By Kelly M. Pyrek
ICT spoke with Marilyn Conde, CRCST, MAOM, FCS, manager of material management at St. Francis Medical Center in Lynwood, Calif. and a member of the board of the International Association of Healthcare Central Service Materiel Management (IAHCSMM).
Q: Do you believe that material management should be a separate function from sterile processing? Central sterile is often combined with sterile processing yet functions are different can you shed some light on the different configurations at hospitals these days and provide your perspective?
A: The term "material management" is like an umbrella which covers many areas. Many different departments will function under the title of material management. For instance, my title is manager of material management and I oversee the functions of the central service department, storeroom, par level (floor supply carts), purchasing, mailroom, reprographics and operating room (OR) supply. Other areas that might fall under material management could be linen and patient transport. Every facility is different. In many facilities the sterile processing function falls under nursing and reports to the OR director. Sometimes that is more difficult, and in some arenas it works well. Personally, I prefer working for materials management. I have a strong nursing background and that helps me with the nursing side. I also have a degree in business, so that helps on the materials side. But definitely, material management functions much differently than a sterile processing department. We just try to live together in the same family. When you refer to sterile processing, to me that means only sterile processing. Central sterile could mean only central sterile supply or it could mean sterile processing as well. It seems in the profession, we cannot seem to agree on a common name or common function. My central service department does everything sterile processing for the OR, ER, labor and delivery, and all units requiring sterile trays; handling of patient-care equipment and the distribution of patient-care supplies, both sterile and non-sterile. Some hospital have the function of sterile processing only in the OR and are only doing the OR trays. In that case, the distribution side is covered by another department. How can we explain things to others, when we cannot decide on the functions ourselves? I am very much in favor of the name that IAHCSMM has adopted: CSSD Central Sterile Supply Department. I think that covers that everything we do.
Q: What are the biggest breaches in protocol that you see happening when it comes to sterile inventory management and how can they be corrected?
A: How we handle sterile supplies is very important. This is when the items first arrive on the receiving dock, to its final destination on the shelf in CS, OR, or the cath lab. This also holds true for all items processed in central service and then transported to the end users. We must make sure that the associates in the storeroom are as educated as to the proper handling of sterile supplies as are the CS technicians and OR personnel.
Q: How can infection preventionists, surgical services personnel and CS/SPD/material management work together to ensure the sterility of packages and trays and other sterile items?
A: I am not sure how the infection preventionists work into this picture, but the surgical services personnel and the CS staff must work together. Each department is responsible for making sure that that item is sterile and safe to use on the patients. CS staff need to make sure all the QA checks are complete. They should never send over a tray that is questionable. On the other side, the OR staff must check that tray before the set it up on the sterile field and make sure it is safe to use. Only by working together can we maintain a safe environment for our patients.
Q: Are you involved in product evaluation and purchasing? If so, what are the challenges of balancing cost, quality, clinician preference, performance/efficacy of the product and impact on patient outcomes?
A: I do sit on the Value Analysis Committee, our products standards committee. I was the chair for many years; now I work closely with the chair, who is the director of material and resource management (my boss). We meet monthly and it is a challenge to get what the nurses need, make sure it is an item that is safe for use, efficient and a good price. It is indeed a juggling act. We do have contracts we must look at as well and system protocols. I think all hospitals have the same issues, but we try very hard to get the nurses what they need to do their jobs and keep within our budgetary concerns. Sometimes if it is the best item, and it may be the only one out there, we will bite the bullet and bring the item in. We certainly want to make sure we have positive patient outcomes no matter what product we decide to use.