The Source | May 14, 2019

Advice from the Field

Attitude is everything. It will accelerate your long-term goals, or it could make you unemployable. Attitude is an individual choice that has individual results. It is an easy decision that many underestimate. Use it for good.

- Travis, TX

Director, Sterile Processing

Keeping Track of All the Moving Parts: Offsite Facility Management 

Author: J. Vincent Sanchez, CRCST 

As health systems continue to grow, the demand within CS/SPD to process and produce expands.  Which is why many organizations have reassessed their sterilization handling and processing, turning to offsite centers to help sustain growth, create space, and adhere to industry standards and guidelines. Offsite process handling success is easier said than done in my experience as a Tech III for a world-renowned hospital system. Below I highlight how preemptive and fluid communication, documentation, and data-driven decisions help keep track of all the moving parts. 

Communication + Accessibility

In order to get any process moving, clear communication and accessible information must be prepared to keep everyone informed and moving in the right direction. As well as to manage, track, and improve.  

Communication between the main facility and the offsite facility is critical. Normally, when inventory is processed onsite, issues with sterility can be resolved relatively quickly. When inventory is processed offsite, there are additional constraints on time caused by the need to transport inventory between the hospital and the offsite processing center 

Offsite considerations: 

  • Shared Management: With a plethora of logistical points to manage, appointing 2-3 Lead Techs to direct your offsite management is advised. And pairing your Offsite Management team with a tracking system that collects your offsite data is essential to successful processes and growth. Plus, this is your go-to team for collecting information on how needs and expectations between the hospital and offsite processing facility are being met. 
  • Collection and Review: If you can’t track it, you can’t manage it. Data will be the clearest indicator of process success; so, setting up meetings to review how production, quality, and throughput data is keeping up will aid in your team’s success. 
  • Accessible Information: The crux of any good offsite system is readily accessible information. Meaning, that everyone on your team has access to process information (can everyone on your team answer the basic questions around your offsite processes?). Similar to how you store IFUs, creating a secure, shared environment to house all process documentation is the pinnacle of an offsite program. No one should be left in the dark of how this new process works. Plus, this is a great source to document process feedback from your team.  
Transportation

In most instances, offsite facilities usually serve more than one hospital. A few things you can document and share with all teams before any sets are sent out for processing are: 

  • Estimated turnaround times {based on sets}
  • Your department’s standards for processing based on IFUs 

Transportation needs to be clearly mapped, timed to ensure shortest time travel, and documented from standard routes to alternatives routes when traffic, accidents, or construction inevitably occur. Transportation standards should also be followed. This ensures that sterile and contaminated items remain completely separate at all times and handling, loading, and unloading are as frictionless as possible. 

Offsite considerations: 

  • Ensure that the vehicle used for transport is totally enclosed 
  • Create (and test) methods to ensure sterile and contaminated items remain separate 
  • Experiment with proper handling, loading, and unloading to ensure this process is as easy as possible 
Storage

Sterile storage policies affect more than just your offsite facilities, internal hospital storage is impacted as well. The potential exists for issues with IFUs and policy and procedure, wherein the operating policies at the offsite facility do not match or conflict with the operating policies at the healthcare facility. 

Most importantly, sterile items should be stored in a controlled environment that does not readily allow contamination. Further, once sterile items are placed into storage, they should only be handled as needed. Preventing excessive handling reduces the risk of compromising the sterile packaging and introducing contamination. In short, whatever policies a hospital uses to control its own sterile storage should also be in place at the chosen external processing facility. 

Offsite considerations: 

  • Store sterile items in a controlled environment that does not readily allow contamination
  • Once placed into storage, sterile items should only be handled as needed 
  • Policies your hospital uses to control sterile storage should be in place at your external processing facility 
Things to Keep in Mind...

As you continue to build and experiment with your offsite processes, keep these takeaways in mind: 

  • If the facility serves multiple healthcare facilities, there will likely be competing processing priorities. Plus, processing time may be longer than expected (see Communication + Accessibility) 
  • Transportation between offsite processing and the healthcare facility opens sterile instrumentation to additional contamination risk, as well as unplanned delays caused by accidents, traffic, and construction (see Transportation) 
  • If instrumentation is routinely processed offsite and found to be contaminated at the point of use, then it may be necessary to employ IUSS or else delay/cancel procedures in order to reprocess the contaminated items at the offsite facility. This is a particularly an issue with one-of-a-kind instrumentation and/or loaners. IUSS can increase the SSI risk for the affected patient, and delays and cancellations generate extra costs and can cause surgeon dissatisfaction. 

