Outpatient Surgery Magazine - Subscribers

Year of the Nurse - November 2020 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/1306204

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Page 65 of 83

In the first six months after changes were made, the bills for replacement parts plummeted to around $5,000. Two years later, the average annual cost of replacement parts was just $3,500. The process improvements they implemented to achieve those incredible results can serve as a blueprint for flowing instruments through your facility in ways that will save money and avoid unnecessary headaches. 1. Identify issues The first thing that has to end is the OR and CSP pointing fingers in the other's direction when an instrument goes missing, according to Brenda Nack, MSN, RN, CNOR, CSSM, CRCST, director of sterile processing at Johns Hopkins. "We created an instrument committee to get to the bottom of the issue and focus on solutions," says Ms. Nack. "Our successes started when we began to commu- nicate and collaborate, and departments stopped blaming each other." As it turns out, how the components of the 10 different power tool sets used by surgical teams at Johns Hopkins were organized in the instru- ment trays was a big part of the problem. It was very disorganized — sometimes the sets were transported to CSP in a single layer, other times they arrived double- or triple- stacked. Some were labeled; some were not. "We had a really good blame game going on," says Carol Gentry, MSN, RN, CNOR, nurse manager in the pediatric OR at Johns Hopkins. After the committee met, both sides realized they had culpability in the problem. Improvements were made when each side real- ized how expensive instruments are — a missing handpiece could cost $15,000 to replace. Also, they needed to understand that replacement parts could take sev- eral months to arrive because the hospital first had to approve the expense, and the manufacturer didn't always imme- diately have the needed item in stock. 2. Reorganize instrument trays Make sure instrument trays are well-organized to make it easier to confirm all components are pres- ent or to notice missing items. The instrument com- mittee's first step at Johns Hopkins was to audit the contents of the power tool sets. Some of the parts, either because of obsolescence or lack of use, were eliminated from the sets before the storage contain- ers were redesigned, says Nick Breslin, CRCST, a CSP manager who oversaw a large part of the reform efforts. The team met with product vendors to create custom containers for all the power sets. Each con- tainer was labeled and dividers were set up, so every piece of each power set had a designated home within the trays. Often, trays offered by manufacturers of power tool sets were deficient, says Mr. Breslin. They were plastic, not durable and had to be blue wrapped. John Hopkins opted for rigid containers for all power sets. The rigid containers worked better because they included baskets and dividers to offer the level of customization needed to keep individual components organized. 6 6 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 2 0 SEEING IS BELIEVING A central processing technician at Johns Hopkins Hospital uses a verification check sheet to make sure all the components of a power tool set arrived from the OR. Johns Hopkins Hospital

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