SELF-STUDY SERIES
5. Last you take the data evidence with the new changes for efficient improvement develop metrics and monitor while docu- menting the success.
I will now walk you through an actual process improvement plan that we are presently working on at this hospital. The Central Sterile Processing Team decided to quantify our accuracy in the processing of instrument trays for patients in the operat- ing room (O). We needed to know how well our team did in providing accurate instrument trays for surgery. The need for this information was important to the over- all care of the patient and our role in case delays, which in some cases can contribute to extra anesthesia during surgery and our potential to impact surgical site infections. The key result areas in the alignment tree for this project were quality and safety. Our goal was to obtain the target of 100%
tray accuracy with our baseline percentage being %. The research with the single case bore identified that the main reasons for tray inaccuracy were missing or too many instruments placed in the tray. These root causes were confirmed with a Pareto Analysis. A Pareto Analysis is a method of analyzing the most common contributing causes for an event. Typically, a chart is created to visualize
and bucket your data to identify the main root causes of the specific event. Each area was defined with a specific chart detailing the information needed to improve the daily process. The Analyze chart shows the single case bore, which details all the reasons given for tray inaccuracy. Then we took that information and placed it on the chart defining the Pareto Analysis, which shows in real time the frequency of the main cause of tray inaccuracy, which was for our group the placing of too many instruments not requested on the recipe or not giving them what was required. Next, we moved on to finding out what the root cause was for these tray inaccuracies, which allows us
Sterile processing mysteries: The story of the positive BI
Current evidence: Monitoring vaporized hydrogen peroxide sterilization processes using chemical indicators
Removing the mystery from reprocessing: Concepts and first steps for reprocessing in the dental setting
Sponsored by
to determine the contributing factors. All these steps found in the graphs pictured show the actual work that is needed to determine the answer steps that will be taken to improve the tray accuracy in this hospital. Here at this institution, each month the
team would open 20 to 0 trays from the shelf using our audit form to evaluate the neatness, presence of an indicator, order of instrumentation according to the checklist and actual accuracy. Our team members in the O would send a tray checklist back that had noted inaccurate counts for the tray. All the inaccurate tray information would be noted for our accuracy percentage. This improvement process project was
followed for over six months to obtain good, solid data. We then proceeded to find the root cause of trays not being assembled with the correct number of instruments and or indicators. The root cause graph, which answers the question of “why”, showed that we had people failure in two areas with a standard failure in one. The root cause is noted in the list of problems numbered from one to three. We proceeded to correct the people failure with education and training making sure our team used the checklist correctly, as this was the root cause of trays not being assembled correctly. Our standard failure was due in part to the tracking system not being complete, so we had to obtain an upgrade to our tracking system, as this contributed as part of the root cause in the standard failure. With education, mentoring and training the percentage numbers began to improve from % to 9% for five months in a row. Our team members were able to see the errors in real time and focused on the correction needed to elevate tray inaccuracies. Our process improvement project allowed this team to increase tray accu- racy by 10% while decreasing anesthesia time due to search for missing instruments.
There’s more to learn online:
Breaking the chain of infection Steam requirements for sterile processing Scopes require higher level of disinfection
Keys to success with vaporized hydrogen peroxide sterilization Device reprocessing in the dental setting
hpnonline.com/continuing-education 26 June 2021 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
Sharon Greene-Golden, BA, CRCST, CER serves as Manager for Adventist HealthCare Shady Grove Medical Center in Rockville, MD. Greene-Golden holds a Bachelor’s in Nursing degree from Albany State University and multiple sterilization-related cer- tifications. She is a ast President of IAHCSMM and has served on numer- ous boards and committees.
We decreased the need for immediate use steam sterilization (IUSS). We have a com- mitment to best practice and will continue to challenge our team to aim for the 100% target. We are committed to world-class performance for our team and ultimately our patients. In the quest to implement an improve-
ment plan you must have the involvement of your team, as they will be the stakehold- ers in the data collection and map process- ing. The plan can take a few weeks or even a year to effectively determine the success of your plan. In the end, you and your team must determine what was learned what could still be improved and if the DMAIC enhanced the process. ou are striving to do better in a work process while showing how effective the team has worked to improve. SPD departments all over the world can benefit from having factual data available that shows how the processes in the depart- ment have become more efficient. It does not take a lot of meetings just plain elbow grease to get in the field and make a process work more effectively. Improvement plan audits will raise the standards and quality in the SPD department. The process plan implemented in the SPD detailed our exceptional results and proved that the trays were able to be processed from the decontamination room to the stor- age shelf in eight hours, an improvement of 6.25 hours. It is a team sport and yes, you do need the buy-in of all the stakeholders. Once your team sees their progress and how well it details the work they do daily, you have believers for life. Implementing improvement plans using the DMAIC model, or any other model, will help you be successful in showing actual data to back up all your hard work. HPN
References
1. ANSI/AAMI ST79:2017 Comprehensive guide to steam steriliza- tion and sterility assurance in health care facilities.
2. “Defining Value and the 7Wastes” Kaizen Training. Kaizen Training, 2014.Web.15 Sept.2013. http://www.kaizen-training. com/
tools.techniques/defining-value-and-the 7-wastes
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66
