While one facility's healthcare leaders are scrambling to explain how 11 years of sterile processing challenges went unaddressed and unmitigated, those of us in the industry know this instance is not an outlier.
As frightening as it may be, the perfect storm of oversights and lack of accountability that have led to a federal probe into the quality of surgical instrument reprocessing at the Detroit Medical Center is much more common than the general public may know.
Simply put, the state of sterile instrument reprocessing in America is broken. From Huntington to Cincinnati and countless other hospitals across the country, the inability of surgical instrument reprocessors to consistently deliver quality instrument to the operating room suite has reached epidemic levels. While there are a number of reasons for these processing challenges, there are at least five quality indicators that could signal that your facility could be the next Detroit...
1) No Required Sterile Processing Certification
Although Tennessee recently became the fourth state in the union to mandate certification for instrument reprocessors, the vast majority of states and facilities require no standard certification for technicians responsible for processing surgical instrumentation. This lack of standardized knowledge and industry credentials has created a 'wild west' of processing guidelines that leave many departments at the mercy of whatever local training program (or lack thereof) that may be in place for new instrument technicians. With these poor training systems in place, quality breakdowns are a foregone conclusion.
2) Inadequate Staffing Models
As the healthcare industry has encountered more and more pressure for cost-savings at the facility level, sterile instrument reprocessing departments have often been the positions that end up on the chopping block. Since the position is often entry level, it is seen by many hospital executives as merely ancillary to higher profile nursing and direct patient care positions. Unfortunately, this has led to many instrument reprocessing departments with inadequate support staff to create and monitor quality assurance programs and develop process improvement initiatives.
3) Limited Capital Equipment/Technology Investment
Many instrument reprocessing departments have been overlooked for generations now when it comes to appropriate investments in the kinds of modern disinfectant and sterilization equipment needed to ensure compliance with medical device manufacturer's recommendations. Instead, money is invested in new surgical equipment and building programs that ignore the reprocessing infrastructure needed to keep up with the increased volume. A large portion of our nation's facilities do not even have computer tracking of their surgical trays, so each instrument has to be manually document with pen and paper.
4) Non-competitive Salary Disincentivizes Quality Candidates
In addition to the lack of capital investment, there is a striking lack of human resource investment in terms of competitive compensation for the level of expertise required for high quality instrument reprocessors. Many hospitals around the country start their sterile technicians out anywhere from the minimum wage up to the mid-fifteen dollars an hour level. This low wage as an industry prohibits department leaders from recruiting and retaining higher quality candidates that would raise quality standards, production capacity, and critical thinking skills that could reduce process breakdowns.
5) Disengaged Hospital Leadership
Perhaps more than any other indicator on this list, disengaged hospital leadership is a likely sign that sterile instrument reprocessing needs are not being addressed as they should be. Although physicians are often aware of instrument quality challenges, few would have the holistic perspective that C-suite executives would gain with regular engagement with instrument reprocessing leadership. Our industry guidelines (such as ST79 from the Association for the Advancement of Medical Instrumentation (AAMI) and the Guidelines from the Association of periOperative Registered Nurses (AORN)) are well known, but inconsistently applied – often because of a lack of administrative support at the facility level.
If your hospital has these quality challenges, you could very well be the next Detroit...
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Weston "Hank" Balch is the Director of Sterile Processing Operations at University Health System in San Antonio, Texas. His articles have been published in Infection Control Today, Communique, and Healthcare Purchasing News, as well as over 50 LinkedIn Pulse articles that feature creative solutions and novel approaches to relevant topics in the world of Sterile Processing.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.