ICT talked to Don Gordon, MPS, CRCST, FCS, a former central sterile manager, past-president of IAHCSMM, and current territory representative for Healthmark Industries Co., about the importance of certification of sterile processing (SP) and central sterile (CS) department personnel.
Q: Certification is preferred over the much more stringent licensing approach; what are your concerns about the impact of licensure?
A: First, I do not have any concerns about licensure except to get across to CS professionals that licensure comes with a licensure fee, that they must pay as individuals. However, in the long run, this will elevate their importance in the healthcare arena and eventually increase their salaries. Originally, New York state wanted to do it the “Jersey way” through the New York State Department of Health. Unfortunately, we did not have a Tony Monaco to champion our cause and “raise the bar” for central service across our state. With Tony as our mentor, we tried working with the state health department, but unlike New Jersey, the state health department did not have adequate manpower to monitor the process in hospitals. We then realized that the only other route toward mandatory certification in our state was through the licensure route and the New York State Legislature.
Q: What is the New York State Association of CS Professionals (NYSACSP) doing to continue to lobby for certification even as the legislature debate the topic? And what is the most up-to date status of the bill?
A: The bill for licensure for CS professionals has many sponsors both on the assembly and state sides of the legislature, but for the bill to come to a vote, it must first receive approval from the state legislature’s educational committee. Right now, this is where the bill stands at this time. CS professionals from across the state have had bus caravans to Albany paid for by the local chapters. Once in Albany, we set up appointments with our respective members of the legislature and met with them in small groups of three or four to get our key points across. We tried to concentrate on members of the state education committee. In the last two years, we have had two such visits to Albany and this year our visit will take place in April before this interview is published. We are very persistent in trying to make our government leaders understand the importance of this bill. Last year, when visiting Albany, we encountered an opposition group lobbying against us; we were surprised to learn it was the state’s AORN. We were surprised because we thought that they would be the one group who would want to “raise the bar” in CS since they are on the receiving end of the end product we produce — a clean, safe, sterilized instrument tray in their ORs with the common goal being patient safety. I believe since then, there have been discussions with the group, but I have not been privy to the outcome of those discussions. We have also employed a lobbyist, which is very costly and is paid for by contributions from our six state chapters and the proceeds from our annual state seminar. Incidentally, we started building up our “war chest” through our seminars over the last eight years.
Along these lines, future support from our national association is important and essential. In my opinion, a budget for assistance in achieving state mandatory certification/licensure by the International Association of Healthcare Central Service Materiel Management (IAHCSMM) should be established. States such as New York are in the process of working with their state legislatures and a lobbyist is essential in this process. IAHCSMM could set up matching funding with a limit for each state (e.g., $10,000) for the hiring of a lobbyist. I believe there are at least six or seven states that are in the process of trying to achieve mandatory certification/licensure in their states. New Jersey started the trend, but without a Tony Monaco in each state, the task becomes very difficult. I started my career as a respiratory therapist and I was very active in our state organization; we were also trying to achieve licensure in New York state. The national association provided funding for a lobbyist, realizing that New York was a key state in the national scene. With the help of the lobbyist, the bill was passed there and respiratory therapists are now licensed – and other states followed.
Q: For anyone who remains unconvinced of the need for certification, what are the benefits of certification?
A: Stephen Kovach and I authored an article in April 2004 (at that time I was IAHCSMM’s president-elect) titled, “Raising the Bar: Why Central Service Certification makes a Difference.” The last paragraph in the article probably sums it up best: “Professionals who become certified generally remain in their profession for the long run. They want to do a good job and to perform at the highest level possible. Their certification announces to the world that they are competent and perform quality work. Many healthcare professions — respiratory therapy, physical therapy, surgical technology, radiology, for example — require some sort of certification or licensure of their practitioners. As a result, people in these professions are more highly regarded within the healthcare hierarchy and better compensated than those in central service. With certification as the norm in healthcare, why has it been so hard for central service staff not only to become certified, but to be recognized.”
Q: What lessons can be learned from New Jersey?
A: That mandatory certification does “raise the bar.” That mandatory certification in CS makes hospitals aware of the importance of hiring a certified CS professional. That mandatory certification meets the AAMI ST 46 recommended standard: “It is recommended that all personnel performing sterilization activities be certified as a condition of employment. As a minimum, all personnel should successfully complete a CS Certification examination within two years of employment.” In the future, I hope that the recommendation from the Association for the Advancement of Medical Instrumentation (AAMI) expands to the cleaning and decontamination side as well, since the cleaning process is the integral first step of the sterilization process -- if it isn’t cleaned properly, it cannot be sterilized. Just as important, it is the CS staff on the processing side that is handling the instruments – it’s an important safety factor for them. And lastly, mandatory certification does raise CS salaries on all levels within the department.
Q: What can SPD personnel do now to prepare for might come down the pike in 2010/2011?
A: Start taking the CS certification courses that are available in your local area or online. Become certified ASAP!