By Tony Thurmond, CRCST, CIS, CHL
Health care organizations – and the departments that comprise them – don’t become successful through a single idea or individual effort. Instead, optimal results come from a collective effort of a team, with all members working toward a common goal.
Collaboration, when used in the context of business, allows people to work together in achieving a defined, common business purpose. Collaboration in the workplace is when two or more people (often groups) work together through idea sharing and thinking to accomplish a common goal. Put simply, it’s teamwork taken to a higher level.
Too often, we look to complete tasks or ventures on our own, either not seeking help from others due to the fear of asking or the fear of relinquishing control. Sometimes, we see ourselves as the experts and don’t want anyone telling us how to do our job; however, this mindset can prove damaging to ourselves, our departments and facilities, our customers and, especially, our patients.
If you aren’t currently working collaboratively with others, you’re missing out on some big opportunities for growth and success. Even more importantly, you may not be doing your best to protect the patients who visit your facility.
Putting best practices in the spotlight
The best changes in our departments often come from reaching out to another department (or, in many cases, multiple departments) and putting our minds together to drive best results. Many departments can help our department achieve best results, beginning with the health care customers we serve.
Let’s explore how collaborating with with the following departments/professionals can help deliver better outcomes for all parties involved.
Surgery: Numerous collaborative opportunities await between sterile processing (SP) and the operating room (OR), and those opportunities often lie within the challenges. Often, it appears these challenges lead to finger pointing between the two departments, but it’s important to remember we’re all on the same team and seek the same outcomes: quality service and safe patient care. Designating a champion in the OR who will work with SP – and, perhaps, assigning an SP liaison to the OR – is a great way to foster greater teamwork. When looking to improve point-of-use instrument care at a previous facility, I recruited the help of an assistant manager in the OR. I gave him examples of how instruments arrived in decontamination in such disarray and were dangerous and difficult for our staff to handle. I showed him pictures of heavy items placed on top of delicate equipment and provided examples of soiled instruments with dried-on soil and explained how dried-on bioburden makes cleaning more difficult and can impede the sterilization process. I also showed how point-of-use care is a practice recommended by the Association for the Advancement of Medical Instrumentation, the Association of periOperative Registered Nurses and the Association of Surgical Technologists; this provided documented proof of what is universally recommended and expected.
What resulted was a collaborative effort to educate all OR staff to begin treating instruments at the point of use (moistening soiled instruments with an approved spray prior to their being sent to the decontamination area). We also began monitoring trays sent to decontamination and recorded in our instrument tracking system whether or not they were sprayed. Our compliance rate jumped from 15% to over 64% in just over five months.
Another collaborative approach we took was having our SP staff witness a surgical procedure. This allowed our staff to see firsthand how the instruments are used and how the OR staff expect to receive them in order to provide proper care. One of our technicians reported back to me that the experience helped her learn the importance of having the right instrument in the tray and she better understood the frustrations and challenges in having to call for another instrument or tray.
Infection Prevention: Sometimes, there’s an impression that infection preventionists (IPs) are only there to look over SP professionals’ shoulders to ensure we are following documented practices. The truth, though, is IPs are eager to learn as much as they can from those in the sterile processing department (SPD). Accreditation organizations will look to IPs to ensure they have a full understanding of the facility’s sterilization practices. SP professionals should ask IPs to come and work with or observe in the department for a day or two. Most will be eager to learn the processes and will serve as another set of eyes on your practices that might even shed light on some process improvement opportunities. Working closely with IPs can also help ensure that SP has the tools and resources needed to work safety, effectively and in accordance with standards.
Biomedical Engineering/Equipment vendors: Collaborating with biomedical engineers and equipment vendors provides an opportunity to have them see how SP equipment is being used, which will help drive positive results. After a recent visit by both groups in our department, it was identified how an ultrasonic could be moved closer to a workstation to save steps and help deliver optimal results. We also were able to identify high-use equipment and rotate equipment cycles for improved utilization.
Environmental Services: Collaborating with Environmental Services (EVS) can help the SPD determine an optimal cleaning schedule for the best outcomes. If EVS does not know the SPD’s needs and understand the reasoning behind those needs and requests, the service may not be viewed as a top priority. Working together builds a stronger relationship that helps set proper expectations to improve patient and employee safety.
Units/Clinics: Often, point-of-use instrument care is not taught or demonstrated, so employees from user departments may not have the information and tools to complete the important function effectively and consistently. They may even falsely assume instrument care is the sole responsibility of SP. A good example is when flexible bronchoscopes or other endoscopes are brought to the floors for procedures; often, endoscopy professionals don’t understand they have a responsibility for point-of-use treatment of the device following its use. If this point-of-care step is skipped, most endoscope instructions for use call for an extended cleaning process, which can add many more hours to the reprocessing of the device. Obviously, such a situation negatively impacts SP and endoscopy professionals – and the patient. Effective collaboration and targeted education on the importance of point-of-use instrument care will help eliminate these (and other) challenges.
Hospital Administration: The hospital administrator will likely not know the needs and challenges of the SPD (including insufficient staffing, limited instrumentation inventories, old or outdated equipment that can no longer meet the needs of the department and its health care customers, and lack of current industry standards, for example). This is why it is essential that the SPD communicates clearly and regularly with those at the administrative level. The more they know, the better they can help you (and, often, the more they will recognize the value of what takes place in the department).
Conclusion
To help ensure effective collaboration, all parties should come prepared to offer solutions to issues and have difficult discussions. Everyone should be prepared to disagree at times but be open to accept suggestions and constructive criticism. A collective willingness to do what is necessary as a team to bring success to the organization and to our departments is a great starting point that will continue serving us in any situation. Many efforts will start small and move gradually, and there is no failure in that as long as we’re all working together toward positive improvements. Remember: the goal of collaborative change is better production, improved communication and greater compliance – all of which leads to improved patient safety and satisfaction.
Tony Thurmond, CRCST, CIS, CHL, is an IAHCSMM Past-President who serves as Central Service Manager at Dayton Children’s Hospital.
