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Here’s Your Sign: The Power and Purpose of Visual Aids in Your CS/SPD Workflow

Human beings are big fans of signs: stop signs, danger signs, big signs (billboards), little signs (labels), and every kind of sign in-between.

It should come as no surprise that this love affair with signage can make its way into our CS/SPD departments. As with all things, this affinity with visual aids can be taken to extremes, but in general, good signage is an important tool for driving standardization and efficiency in the world of surgical instrument cleaning and sterilization. Let’s take a look at a few critical areas where signs can take your teams to the next level of instrument processing excellence.

Through new eyes: Cleaning in progress
One key to creating spectacular signs is learning to view your department as a new hire views it. Imagine it’s your first day working with a trainer in the decontamination area. You walk in, see a bunch of buzzing machines, surgical trays in various stages of processing, and a whole lot of stainless steel. What is the flow of this room? Where should things go and how would someone know?

For example, if you separate the workflow of your decontamination area according to items that will require terminal sterilization and items that will be disinfected only, posting signs that identify these specific instrument routes through your physical decontamination space can assist technicians in routing this inventory appropriately.Using visual cues to designate areas for hand-wash-only items can also help take the guesswork out of where to stage these devices for further processing by your CS/SPD team.

This foundational workflow signage has potential application throughout the entire reprocessing lifecycle, from creating signs in the assembly area based on the staging of priority trays and service lines to designating sterilizer cooling areas to quickly and safely distinguish between carts that are being loaded and carts that have already undergone the sterilization process. Again, the key is to view your department with new eyes and visualize the workflow in a way that communicates the general flow of instrumentation from one stage to the next.

Little labels, big impact
Besides workflow signage, another particularly useful sign-related tool available to CS/SPD teams is the indispensable, information-packed label. You may not even be aware of how many types of labels you are already using in your workflow, from tray-specific labels and barcodes to sterilization load stickers to flexible endoscope hangtags. These little labels can and do have a tremendous impact on the overall quality and efficiency of your reprocessing mission.

For tray labels in particular, the possibilities for excellent signage can be endless. If your CS/SPD is one of the lucky 50% of departments in the industry that uses a computerized instrument-tracking system, you know how powerful one little barcode label can be for creating critical transparency in your reprocessing chain of custody. But even without a barcode, tray labels can communicate all kinds of useful information as they accompany a surgical tray through your workflow.

For instance, you could put any or all of the following helpful information on a tray label:

  • Name of the tray: To assist with rapid identification and correct labeling for sterilization and storage.
  • Service line: To assist with workflow routing and enable more efficient searches for instruments that become mixed up between trays, known as instrument migration.
  • Priority status: To notify technicians in the decontamination and assembly stage of the critical or priority status of a particular tray (this can be written or color coded on the label).
  • Processing parameters: To remind or reinforce parameter compliance throughout the workflow (i.e., Soak 5 min, Sonic 10 min, Sterilize Steam 4min, 270, 30 min Dry).
  • Brush size: To specify manufacturer recommended length and diameter of cleaning brush needed for particular devices.
  • Tray weight: To assist in IFU-compliant loading of sterilizers (they have maximum load weight limits, but that’s for another article) and compliant storage (most instrument wrap also has a maximum weight limit associated with it).
  • Packaging method: To ensure trays are packaged according to their assigned method, via wrap, peel pack, or container system.

Technical aids: Eternal training reminders
In addition to wonderful workflow signage and luxurious tray labeling, let’s cover one more outstanding opportunity for high-quality visual aids: technical reminders. While new employee orientation may only last 90 days, learning should last a lifetime, especially when it comes to the technical aspects of the sterile processing profession. Signage focusing on technical reminders could include anything from displaying specific IFUs for complex devices at the point of processing, such as wall sheets for robotic arms and flexible endoscopes, all the way to instrument inspection posters hanging in your department breakroom.

The important aspect of this type of signage is that it should target particular tasks and decisions that carry with them a higher level of complexity or risk. For instance, you may not need a sign in your department for how to empty the trash can, but you may want to think about creating one for how to correctly document readings from your biological indicators. If you notice reoccurring errors and oversights happening among your team, consider the impact that a well-crafted and well-placed sign could have as one aspect of your corrective action plan.


Best practices and the best signs
As with anything else, there are a few guardrails to keep in mind before you go drop a nuclear sign bomb in your department tomorrow morning. Too much of a good thing can turn even the best signs into mere white noise and wallpaper, instead of a true asset to your department ambiance. Moderate your signage decisions to the most important, most helpful signs for each area of your workflow, and then find other creative ways to supplement the process along the way.

For the most professional (and accessible) effect, ensure signs are of an adequate size and font to allow for easy reading by your technicians, especially if they are posted in the decontamination area, where PPE can make visualization of a small font more difficult. When possible, use the same color scheme and format to give your signage a uniform and professional presentation for your team and department guests. You want it to look more like a doctor’s office and less like a college dorm room. Finally, be willing to read the writing on the proverbial wall and update your department signs when necessary. As your processes and policies change over time, so should your signs.

With that, STOP reading, YIELD to the temptation to make some awesome signs, and GO make greatness happen in your department today.

1AAMI ST79:2017 3.2.2(a)

Feature articles exclusively for Ultra Clean Systems by Weston “Hank” Balch, BS, MDiv, CRCST, CER, CIS, CHL

Weapon of Mass Microbial Destruction * Professional Clean Freak * Podcast Host * Safety Addict * CS/SPD Consultant

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