By Weston Balch, CRCST, CIS, CHL
The field of sterile processing is awash with new technologies, ever-tightening accreditation requirements, and an overwhelming flood of cutting-edge surgical instrumentation. But are departmental certification standards and training programs keeping up with these growing trends?
The sterile processing department (SPD) at Jewish Hospital in Louisville, Ky., has committed to doing exactly that. In 2011, the department, which is tasked with processing instrumentation for the 462-bed, internationally renowned, high-tech tertiary referral center, had a total of 26 employees, with half of those being 13 contract travelers. Of those original 13 employees, only one possessed an associate’s degree, and none held certifications in the field. Four short years later, anchored by aggressive certification initiatives and bolstered by an integrated training regime, the department consists of 33 employees who hold a total of 24 college degrees (including six graduate degrees), 22 CRCST certifications, eight Certified Instrument Specialists, and six Certifications in Healthcare Leadership.
Jewish Hospital’s SPD has not always been defined by such success. When hospital administration released its top 10 patient safety concerns just four year ago, sterile processing was third on the list. “It was a very different time and very different departmental culture,” recalls Karen Owens, BSN, CRCST, CIS, CHL, FCS, system director of sterile processing for KentuckyOne Health. “The turn-around began when we instituted the CRCST certification requirement, but the rest was accomplished by the team buying into the vision that their jobs were too important to patient safety for them to be content with professional mediocrity.”
The team traces the roots of their success back to education and certification. “There is a structure to everything, and not a day goes by that we are not intentionally learning or teaching something to someone else,” explains Jennifer Hay-Fernandez, CRCST, an SPD technician. Every department preceptor is given an integrated certification training matrix to follow with new employees that combines hands-on competency training with chapters from the International Association of Healthcare Central Service Material Management (IAHCSMM) certification book. “The new hires love it,” Hay-Fernandez notes, “because it gives them technical categories where they can put everything else they are learning on the floor.”
While two states (New York and New Jersey) currently require sterile processing certification, and two others have similar legislation in the works, there are still large portions of the country that more resemble the Wild West rather than the 21st century in terms of healthcare. This is not the case at Jewish Hospital, where structured education has been made paramount. Their SPD requires new hires to go through a rigorous three-month training period and then pass the Certified Registered Central Service Technician (CRCST) exam within 15 months of their hire date. However, this was just the first stage of their progress. Even with the required certification and training period, the facility noticed that there can be a very real disconnect between viewing certification knowledge as what you need to keep your job and viewing it as what you need to actually do your job – and do it with excellence.
The team began looking for every opportunity available to integrate industry standards and professional development into their department’s daily schedules. Second shift supervisor Robert Parker, CRCST, CIS, CHL, explains, “We took 10 minutes at the beginning of every shift to educate staff on proper procedures from manufacturers’ instructions, held weekly staff meetings covering new processes, set aside time for staff members to study for their certification exams, and by that, began building an entire ‘certification mindset’ among the staff.”
The impact of this mindset in Parker’s department has been widespread, not only increasing the confidence of his staff in handling day-to-day processing issues, but also raising the entire tenor of professionalism experienced by the rest of the hospital. The facility's sterile processing team – from the manager to the newest technician – is now capable of engaging with and even educating OR nurses, scrub techs, and physicians on technical issues regarding microbiology, the mechanics of steam sterilization, and AAMI standards for processing surgical instrumentation.
Their entire leadership team have been advocates for this professional worldview. “We know that credentials alone do not create the kind of quality-centered culture being promoted here,” says John Rowe, CRCST, CIS, CHL, instrument coordinator for Jewish Hospital, “and that is why we focus on applying that knowledge, and viewing ourselves as a conduit for spreading it to the rest of hospital.”
Rowe and five others have helped put Jewish Hospital on the map for the number of triple sterile processing certifications employed in a single facility. Data collected from IAHCSMM ranks the Jewish SPD fourth internationally in total number of triple certified technicians, meaning they hold the required CRCST certification, as well as the CIS (Certified Instrument Specialist) and CHL (Certification in Healthcare Leadership). “The knowledge gained by obtaining the CRCST is instrumental in a technician’s ability to perform. But, the knowledge gained from both the CIS and CHL increases that knowledge exponentially; thus making these certifications imperative for technicians to provide excellent patient care,” Rowe urges.
Even with the progress that has been made over the last few years, the Jewish Hospital team is not about to stop here. Healthcare does not stand still, nor does industry knowledge. That means that we cannot afford to stand still as a department. These certifications we pursue and the education we focus on tell our patients that we care, and that we are serious about providing the best sterile processing service in the country.
In a world of increasing accountability for healthcare outcomes and tighter accreditation standards from various agencies, the worldview that sterile processing industry certification provides is vital for hospitals wanting to reach that next level of quality care. If sterile processing technicians are really the experts when it comes to sterile surgical instrumentation, then it’s about time our resumes start looking like it.
Weston "Hank" Balch, CRCST, CIS, CHL, is manager of sterile processing at Jewish Hospital & St. Mary’s HealthCare in Louisville, Ky.