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Daily huddles. We hold daily huddles for SPD staff to ensure
consistency in practice and process improvement by reviewing
elements such as broken equipment needing replacement and
receipt of new equipment inventory. The SPD leader reviews all equip-
ment with the staff that is processed through SPD and needed for the
next day's schedule to ensure items are sterile and available. We note
how many items we processed using immediate-use steam steriliza-
tion. We also celebrate small victories, such as the number of days
that have passed since SPD had a break in processing.
Change takes time
We implemented these changes over a 3-month period. The director
and assistant director of the OR as well the new head of SPD oversaw
each change. Assessing the impact of change is arguably every bit as
important as identifying opportunities for making it. Our team tracked
and reviewed SPD safety after our "reboot" and found a 91% reduction
in safety events just 6 months after implementation. As of January
2018, that reduction had increased to 96.2%.
This kind of improvement not only improves patient safety — the
most important goal — but also improves employee and physician
satisfaction. OR throughput is enhanced when you don't have to
pause cases because instruments aren't available, or they need to be
returned or replaced. Additionally, cleaning, disinfection and steriliza-
tion are included under Conditions of Participation and Conditions of
Coverage issued by the Centers for Medicare & Medicaid Services
(CMS) and the Joint Commission's accreditation requirements.
OSM
J U L Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 0 7
Ms. Montello (judy.montello@lcmchealth.org) is the clinical lead of nursing
operations at Children's Hospital in New Orleans.