Infection Control Today: Case Study

Thinking Back Into the Box

How One Healthcare Provider Created Significant Savings by Reprocessing Single-Use Medical Devices

By Susanne Burnham

The program has been very successful from the perspective of our primary goal achieving quality patient care and cost savings. As an added bonus, we have learned valuable lessons in team building, shared responsibility and shared pride in success. These lessons will also be applicable in future programs that we undertake. This is a review of our program from inception through implementation.

A Kernal of An Idea

Like any other hospital or hospital group, we pride ourselves in continually striving to deliver the highest possible quality of patient care. In order to complete that mission, we have another responsibility and that is to maximize the use of our resources. Everyone in healthcare knows to achieve both goals simultaneously is no easy challenge.

Could It Be Done?

Among the cost-savings program ideas presented was one from a consulting group: in-hospital reprocessing of SUDs. Such a program had the potential for enormous cost savings because it could be accomplished using existing equipment and personnel. It sounded good but we had our doubts and a great number of questions.

Among our initial questions were:

  • Wasnt reprocessing regulated by the FDA, and how would we deal with that agency?
  • Would we have to make investments in expensive equipment and add personnel?
  • What products and criteria should we consider for in-hospital reprocessing?
  • How could we assure the safety and efficacy of the products we reprocessed?

Armed with these questions and many more, we confronted the idea head-on. Admittedly, some of us may have had our minds made up that the idea of in-hospital reprocessing of our own SUDs was preposterous. That is, of course, until we began to listen, learn and understand the entire process. The process was demystified for us, thanks to the consultants who had firsthand experience with procedures, regulations and products involved.

Pursuing the Goal

Like other things in life, SUD reprocessing can seem terribly complicated and even impossible until the facts are laid out in an organized and lucid manner. After completing the education process, we found the risks to be low and the rewards very high. As a group, we decided to pursue this program. In retrospect, were glad we did. We now have the program implemented and the savings and products in the program continue to grow.

Taking a Team Approach

We feel that a key element leading to program success was predicated on our initial organizational scheme. Early on, we recognized that consensus among the principals in each hospital needed to be established. Our in-hospital reprocessing committee comprised representatives from infection control, risk management, materials management and sterile processing. We also consulted nurses and physicians on clinical issues. Shared responsibility, we felt, would result in shared ownership and a greater potential for success. Our premise proved to be correct and a key factor. The strength of the committees shared responsibility kept the program on course, moving forward and resulted in a successful, patient-safe cost-saving program.

The Learning Curve

Now the people implementing our reprocessing programs are trained and certified on all of the required procedures. This learning and the inclusive attitude of the reprocessing program not only energized the participants but provided some unexpected learning experiences in many areas. For example, we learned that by working as a team and using the consultants procedures, we can identify and fix potential product quality problems before they happen. We learned that using hospital facilities for reprocessing not only saved our hospital significantly more money, it also gives us pride of ownership and a job well done. It energizes us to participate in this program because it provides so many advantages to the hospital and participants. Other important learning experiences were:

  • The importance of including all principal parties in goal setting and planning
  • The FDA can be dealt with effectively by following well-defined procedures provided by our consultants
  • Low-risk products such as compression sleeves can be easily and safely reprocessed using hospital equipment and personnel
  • Nurses and physicians will accept and use reprocessed low-risk products that meet required quality and safety criteria
  • The importance of using the consultants reprocessing experience and procedures for the best utilization of existing hospital equipment and personnel

The End Results

We have profited greatly from this experience both from a quantitative (savings) and qualitative (improved procedures) perspective. We discovered that to get on the fast track to success it is very important to have collaboration in the form of a core implementation team right from inception. We experienced that a synergy developed within the team which improved our ownership of the program, and resulted in high-energy participation of the members and ultimately in a significant cost savings program for our hospitals. Recognition of the successes of the program, contributions of the team, and even individual members by senior management served to enhance further the pride we have in our new reprocessing program. Our reprocessing program rewarded us in many ways. Among our many accomplishments, there were some that were particularly enjoyable:

  • Savings as much as 30 percent to 50 percent more than sending products out for reprocessing
  • Additional savings used to improve our hospital programs
  • Goodwill generated by the program
  • Our reprocessing committee regularly receives kudos from management and glowing write-ups in the hospital newsletter for a job well done

Starting from Scratch?

We recommend the following steps for implementing a successful in-house reprocessing program:

STEP 1: Work with an expert. Select a consultant who specializes in FDA reprocessing regulations and has first-hand experience to help put you on the right path quickly and efficiently.

STEP 2: Form an oversight committee with members from relevant hospital functions, such as infection control, risk management, central services, sterile processing and materials management. Nurses and physicians should be consulted on product selection and product usage validation.

STEP 3: Elect low-risk, high-volume products that can be easily and safely reprocessed. We recommend starting with compression sleeves and tourniquet cuffs.

STEP 4: Goal setting and planning. As with most successful programs, goal setting and planning are vital elements of success. This involves identification of precisely what needs to be done, who is going to do it, the equipment and facilities required, and a time frame for completion.

STEP 5: Training and implementation. The expert consultant provides procedures, sets up the facilities and equipment, and trains your personnel. Your current hospital cleaning and disinfection procedures are similar to the consultants reprocessing. You will need product functional tests that are simple to learn and implement.

STEP 6: Monitor and report on the programs progress. A most rewarding and important aspect of our program is keeping track and reporting on it. This has highlighted to the team and management the successes and value of the program and made visible the outstanding success in meeting both our savings and quality goals.

It is no secret that our team is very proud of this worthwhile reprocessing endeavor. It has reaped so many rewards that we wrote this article so that others can benefit as we have. Please dont be mystified about your ability to do this. You have the equipment and the personnel and with a little help and support from an expert consultant, you too can experience the rewards we are experiencing. When this idea was first introduced to us, we thought the FDA regulations, the investment in time and equipment, product testing, product quality, product safety and efficacy obstacles would be too much for us to handle. We thought we were too busy to take on this project and it seemed easier to just give our precious savings away to an outside reprocessing firm. As you can see, none of these concerns was valid. To the contrary, we are now better organized, more energized, have improved reprocessed product quality, and are really enjoying the extra money and kudos from our hospital colleagues. There is still a lot more room to expand and still more to save.

Susanne Burnham is director of sterile processing for Wheaton Franciscan Services, Inc. in Wisconsin.

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