Understanding the Elements of Reprocessing Surgical Instrumentation for Clinically Safer and Financially Sound Outcomes

Understanding the elements of reprocessing surgical instruments is pivotal to the overall success of surgical operations. The components are often overlooked and not considered and as a result sometimes harms our patients or causes undue excess expenses. This article will capture some key considerations in the instrument processing function.

Instrumentation used during surgical procedures requires special management to help prevent the spread of infection and potential costly and unnecessary additional acquisitions. Appling appropriate purchasing techniques to ensure adequate operational funding for needed equipment through the fiscal budget year is important. Proper handling pre- and post-operation usually lengthens the usable life of devices and helps to prevent the loss of having the “right item at the right time” for care providers. Precious time in reprocessing is also often gained when basic principles are applied once an instrument is used. All of these elements can be used to augment and improve the total reprocessing program for various types of facilities, regardless of the size or nature of the institute and all help to keep all customers and key stakeholders content.

A deeper look into reprocessing instrumentation uncovers various root elements that can hinder the process of making an item suitable for reuse. Simple changes in the methods and techniques used to reprocess can greatly change the outcome from marginally acceptable to appropriate on many levels. In order to achieve this, an in depth understanding of the inevitable variables is needed to be able to create a structure to work within. Some of these considerations include the following:

• Limited quantity of frequently used items

• Special processing requirements, such as unusual sterilization parameters or agents

• Design limitations

• Unusual materials

• Unforeseen add-on cases

• Changes in the order of previously scheduled cases in relation to the pre-coordinated instrument/equipment processing orchestration/timing

• Physician requests conflict with availability

Having a less-than-robust inventory of critically needed reusable devices can greatly hinder the process of providing surgical intervention in a timely manner, especially if there is a knowledge deficit or lack of communication to and from the direct surgical team to any and all other supportive staff members concern this issue. However, it is not always possible or wise to have such an abundance of instrumentation as general overall volumes often change and as such, the type specialties of cases and their related volumes also vary.

Quantity of instrumentation alone is not the most limiting of factors. In fact, with a properly designed program aligning equipment needs with equipment availability and cross-referencing/conflict resolution and the seemingly inevitable situations can be avoided, often without the need of excessive instrumentation. There is a push from both the clinical and materials side to take hold of instrumentation processing and both have good arguments. However, partnering with materials management and other supply chain imperatives can help to put instrumentation back into the hands of individuals geared towards logistics as long as the clinical mind and skill set is available from this reporting function.

Ensuring that next-year budgets are crafted and submitted based from analytical data and general information is critical. Making reasonable assumptions, based on research, past volume, reasonable forecasts and inflation can greatly and positively affect how well your hospitals resources are used for not only the immediate future, but also for the longer term. This should include, but certainly should not be limited to the following:

• A reliable expectation of what the additional future workload will be is an important factor.

• A reasonable assumption of what the surgical specialties percentage growth should look like is imperative.

• Review of current research on the latest and most likely tools/methods of operations from a clinical and financial approach is a standard.