing team members within the facility. This short article will give you a couple insights on how to accomplish an internal consult for your own SPD.
Secure administrative buy-in up front
For any traditional consulting project, hospital administrators have already bought into the project before the consultant arrives, which is why they signed the contract in the first place. If you want to do your own internal consult, it’s best to start in the same place. Approach your administrators with your plan, making sure to explain why you are doing the assessment and what you hope to accomplish, and then outline your process and deliverables, such as final reports, recommendations, etc.
Keep in mind, this is different from simply performing the assessment first, then bringing the results to your leadership. You want and need to establish a shared vision for the project on the front end, so that there is shared accountability for whatever opportunities you eventually identify.
Develop an agenda and invite collaboration
Next, you will want to develop and distribute an agenda for your assessment. This should be shared with the administrators mentioned above, as well as every department that may be impacted during the assessment visit itself or the findings that surface during it. Examples include: sterile processing, endoscopy, operating room (OR), infection prevention (IP), materials management, emergency room, labor and delivery, ultrasound, and wound care clinic. You should try very hard to notify everyone of this project before arriving in their areas.
The best assessments always require interdisciplinary collaboration. In the case of SPD assessments, you will typically want to invite collaboration from your Infection Prevention (IP) team, Quality and Risk team, Facilities team, the OR, surgeons, and even certain vendors. In general, it’s usually a good idea to have IP present during the entirety of your assessment (outside of reviewing things like human resources files) and some kind of representation from the OR. This is not always possible, but the more collaboration you are able to coordinate, the more valid many of your findings will come across in the final report. I’m not saying it should be this way, but it is.
Becoming your department’s own best critic
Prior to the hands-on portion of your assessment, you may want to pull pertinent data such as productivity reports, IUSS tracking, employee competencies, preventive maintenance records, and related materials so that everything is in one place for the most efficient review of your department documentation.
Now the big day has finally arrived. With agenda in hand, and collaborators by your side, you can begin the journey of becoming your department’s own best critic. Like any good consult, it will be important to communicate your purpose clearly to the frontline clinicians you encounter in SPD and the OR throughout the assessment. Employees often have negative connotations with the terms “consultants,” “assessment,” “findings,” etc., so it’s always best to proactively speak of your desire to help and assist the team, not to get them in some kind of trouble.
There are many potential areas to start an SPD assessment like this. Some consultants prefer to begin in the OR at the point of use and trace the flow of instrumentation from surgery to decontamination, through to inspection and assembly, on to sterilization and storage, and then back again to the OR. Because this is a circular process, anywhere you begin will eventually take you through all stages and back again, so this piece is really up to you.
What’s most important is to take your time and don’t take any part of the process, department, or people for granted. Since this is your own department, the temptation will be to go straight for the problems you are already aware of, but this will short circuit your assessment in a manner that wouldn’t occur with an outside consultant. Go slow, force yourself to ask questions, open cabinets, observe closely, and take copious notes.
The homework report
While the bulk of an SPD assessment happens during the observations, interviews, and documentation reviews, much of the value actually is found in the development of the final report and recommendations. Remember those copious notes you took? The final report is where all these things come together, along with any explanatory photos, industry guidelines, and other information to give context to areas that need to be improved. This could be anything from recommendations for better cleaning brush storage to the need to validate that peel packs can be double-packed per the manufacturer’s instructions for use (IFU). If you saw it in the hands-on assessment, you should include feedback in the final report.
As mentioned in the introduction, you should pull together all your original stakeholders from hospital administration and other departments impacted by your findings to review your final report as a means to discuss particular opportunities for improvement, but also to gain support for larger changes that may require capital funds, major workflow changes, or staffing realignments.
As you can imagine, there is much, much more that goes into a full-scale sterile processing assessment, but this outline is a great place to start in taking the process improvement of your department into your own hands. Whether it’s a short half-day project, or a larger multisite, multiday review, you likely already have what it takes to bring the value of consulting to your team. Just make sure you’re intentionally looking at it all through new eyes.
What say you?
Author: Hank Balch, Featured, Sterile Processing