This community hospital had no formal process in place for updating operating room instrument sets and requested that Novia provide assistance in the development and implementation of a strategy to standardize their approach and to reduce waste in the process.
Setting up and monitoring a sterile field in an operating room is a challenging task, especially when complicated by numerous instrument sets that only contain a small portion of the instruments needed to perform that specific surgery. Years of adding a few more instruments to a set to satisfy surgeons without removing unnecessary pieces had resulted in sets that were too large and too heavy, and potentially compromised regulatory standards and sterilization processes. Additionally, the reprocessing of unused instruments was creating rework for the central sterile supply department (CSSD).
The initial work to identify set consolidation opportunities occurred via two methods. The first method was to work with Instrument Specialist (IS) and Specialty Charge Nurses (SCN) to review usage history and document opportunities identified in orthopedics, general, and gynecological surgery. Secondly, pick sheets for the top 20% of surgical procedures performed during the previous 12-month period were reviewed to determine opportunities by comparing pick sheets for surgeons performing the same surgeries. Anecdotal evidence was also gathered through interviews and discussions with staff from both departments which provided qualitative information.
The approach is discussed in more detail in the full case study.
“A decrease of 30% to 50% in the number of sterile instrument sets opened demonstrates the success”.
The decrease also translated to less time spent in rework for CSSD when unused instruments were returned for reprocessing. This decrease in CSSD over-production and extra processing allowed staff to focus on improving set accuracy and reducing defects during reprocessing, resulting in a higher level of customer satisfaction from surgeons and operating room personnel.