Click to learn how you can start using Data Optimization services today to analyze, optimize, and streamline your inventory data!

Data Utilization in Sterile Processing

Hear how one certified SPD technician took his department data into his own hands and the three takeaways that can benefit your department.

The All-New CtUC Awards Program

Step 1: Submit

To kick this off right, we are offering:

  • $50 off discount on registration for completing a 2019 CtUC Award submission

Step 2: Finalists Announcement August 1st

Three finalists per category will be offered the following:

  • Private dinner at CtUC on Sunday night with Censis Senior Leadership Team
  • Two additional $150 off discounts for 2019 registration

+ More

Step 3: Winners Announced September 24th at CtUC

Winners will receive the following:

  • On-stage recognition with Censis Leadership
  • A customize engraved trophy and a framed certificate
  • Two free registrations for CtUC 2020

+ More

IAHCSMM Recap: A Refreshing Perspective 

By Michelle Gallagher, CRCST, CIS, CER, CCSVP and Sam Harrison  

We had a blast this year in Anaheim, CA for IAHCSMM 2019.  From sunshine to scopes, the experience of gathering together with likeminded individuals passionate about patient safety and sterile processing is always rewarding. This was Sam’s first year at IAHCSMM, and I’ve been attending for over 12 years. We thought we’d share our unique experiences and the takeaways we found valuable:  

Sam: It was my first year attending IAHCSMM. While I sat in on a lot of different sessions, the one that provided me the most knowledge transfer was the Joint Commission’s presentation on standard approaches to infection control requirements. From explaining the difference between regulatory organizations to clarifying HLD requirements (generally a big topic during a Joint Commission survey), I walked out of that presentation ready to debunk any common industry myth regarding the JC.  Another great aspect to attending IAHCSMM is being able to connect with clients I haven’t seen in person for years. It was good to catch up with them and continue building relationships. 

Michelle: I look forward to the IAHCSMM conference every year. Not only do I get to see friends and network with new professionals, but the continuing education opportunities are also endless, and I always leave learning something new.  The theme this year was a fresh perspective and I would agree that the sessions and speakers provided new concepts and viewpoints.  The greatest takeaways for me this year focused on the updates AAMI and SHEA presented. From workstation computer ergonomics (tip: If a CS workstation has a computer, they recommend the video display monitor be positioned in a neutral position relative to the viewers’ eyes) to infection prevention in anesthesia (tip: Use checklists to improve cleaning methodology, such as checking cleanser and using visual indicators such as ATP or ultraviolet-visible markers), I walked away from IAHCSMM feeling full of knowledge. 

MythBusters: Joint Commission Edition

We thought it'd be fun to share a little of what we learned at IAHCSMM with you!  Take a moment and see if you can guess if the statement is a myth or if it's true. Don't be too quick to flip through, as the answer to the question follows on the next slide. Good luck!

All visible blood or tissue must be removed from instruments at point of use...

All visible blood or tissue must be removed from instruments at point of use... 

Myth: Terminal cleaning of instruments should be done in a decontamination area with appropriate facilities, PPE, and equipment to protect staff from potential injury or exposure

Facilities must use an enzymatic spray to keep instruments moist...

Facilities must use an enzymatic spray to keep instruments moist...

Myth: Facilities must develop and implement a process to keep instruments moist if immediate terminal cleaning is not possible.

Instruments must be opened or disassembled before they leave the point of use...

Instruments must be opened or disassembled before they leave the point of use...

Myth: Instruments must be opened or disassembled in accordance with IFUs during the terminal cleaning process.

Endoscopes must be pre-cleaned immediately after removal from the patient in the procedure room...

Endoscopes must be pre-cleaned immediately after removal from the patient in the procedure room...

True: Drying of organic matter on surfaces and in the channels could lead to disinfection failure

Source: Infection Prevention and Control, The Joint Commission