Author: Vincent Sanchez, CRCST
The business side of healthcare is no cup of tea. With regulatory shifts, changes to the world of insurance, and natural disasters bringing challenges to all sides of the industry, managing hospital revenue cycles is only getting more difficult and more complicated.
The Correlating Cost
Hospitals exist to effectively care for patients, but their ability to consistently do so is limited if they’re running at a financial deficit.
Unfortunately, that seems to be the direction that many hospitals are going. According to Healthcare Finance News, “hospital operating margins plummeted from roughly 3.5 percent to a record low of 1.6 percent” between 2015 and 2017. In a paper published in September 2016, the Congressional Budget Office predicted that, if hospitals do not improve their productivity, 60 percent of U.S. hospitals will be operating at a deficit by 2025.
It’s crucial for revenue cycles to be managed—and managed well—and there are a variety of ideas about how data and artificial intelligence can be used to bolster those management efforts. But what does any of that have to do with the Sterile Processing Department?
Reprocessing instruments in one central department have been shown to be vastly more effective than distributing the reprocessing work across an entire facility. Well-run SPDs improve patient safety and satisfaction, while also building up the facility’s reputation and simplifying the lives of medical professionals. However, inefficiencies in the SPD can contribute to the shrinking margins on the business side of the healthcare organization. If mistakes happen frequently, if instruments need to be reprocessed multiple times due to shoddy work, the costs of running the SPD add up and negatively impact the hospital’s bottom line.
This is where department data comes in.
Hospitals collect a wealth of information, and SPDs are no exception. Your department may collect data on every step of the sterilization process that each instrument goes through. You may measure the productivity of your team—maybe even down to specific team members.
All of these data points have some sort of correlating cost. The missing or damaged instrument has a dollar value. The second round of cleaning for the returned inventory requires time, energy, and personnel, all of which amount to a monetary cost. Every wasted or well-spent hour in the SPD has an expense. And because you have the data, you can use it to make sure the dollar values are heading in the right direction.
Here are a few tips for using data in the SPD to positively impact the revenue cycle:
Determine Instrumentation Needs
Recent historical case data can easily show you what types of procedures are the most common. Maybe ski season sees an uptick in ACL surgeries. Maybe summer brings more heart operations. Maybe different times of day call for more of a certain instrument. Looking at the data of past cases can help you prepare for the future, in terms of both stocking additional instrumentation and scheduling additional staff.
Prevent Patient Safety Events
According to the World Health Organization, an average of 8.7 percent of hospital patients have healthcare-associated infections—and one of the most common types is surgical site infections. SPDs exist to make sure no infections happen as a result of contaminated instruments, but sometimes, bacteria still get through. By carefully analyzing the data around patient safety events (times when a patient’s health has been compromised in some way), you can discover factors that might have contributed to those events and use that knowledge to develop strategies to prevent future incidents. Any findings should be shared with all SPD staff so everyone is on the same page about ways they may have contributed to past incidents and how to avoid doing so in the future.
Spread the Word
If an instrument has been improperly reprocessed, it might be tempting to hide the mistake and pretend everything’s fine. But not only does that have ethical (and potentially legal) implications, but it also keeps patients who are at risk in a precarious place. “Prompt reporting of improperly reprocessed instruments is … essential to determining whether any patients are at risk from contaminated instruments used during their treatment,” says the Emergency Care Research Institute. If your healthcare organization isn’t keeping track of what particular instruments are being used on which specific patients, that’s the first step to being able to properly respond to the knowledge that an instrument wasn’t reprocessed correctly. The faulty reprocessing should be reported and the patient on whom the instrument was used should be notified so that they know about their risk of infection.
Pairing proper reprocessing procedures with accurate maintenance tracking at the instrument level increases your inventory management database effectiveness. And as we’ve learned, clean data translates to better cost savings and, most importantly, increased patient safety standards.
Take for instance reposable instruments, such as the DaVinci robotic arms. By documenting usage at the instrument level, your team is aware of how many opportunities are left to use the instrument and when to place an order for more. Plus, when it comes to sending an instrument out for repair, instead of sending the entire container out you can simply send the instrument that needs service. By automating maintenance and scanning at the instrument level, your inventory will begin to tell you when it needs maintenance instead of guessing and spending resources unjustly.
Transitioning from a Manual Process to Automated Instrument Management
Learn what to be aware of when moving from manual instrument management to automated
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