Believe it or not, you’ve likely been caught on multiple surveillance cameras this very day. Whether it was a traffic camera, at the ATM, gas station, hospital security, doorbell camera, or toll booth, surveillance is all around us. For many of these situations, we never give that little recording device on the wall a second thought. We understand the reasons behind most of these different examples and decide instead to focus on all the other things in life that require our attention. When it comes to cameras in sterile processing departments, however, the jury is still out for many teams. Do we need cameras? Do we want them? How should we consider it from the perspective of all parties involved? Let’s take a look at the various insights that inform this question of whether or not to put an eye in your SPD sky.
Get that camera out of my face
First, there is the obvious objection from frontline staff who do not believe their every movement should be captured on video during their time at work. Often you will hear the term “invasion of privacy” brought up and comparisons made with other departments. If you want cameras in our SPD, why don’t they have them in the OR? If you do have your OR suites equipped with a video system, then what about material management? Is it fair that our team is the only one with cameras on our primary assignment areas?
For department staff who have serious concerns or misgivings about surveillance systems in their work areas, one of the most powerful arguments in support of their position is the fact that these employees did not sign up to work in a department with cameras. It’s one thing if you applied for a job in a bank or a convenience store where the standard employment agreement outlines that you will be under video monitoring for your safety and financial compliance. On the other hand, if a technician interviewed for and accepted an offer from a hospital that then decided six months later to install cameras across the sterile processing department, a point can be made that a substantive dynamic of the work environment has now changed. Simply put, 24/7 surveillance is not what they signed up for.
Seeing what needs to be seen
Looking at the other side of the argument, there are a number of reasons why cameras could actually have a positive impact on the department, workflow, and quality outcomes. Facilities where I have seen cameras used effectively have focused on two primary issues: retroactive incident review and asset security. Consider the following scenario: A wrapped but unsterilized instrument tray somehow makes its way upstairs on an OR case cart. Thankfully, it is caught during the setup for the case, and now both teams are scrambling to figure out how such a major breakdown in SPD workflow and instrument tracking could have happened. Perhaps you could ask previous shifts if they remember what happened with that particular tray. Maybe you could hypothesize around the last scan available in your instrument tracking system and pinpoint a particular window of time when the tray was accidentally moved over to sterile storage. But unless a particular person remembers or admits to the error, there is really little else to go on to drill down to the root cause of the incident.
If an SPD camera system was in place during such an event, the situational analysis would be much quicker and more precise. The team could simply rewind to the previous day and watch the steps the tray went through from assembly, skipping over sterilization, and directly into an OR case cart. Perhaps you could see the moment the staff member was interrupted by a phone call or stepped away to unload a cart washer, only to return and inadvertently place the unsterile tray on the wrong shelf, leading to the ultimate result of sending it up for patient use. This scenario is only one example of the myriad potential and real incidents where surveillance footage could be used to identify where and how a process broke down to better determine a process change that can fix it.
Asset security is the other common reason given for installing cameras in a sterile processing department, and the justification for this is almost self-evident. Our departments house anywhere from hundreds of thousands up to multimillion dollars’ worth of surgical instrumentation and supplies. And even though our departments typically have some kind of restricted access, the sheer number of potential visitors, including OR, materials management, vendors, clinics, ER, and environmental services poses a real challenge to the security of these surgical assets. Vendor-owned and consignment implants and inventory in particular represent an expensive and mobile financial risk to our departments. A single large fragment implant tray could easily walk out our door to the tune of $120,000. To reference more recent incidents, a hospital could see $450,000 worth of colonoscopes stolen in broad daylight.1 Surveillance systems are a known deterrent of these kinds of crimes of opportunity, and can give much peace of mind to department leaders who struggle with high foot traffic around their storage areas.
Cameras should be tools, not weapons
One final word on the potential for misuse of surveillance systems in the SPD. If the primary reason that you (as a manager) or your department leadership are considering installing cameras is to enable you to nitpick, hover, spy, or play gotcha on your technicians, don’t even think about it. Camera systems should never be weaponized to undermine trust in your department or replace healthy cultures of honesty, support, and growth. If you feel that the only way that you can know what is going on in your department is to install a recording device, there are five words that you need to hear instead: “Get out of your office.” Spend more time on the floor, talk more with your frontline staff, and build stronger relationships with your shift leaders. These are the things that should always be in the background of every department, whether you have cameras or not.
Ultimately, the question of SPD surveillance is as much of a cultural one as it is a practical one. If used for the right reasons and in the right ways, they can equip teams to better respond to process breakdowns and increase asset security. Used inappropriately, they can further drive a wedge between staff and leadership, and create an atmosphere of anxiety and distrust.
What do you think?
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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