Challenges and Flaws in Productivity Models for Sterile Processing Departments

Over the past 35 years of managing sterile processing departments, I have encountered many challenges related to various productivity models. Throughout my career, I have come across numerous frameworks intended to improve efficiency; however, in most cases, these models were primarily focused on reducing staffing levels within the department.

The Pitfalls of Benchmark Comparisons in Hospital Productivity Models for Sterile Processing

The comparisons that shaped productivity models in sterile processing were often driven by both internal hospital benchmarks and external standards set by industry leaders. However, the inherent challenges and flaws in this approach are the tendency to engage in what can be described as an apples-to-oranges comparison, even when evaluating sister hospitals that may share similar operational goals. For example, one of the comparisons between our hospital and a sister facility involved a cardiac tray. The disparity was stark: one tray contained approximately 40 instruments, while the other hospital's comparable tray boasted well over 100 instruments. In the context of data comparisons, both hospitals were assigned an equal workload based on one tray processed, which ultimately skewed the productivity numbers. The equation utilized to measure productivity then becomes a straightforward calculation of items reprocessed (the number of trays) divided by worked hours (excluding non-productive hours). This method of assessment is inherently flawed and does not accurately reflect the true productivity of the departments involved. To delve deeper into the complexities associated with calculating productivity, particularly in terms of productive work hours, let us explore several critical issues.

Challenges, Flaws, and Solutions for Manual Tracking of Productivity for the Hospital Sterilization Processes

In hospitals that lack comprehensive tracking systems, staff often rely on manual counts to keep track of sterile items being produced. It’s essential for team members to diligently count the number of trays being processed or, ideally, the total number of sterilized items. However, manual counting presents several challenges; it’s easy to lose track of the actual number of instruments being processed, especially since peel pouches can contain varying quantities of instruments, as well as trays themselves.

To improve the accuracy of productivity calculations, consider assigning specific time values to each type of tray or peel pouch produced. For example, a large tray could be assigned a processing time of 20 minutes, while a medium tray might be assigned 15 minutes. This approach will yield a more realistic estimate of productive work hours. The timing assessments should be based on the number of instruments in each set.

Manual tracking is time-consuming and often inaccurate due to human error.

Enhancing Hospital Productivity Tracking With Advanced Tracking Systems

In contrast, hospitals that have implemented effective tracking systems enjoy a wider array of options compared to those that do not. For instance, generating a report to determine what items have been reprocessed can typically be accomplished in just a few minutes, with the added advantage of being able to track when these items were processed. This "when" data is invaluable for mapping out appropriate staffing models, allowing departments to maintain a push/pull model that remains as neutral as possible. With several advanced tracking systems available, it is possible to embed productivity metrics into the database for each set, encompassing both decontamination and prep/pack processes. You can continue to use a similar flat rate as described earlier, but a more effective approach would be to use a specific mathematical equation for each instrument. For example, you could allocate 7 seconds for decontaminating each instrument and 14 seconds for prepping and packaging each instrument. By doing this, you move closer to accurately estimating the total number of productive hours accomplished.

Unaccounted Factors Impacting Productivity

It is important to acknowledge that the remaining lost time, which may not be included in your initial calculations, significantly impacts your final productive hours worked. Below is a list of often overlooked items that can impact productivity:

• Case Carts

• Equipment cleaned

• Deliveries

• Sterilization Loads

• Hand wash (which may necessitate additional time in decontamination)

• Implant trays (which require extra time for restocking)

• Laparoscopic trays (which require extra time for insulation testing)

This list is by no means exhaustive, and many other factors could contribute to productivity discrepancies.

Establishing Realistic Productivity Benchmarks for Hospital Efficiency

Finally, it is imperative to establish a mutually agreed-upon productivity percentage. It is a well-acknowledged fact that no one operates at a 100% productivity rate. The moment an employee is interrupted, their productivity invariably dips below 100%. For instance, if instruments are returned from the operating room and are not in the trays they were originally sent in, significant hours can be lost as staff members search for the correct instruments. The extent of lost work hours will vary from one hospital to another, depending on the design of the department, the methods used for returning instruments to the Central Sterile Supply Department (CSSD), the tracking methodologies in place, and the inspection tools utilized. In my experience at previous hospitals, the agreed-upon productivity percentages typically hovered around 80%-85% for decontamination and approximately 70%-75% for prep/pack.

Conclusion

In conclusion, improving productivity in sterile processing departments requires a comprehensive understanding of the inherent challenges and a thoughtful approach to measurement. The reliance on flawed benchmarking comparisons can lead to misguided strategies that prioritize staffing reductions over genuine efficiency enhancements. By transitioning to advanced tracking systems and assigning realistic time values to different trays and instruments, hospitals can achieve a more accurate picture of productivity. Additionally, recognizing unaccounted factors that impact workflow is crucial for a thorough assessment of operational efficiency. Establishing realistic productivity benchmarks that acknowledge the unavoidable interruptions and complexities of the sterilization process will help departments strive for improvement while maintaining a focus on quality and safety. Ultimately, a collaborative approach to productivity measurement will not only enhance departmental effectiveness but also contribute to better patient care and outcomes in the hospital setting.

At Evolved Sterile Processing, our consultants have a greater focus on sterile processing. With our decades of experience, we will help you develop better processes and educational resources for your staff. The comparisons that shaped these models.