Editor's note: This piece originally appeared in the Perspectives column in the January 2012 issue of ICT.
By Josephine Colacci, JD
The central sterile supply (CSS) discipline is ever-evolving and routinely faces new technology, instrumentation and standards. Staying abreast of these changes is a pervasive challenge, yet is essential for ensuring quality in the central sterile supply department (CSSD), providing exemplary service to the Operating Room and other hospital customers, and, above all, promoting the delivery of safe, high-quality patient care.
The International Association of Healthcare Central Service Materiel Management (IAHCSMM) has long been an outspoken advocate of state certification of CSSD professionals, and certifications role in keeping technicians well-versed on standards-based instrument processing practices so these professionals can be skilled, competent and confident in their ability to keep safety and quality at the forefront.
In September 2010, IAHCSMM advanced its certification-related efforts with the development of a formal Government Affairs Committee and the delegation of a dedicated government affairs director to lead state certification initiatives nationwide through targeted education of state elected officials and the strategic introduction of legislation. Although New Jersey currently is the only state in the nation to require certification of CSSD professionals, IAHCSMM is confident that more states will be following suit. In fact, state certification is IAHCSMMs number one legislative priority, and notable developments are already unfolding.
For the 2012 state legislative sessions, bills will be introduced in New York, Pennsylvania and Ohio, and one or two additional states may join that list; however, that cannot yet be definitively confirmed.
In 2011, legislation (A.6030-b and S.5155-a) was introduced in New York to certify CSSD professionals. In June, S.5155-a passed out of the Senate Higher Education Committee with no negative votes, and with one member voting without recommendation (note: without recommendation means that this individual was neither voting Yes nor No). Unfortunately, because New Yorks legislative session runs from January to June, time expired before getting the legislation passed.
During our attempts to pass the New York legislation, a couple of language changes were made to the bill in an effort to appease certain organizations. The Association of periOperative Registered Nurses (AORN), for example, requested that we insert the statement collaboration with the nursing department into the bills language. Additionally, a grandfathering clause was added to the legislation that exempts CSSD personnel who have worked for 10 years or more from having to take the certification exam (they will, however, be required to complete annual continuing education requirements). The addition of this clause stemmed from concerns from unions and some legislators that the bill would create job loss. We have been working with various stakeholders during the New York legislatures adjournment, and we will reintroduce the legislation in 2012.
Progress is also underway in Pennsylvania, where we have a House sponsor for our legislation. Currently, we are receiving some push-back on the legislation from the hospital association; however, as IAHCSMMs government affairs director, I am hopeful we can negotiate agreement on any concerns the hospital group may have. Currently, the House sponsor is trying to work out any potential problems with the legislation before it is introduced. Pennsylvanias legislative session runs from January 2011 through Dec. 31, 2012, so, fortunately, there is significant time to get the bill passed in the state.
We have also secured a House and Senate sponsor for certification legislation in Ohio and are awaiting the bills introduction. The Ohio legislature runs from January 2011 to Dec. 31, 2012, so, again, time is on our side.
Laying the Foundation
Several additional states are actively engaging in educational campaigns a critical first step toward introducing legislation and attaining state certification. We are reaching out to state elected officials to introduce them to IAHCSMM and the CSSD profession, and educate them on the critical duties CSSD professionals assume each day and how their roles impact patient safety. This education is essential for laying the foundation for legislation and securing sponsors and support.
What follows is a brief summary of the educational initiatives currently underway:
In Arizona, our members met with the Chair of the House Health Committee and Chair of the Senate Health Committee. They asked us to fill out an application for a sunrise review. (Sunrise review examines whether or not there is a need to regulate a previously unregulated occupation or profession.) We are in the process of getting additional feedback from the legislators before we fill out the application.
In California, our members met with staff of a surgeon in the legislature. This office provided beneficial feedback and requested that we reach out to the chairs of the House and Senate Health Committees.
In Colorado, I contacted a state senator to discuss the possibility of introducing certification legislation for 2012. This senator advised me to speak with the lobbyist for the Colorado Department of Regulatory Agencies (DORA); I was informed that I would need to complete an application for a sunrise review and that the department would then take 120 days to issue a report. An application has not yet been filed.
In Maryland, our members contacted an emergency department physician who serves on the House Health and Government Operations Committee. He provided us with some useful advice on how to move forward -- and also informed us of other legislators to contact about the legislation.
In Oregon, our members met with three legislators, two of whom are co-chairs of the House Health Committee. The co-chairs offered useful advice and suggested we reach out to several different organizations, as well as two other elected officials; we are in the process of contacting these individuals. We also met with a state representative who believed the certification issue was best left to individual hospitals to determine whether their CSSD professionals should be certified. Our goal is to introduce legislation in Oregon in 2013.
In Virginia, IAHCSMM president-elect Sharon Greene-Golden is meeting with a state senator and representative on the certification issue. Her initial contact with these two elected officials has been quite positive and she is providing them with IAHCSMMs certification-related materials to help educate them on the key issues and the merits of CSSD certification.
In Washington, our members reached out to their elected officials and we were instructed to contact the House and Senate Chairs of the Health Care Committees. The Senate Chair of the Health Care Committees staff contacted us and requested a copy of the draft legislation. Upon reviewing the draft, they followed up with a list of questions. Those answers have since been provided and we are currently awaiting word to determine whether legislation will be introduced for 2012.
In West Virginia, our members are working on educating their elected officials about the CSSD professional and its role in patient safety.
Getting a bill approved is, of course, no easy undertaking, but significant strides are being made across the country. Through IAHCSMMs targeted efforts and through the direct involvement of its dedicated Government Affairs Committee members we are confident that more widespread state certification of CSSD professionals will soon become a reality.
Josephine Colacci, JD, serves as IAHCSMMs government affairs director.