This year for Christmas our sterile processing department would like 8 new cleaning brushes added to par level inventory, 7 new technicians (preferably certified), 6 sterilizers deep cleaned, 5 take-apart Kerrisons, 4 cushy floor mats, 3 borescopes, 2 turtle doves, and a partridge in a pear tree.
Struggling, Overworked CS Manager
You get the idea. Wouldn’t it be lovely if Santa could magically appear on Christmas Eve, PPE it up, and leave the department fully staffed and equipped with all the tools necessary for patient safety? The sad reality faced so often is financial decisionmakers don’t see your wish list as critical needs, but rather as another capital equipment request. So, let’s break this down into the three approaches and the people you need to get involved to build a case for your immediate needs. It starts internally and moves outward.
Infection control can be your Rudolph and lead the sleigh through the foggy night. Let’s use a take-apart Kerrison for an example. When approaching your infection control (IC) specialist, here’s what I recommend:
- Meet with IC. If you have any recent photos of mishaps that have taken place intraoperatively, bring that evidence, as well as the case date, time, and any supporting photos that coincided from this occurrence. Pro tip: Bring the angry nuero coordinator to the meeting. After all, they had to deal with the fallout during the case and they will have invaluable feedback.
- Bring the culprit (a Kerrison) with you to the meeting. Walk infection control through the current process for cleaning them, the function, and the IFUs that support the specific model. Explain the challenges you face and why it’s nearly impossible to follow the recommended best practice.
- Show them the best alternative to this problem. This would be a model of Kerrison that can be cleaned, that you’ve researched with the nuero coordinator, and that has been surgeon approved.
Get your vendors involved. Believe me, they want to make a sale and they want to see you win. They can absolutely help build your case. Let’s stick with the take-apart Kerrison example. The rep can do more than provide you a quote.
- Ask the rep to assess the current state without their product in use. What have they seen in cases, what conversations are happening behind closed OR suite doors, and what is their professional outlook on where you are today?
- Education is key at this juncture. Ask your rep what education (if any) can be provided to address the current state, and what education would look like if the device they sell gets internal approval. How will that rep help your staff understand the IFUs, the product use, and the care and handling required to increase its longevity?
- Get success stories from them. For example, Hospital Santa’s Good Samaritan purchased our Kerrisons six months ago and they have seen a decrease in delayed cases, as well as a decline in documented complaints related to gross debris found in sterile sets.
Get the cost analysis facts to the financial decision makers, because we all know that bottom line they are tasked with is not buying a mistake and managing a strict budget.
Scrooge (actually the CFO) says, “Yes, Susan, that’s an excellent wish list. Hopefully you’ve been a good girl this year.” Swiping left in his mind, he hands you a candy cane. You swear you hear “no, no, no” huffed under his breath. What can you give them to get buy in?
- Documented findings from conversations with infection control. Provide the cases that have been a liability because you didn’t have said new Kerrison. State the number of occurrences where it would have looked very different if you had the necessary tools. Quantify the delays and add up all the numbers to demonstrate that doing nothing is not a viable option.
- Professional recommendations that were gathered from your vendor. With additional vendor support, it might be helpful to establish the cost to eliminate the liability and replace the devices with the new ones. The proven success stories from that rep visiting other facilities (bonus points if it’s from a facility within your same healthcare IDN) may prove beneficial.
- Data and spend assessment. Spell it out. A typical delay from finding blood in a Kerrison set us back 30 minutes, 8 trays had to be reprocessed, and the soft goods (disposable drapes, gauze, cotton balls, disposable syringes) had to be replaced. Let’s also add in surgeon and OR staff time. Find current data for cost per minute in the OR and the cost of all soft goods. Let’s say the hypothetical cost for one tray and the delay can range from $140–373. Now multiply that by 8 trays and it can cost up to $2,984 for one incident. This is low-balling it. If a single Kerrison costs $1,400 and a set of 5 comes in at approximately $7,000, you can see how this device pays for itself quickly.
- Risk avoidance is worth bringing up. If even one patient gets a surgical site infection that can be tracked back to this, it’s bad press. If the bad press escalates into something bigger or your operating rooms are shut down until remedied, then it’s a whole different story, financially speaking.
Finally, as a professional working in the field and daily in your department, no one understands your specific needs quite like you. To see success and gain approval on that wish list, involve infection control, vendor expertise, and come armed with data that will support your case from a liability and financial perspective. Let’s turn your wish list into a wake-up on Christmas morning bright-eyed. “Holy heck! Santa came! I can now rest a bit easier knowing my patients will be safer, and I’ve done everything within my power to make that happen.”
Rebecca Kinney has been working to improve patient safety in the medical arena for more than 13 years. She provides educational content on LinkedIn to help sterile processing and medical professionals gain knowledge as it relates to surgical devices, and her articles have appeared in Outpatient Surgery magazine. Her articles focus on the practical, hands-on knowledge operating room professionals can benefit from—never lacking in entertainment as she unfolds the true reality and struggles that are faced every day in the operating room setting. She is also a small business owner of a startup sales and marketing consulting agency.
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