Question: What trends do you see in offsite sterilization providers?Â Are most SP/CS departmentsÂ tending to focus on in-house sterilization, or is there an interest in outsourcing as a cost saving or capacity enhancement measure? -- RB, Florida
The trend is slow.Â The reasons:
1. No way to be assured all processes are followed.
2. Cross contamination related to delivery trucks picking up dirty items and delivering sterile ones in the same vehicle and the use of untrained staff.
3. No control of quality of instruments used.
4. Instruments could be used in multiple facilities; there is no control over potentially infectious pathogens or cross contamination from patient to patient.Â There is no way to track a set to aÂ patientfrom one facility to another, which raises concerns for such diseases as CJD, MRSA,VRE, hepititis, and the potential to spread these diseases.
5. Although there has been success in this arena, smaller facilities usually benefit most from these services, and laparscopic instrumentation is the most common service I have seen as of late.
If you are considering this as an option:
1. Do your research.Â Make sure the company is approved for this.
2. Check out the entire operation from recieving to distribution.Â If the company allows surprise spot checks this is a good sign.Â Take your doctors and department heads along on the first walk-through and make it a surprise visit!
3. Ensure you have control over instrument type and quality as well as company choices.
4. What is the turnaround rate?
5. Look at all costs, including hidden fees that may drive your processing costs up rather than down.
6. Who will monitor its success or review the processes intermitently?Â We should never take a turn-them-loose kind of attitude with secondary processing options.