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CS CONNECTION


cleaning the instruments with built-in countdown timers. No more having to rely on your memory to know what to do.” Regarding IFU compli-


ance, Lars Thording, Vice President of Market- ing and Public Affairs, Innovative Health, says he has received reports from multiple clients across dif- ferent regions of the U.S. that the Joint Commission is “cracking down” on CS/SPDs that can’t accurately track how many times a given electrophysi- ology (EP) cable has been used. See sidebar: Efficient electrophysiology cable sterilization can land hospitals in hot water.


Lars Thording “The focus of the Joint Commission seems


to be on confirming SPD cleaning methodol- ogy is standardized across device categories and follow the appropriate instructions for use,” said Thording. “We do not know what has caused this focus, but the introduction of more single-use EP cables that cannot be sent to the SPD could be a contributing factor. Hospitals are just not used to distin- guishing between different EP cable types.


“CS/SPDs must ensure their staff mem- bers can actually identify individual cables and treat them according to their specific use instructions,” he added. “If not, there is a risk that single-use cables are reused several times, cleaning is inadequate or no testing is conducted.” Ramos recommends CS/SPD leaders provide their staff members job aids, pic- tures and diagrams, which he describes as “great tools” to support staff in different process steps. “A comprehensive and precise count sheet is essential for the consistent completion of the set with no variance,” Ramos added. Training CS/SPD technicians as spe- cialists in specific procedural areas and related instrumentation can boost process efficiency both in the CS/SPD and the OR, according to Agoston. He notes that the most common areas for specialization are arthroplasty services and minimally invasive surgery, including gastrointestinal (GI) endoscopy. “The number one tool to improve effi- ciency in SPD is the introduction of specialization. The challenge is in break-


Efficient electrophysiology cable sterilization can land hospitals in hot water


Balancing effective and safe reprocessing of reusable instruments and devices with the pressure for efficiency is a significant struggle for Central Service/Sterile Processing & Distribution (CS/ SPD) department professionals. Joint Commission compliance is at risk when staff members are pressured to streamline or skip steps necessary to deliver a clean and sterilized item into the hands of clinicians. Lars Thording, Vice President of Marketing and Public Affairs, Innovative Health, says reus- able electrophysiology (EP) cables are a good example of items that require a critical eye and attention to detail when reprocessed in accordance with Joint Commission standards. He explains how reusable cables come with instructions on how to clean and make ready for another use, but with hundreds of different cables that look alike, CS/SPD teams face chal- lenges in identifying each type of cable and its individualized cleaning methods. “Most cleaning instructions are very broad, as in, ‘The cable can withstand cleaning with soap solutions or alcohol,’ while others are more extensive and specific; they may require special treatment of the connector or even testing before reuse,” he said. “Add to this that EP cables come with an FDA-regulated maximum number of times the cable can be used.” Most CS/SPD departments don’t have the capacity or work routines to ensure cables are cleaned exactly to instructions, that they are tested, and that the number of uses are counted, according to Thording. “There is an unfortunate trade-off between efficiency and compliance with Joint Commission


rules here, and frequently, efficiency becomes the guiding principle,” he added. “Recently, we have heard from a number of our hospital partners that the Joint Commission has honed in on these practices and demanded change.” By outsourcing the reprocessing of items that require complex work routines, such as EP cables, a CS/SPD department can remain efficient in its operations while adhering to Joint Commission rules, Thording explains. “Reusable EP cables can legally be reprocessed by the Central Sterile department, but it comes with regulatory risk,” he stated. “We have seen more and more hospitals sending their EP cables to third-party reprocessing companies that have the capacity to accurately identify, serial tag, clean, test and sterilize these cables. Moreover, serial tagging allows for accurate count of number of uses. This helps the hospital remain efficient, yet also comply with Joint Commission rules and avoid the operational disruption of having to replace cables during procedures.”


20 July 2021 • HEALTHCARE PURCHASING NEWS • hpnonline.com


ing the old standard that everyone must be trained and perform all SPD func- tions. Specialists trained to process the instruments and assist with OR set-up, take-down and troubleshooting ensure that the OR is operating at its peak of efficiency. SpecialtyCare can provide assistance with transforming your SPD into a highly efficient operation.” To assist with OR efficiency measurement and improvements, SpecialtyCare offers a software solution called OR Insight, which provides analysis on key OR performance metrics, including OR usage, block sched- uling and cost of supplies and implants, down to the surgeon level. It can be used in conjunction with several instrument management software programs.


Automated equipment In an effort to increase efficiency, standard- ize processes and improve both patient and staff safety, more and more CS/SPDs are implementing automated processing equipment. By minimizing manual labor, departments can reduce variation (which increases quality), streamline workflows and reduce the risk for staff injuries. “Equipment automation is another critical


component for efficiency improvement to keep the process moving and improv- ing instrument turnaround times,” said Polston. “One of the more exciting tech- nologies has been the addition of automa- tion to the washers and sterilizers.” As Polston explains, sets are getting com- plex and heavier; therefore, when CS/SPD staff members manually push washer and sterilizer transport carts they face greater risk for lower back and hand injuries. Washers and sterilizers that feature auto- mated loading, unloading and transport relieve them of strenuous, physical steps in the process.


“In today’s ever evolving SPD, the ergo- nomic challenges the clinicians experience are an area of concern,” he said. “Work- place incidents negatively impact the staff- ing of the SPD and can have a detrimental impact on meeting productions needs of the department. Having these ensure the instruments keep moving to meet produc- tion needs in a safe and efficient means has reduced injuries.”


Workspace design


Ramos recommends that manufacturers’ IFUs be consulted during the design and planning of workspaces to ensure techni- cians can safely reprocess surgical instru- ments. To help protect staff from injuries, he recommends sets be limited to under 25 pounds and storage locations organized based on set weight, with heavier items


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