7 Common Pitfalls to Avoid to Ensure a Successful ASC Reprocessing Program
By now, most ambulatory surgery centers have heard of, or have even tried, reprocessing programs, often with varying degrees of success. If we dissect what often goes wrong in a reprocessing effort, we can develop some guidelines for implementing one successfully.
But first, let's define what we mean by reprocessing of single use devices. Reprocessing companies, under FDA regulation, develop processes whereby devices undergo rigorous cleaning, inspection, refurbishing, testing, packaging and sterilization to deliver devices that function like new. While much time and education is spent on the science behind the efficacy and safety of reprocessing, which is appropriate, the real results of reprocessing are borne out in the service of reprocessing. So, I will start with the premise that the quality, efficacy and safety of reprocessed devices has to be and is in fact is similar to new devices, as demonstrated by the over 70 million devices that have been successfully reprocessed in the United States.
Therefore, the breakdown or the barriers to maximizing reprocessing often lie in the service of reprocessing. The seven issues outlined below tend to be leading causes of a reprocessing programs lack of success.
1. The reprocessing opportunity is not clearly defined. What does success look like? The best way to know how much can be saved by reprocessing is to analyze your facility's current spend on devices that can be reprocessed. Your reprocessing company should be able to do this for you. Done correctly, the reprocessor and facility can agree down to the individual device what, and how much, will be reprocessed and what the targeted financial results will be. Goal-setting and agreement is the first step to any successful reprocessing program.
2. There is a lack of the right education at the right time. Education is at the core of successful reprocessing because there are many misconceptions around the science of reprocessing and reprocessing requires a change in behaviors and patterns at a facility. People in your facility will have questions at different times about various aspects of reprocessing. Your reprocessing partner has to be available to give you those answers. Education also needs to be conducted with all parties — from surgeons, to technicians to administration — all of whom will have very different questions from their own vantage point. This education needs to be tailored around the specific needs of your facility and your people: who has issues or poor history with reprocessing? Who has never heard of it? Who is already a strong advocate? Often the best education is first listening to individuals' concerns, then providing factual feedback. Surgeons sometimes prefer to "experience" reprocessing after understanding the evidence. Experience is best done through a blind study (side-by-side use comparisons of new and reprocessed devices) with the outcomes ultimately being that surgeons cannot tell the difference between new and reprocessed.
3. Lack of WIIFM (Whats In It For Me) for your staff and surgeons. Many of the most successful reprocessing programs throughout the country have established incentive programs that benefit key staff. At the least, consistent communication on the financial benefit for the center needs to occur on a regular basis. When reward programs are put in place, reprocessing programs thrive.
4. Potential issues are allowed to fester. After the critical launch phase of education, the next most important point of education needs to occur after perceived or real issues surface with a reprocessed device. I have often heard surgeons say, "when in doubt blame reprocessing" — often accompanied by a smirk or chuckle. This sentiment underscores the skepticism that lingers around reprocessing. Your reprocessing company needs to acknowledge device issues. Further, failure to respond quickly will cause a negative perception to spread and can erode even an established reprocessing program. A good service-oriented company will take this opportunity to reinforce the quality and rigor behind the science of reprocessing — and remind surgeons that as reprocessors we cant make a device better than new. If a surgeon experiences performance issues with new devices, s/he will experience those same performance issues with reprocessed devices — although it should not be at a greater rate than that of new devices.
5. OEM tactics confusing the benefits of reprocessing. Original equipment manufacturers have been fighting reprocessing for years and are spending millions of dollars to do so. The forms of "evidence" used to combat reprocessing include OEM-sponsored studies with loose scientific parameters, spreading surgeon perception of reprocessing from years ago and contracting strategies used to prohibit reprocessing. It is critical that when these tactics are encountered, immediate education is provided on the safety and cost effectiveness of reprocessing. The facts speak and scientific evidence in support of reprocessing speaks for itself and can't be refuted. Very few OEM proposals can match the financial advantage of a reprocessing program when you consider that reprocessing will nearly cut your device acquisition costs in half.
6. Lack of a true partnership. A reprocessing program is a true partnership with your reprocessing company. The reprocessing company can't do it all without having a committed and willing partner — your facility. The best examples of partnership start with a commitment to the outcomes from the very top – from the CEO, CFO, COO, for example. Consequently, the tone is set on expected goals and the behaviors reinforced to achieve those goals. The next critical constituency to have "on board" is the surgeons. Excluding them from the decision-making process is a fatal flaw to launching a reprocessing program. Finally, the best run programs have a designated "Champion" within the facility who is reminding, cheerleading and continuing to reinforce the goals set forth by leadership and how your facility is executing towards those goals on a daily basis. Often it is just simple reminders for attentive behaviors in order to get single-use devices to the reprocessing company.
If the reprocessing program is merely "pushed" by the reprocessing company, it will be seen as a "vendor" trying to make money, rather than a partner working alongside you and your facility to achieve a common set of goals.
7. Lack of detailed information needed to continue to drive savings. A given surgery center may use hundreds of different devices that can be reprocessed. In general, all single-use devices should be sent to the reprocessing company. Too often, however, only a dozen or so are captured at the facility, far from the quantity of new instruments being purchased. Therefore, using the data from the original opportunity identification/goal-setting phase and comparing it to what/how many devices are being sent to your reprocessor helps to prepare "gap analysis" reports. This gap analysis reports highlight the top cost savings opportunities left on the table for your facility to capture. It creates actionable items for the reprocessing company and the facility to integrate those devices into the reprocessing stream. This is the only way to create specific, measurable steps to continue to drive towards your targeted reprocessing savings goals.
Your potential reprocessing partner should be able to provide information to satisfy your concerns about their company's ability to deliver a successful reprocessing program that avoids on the common pitfalls outlined above.
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