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/993644
Employing standardization to improve quality, operating efficiencies and safety inside and outside of the central sterile department is hardly a new concept. As far back as the 1930s, William Edwards Deming, the father of Total Quality Management (TQM), forerunner of ISO 9000 and Six Sigma, warned of the dangers of process variation. Over the years, commercial aviation, in particular, has demonstrated the value of this philosophy. Standardized pre-flight checklists and maintenance protocols for a given aircra are followed regardless of the individual pilot, mechanic, carrier, hangar or airport, and have helped the airline industry achieve a remarkable record of safe flight. Achieving similar buy-in within surgical workflows has been more difficult to achieve. Many observers have aributed this resistance to change to the perceived necessity that a surgeon's "individualism" must be protected at all costs – a need that has yet to be correlated to improved patient outcomes. These personal preferences and legacy processes help contribute to the fact that in many cases, 60% to 70% of the instruments on a surgical tray are returned to the central sterile department unused, but still require reprocessing. While many hospitals continue to expand their OR departments to accommodate an increasing volume and complexity of procedures, the CSD oen has failed to receive a commensurate boost in resources. Oen facing insufficient space, equipment and staff, more and more CSD managers – out of necessity – are taking the lead to quantify the potential savings and throughput improvements of matching actual MCV00071547 REVA EXP 05/20 Getinge is a registered trademark of Getinge AB, its subsidiaries, or affiliates in the United States or other countries • Copyright 2018 Getinge AB or its subsidiaries or affiliates • All rights reserved. Sales Office · Getinge • 1777 East Henriea Road • Rochester, NY 14623 • 1-800-475-9040 w w w.getinge.com Managing Risk readers are invited to subscribe to a digital version of this newsleer by visiting info.getinge.com/ManagingRisk Use it or lose it. What's on your tray? instrument usage to the content of the trays to make a strong clinical and operational case for standardization. A 2013 AORN Journal article, Standardizing the Management of Reusable Medical Equipment, points out that "the number of critical-use individual instrument sets used in the OR can exceed 300." The expectation remains that every item in service must be appropriately cleaned, decontaminated and sterilized and be available to the OR without delay when requested. Without standardization, this expectation is becoming increasingly difficult to achieve. Standardizing sterile processing goes well beyond the elimination of unnecessary variations in instrument trays which only can be accomplished by standardizing surgical procedures as well – a measure that has shown to improve outcomes and one that is supported by The Joint Commission, among others. Not surprisingly, surgeons haven't been overly keen to relinquish a degree of personal choice and preferences. The counterargument is they won't have to if their way represents the best way and is instituted as a system-wide best practice. And if it's not, the best interests of the patient obligate them to make the change.