By Bruce T. Bird, CRCST
I have been around long enough to see many changes in the way items are processed for reuse in healthcare. Years ago, cleaning, packaging and sterilization took place in many different locations throughout a healthcare facility. Most of the time, these functions took place in the user departments, and the thought of centralizing these functions was not always met with enthusiasm. It was difficult for the end-user to envision someone else processing items that were essential to their delivery of quality patient care.
In many institutions, bits and pieces of the processing function were centralized; however, it typically wasnt done all at once. In the first place I worked (as an operating room technician and, later, as a CSSD manager), the instruments were cleaned, inspected, assembled and packaged in the operating room and sent to central sterile supply for sterilization. Many surgical specialty items were cleaned and assembled between cases by instrument aides and sterilized in the sub-sterile rooms for immediate use on the case that followed. This certainly has changed! When we moved into new replacement departments years later, the OR and CSSD were designed to meet the centralized concept. At that time, all processing functions were given to the CSSD. Some were still tackled in a special instrument room located within the surgical suite, while the bulk was sent to CSSD to manage. Both locations were staffed by CSSD.
Everything did not run smoothly in the beginning. It took a lot of time and effort to smooth out the processes and work on team member abilities and attitudes both in the CSSD and OR. The end result was quite positive and very much worth the effort.
Key Components Drive Quality
No question, the CSSD plays an integral role in the delivery of patient care and the department requires more than processing equipment and supplies if they are to function as an entity for infection control.
Qualified personnel must interpret the objectives of healthcare facility administrations and must be knowledgeable in the concepts to be employed in the implementation of a processing system. CSSD professionals contribute to the kind of total patient care that is dedicated to help patients regain and maintain their maximum degree of health. It is also necessary for a CSSD to have adequate space to perform all necessary functions, as well as have access to all the necessary equipment and supplies to carry out all of the processes that make items safe for reuse.
After news segments about improperly processed surgical instruments aired on NBCs TODAY Show and NBC Nightly News in February, many interesting follow-up discussions arose as a result. The segments sparked national attention on the importance of the processes involved in making surgical instruments clean, sterile and safe for reuse. It also brought up the need for adequate and qualified staff for CSSD. Certainly, this is an issue that deserves national attention.
I believe the majority of people who watched the news segments appreciated that the issues hit the national media, especially the issue of certification for CSSD technicians. Without the necessary knowledge, education and experience, it would be difficult for anyone to effectively carry out all of the functions required to turn around instruments safely for reuse.
I am fortunate to work in a healthcare system that recognizes the importance of the CSSD. All employees are required to become certified within nine months of being hired. Each CSSD in our system has a program for technicians to allow them to progress and receive a pay increase as they gain knowledge, experience and responsibility. This policy arose after many years of hard work and support from many individuals, groups and departments within our health system.
As the first chapter in IAHCSMMs Central Service Technical Manual states, the CSSD is dynamic and fast-paced. The work is challenging, highly technical and complex. The performance of this vital department has a major impact on the smooth operation of the many departments to which it provides products and services. Inefficiencies in productivity, errors that create the need for re-work, and poor quality performance, are costly to hospitals. Further, the manual states, with the ever-increasing costs of healthcare, CSSD professionals must strive to conserve resources and minimize expenses. More importantly, however, is the safety and welfare of the patients who have entrusted us with their care. Negligence and carelessness in the CSSD could cost a patients life!
Conscientious CSSD professionals will find great satisfaction in knowing that their efforts, service and special skills play a critical role in every surgical procedure, each patient recovery, every birth, each patient discharge, and every positive outcome.
Leading the Way to Success
Indeed, its obvious that our role is very important to all those we serve, but ensuring that quality stays a top focus requires a lot of hard work and planned effort. We need to constantly work to acquire adequate space, the best processing equipment, and to improve our processes to help us meet volume, quality and service expectations. The best place to start advancing these goals is with our staff. Someone once said that People are the greatest untapped resource in any organization. I believe this to be true. Often, our answer lies with the people who comprise the department. And it also starts with the right leader,
As IAHCSMMs Central Service Leadership Manual states, there are many types of leaders. Some are formally recognized by their organization and have titles such as administrator, department director or manager. Other leaders only have an informal influence on their department. Still, all effective leaders have something in common: the potential to impact changes in their healthcare facility, department and profession. The changes can be good or bad, and their influence is often critical to the success or failure of people and work processes.
CSSD team members must have and apply knowledge and skills in order for their department to successfully deliver quality products and services to customers. They must demonstrate the ability to communicate and fully understand their role (including the knowledge and skill sets required to accomplish their responsibilities; legal implications; ethics; safety practices; teamwork; resource management; and more).
The right people with the right plan can make the seemingly impossible possible. While it does require time and effort, we can start by evaluating our current circumstances and taking an honest assessment of how things are done and where improvements might be made. From there, we can devise a strategy for overcoming challenges and implementing more effective practices that will deliver successful, consistent performance. IAHCSMM offers a wealth of resources and manuals to help CSSD professionals conduct assessments and chart the course for departmental improvements.
Its this exemplary performance that will ultimately lead to greater recognition and respect in the CSSD. And it all begins with you.
Bruce T. Bird, CRCST, serves as central processing manager for Primary Childrens Medical Center in Salt Lake City, Utah. He also serves as president of the International Association of Healthcare Central Service Materiel Management (IAHCSMM).