Becker’s Hospital Review recently spoke with three professionals who manage or liaise with SPDs:
- Roger Fries Jr., SPD clinical manager of OrthoIndy Surgical Sites (Indianapolis, Brownsburg, Greenwood)
- Ryan Pistone, Former orthopedic representative at Zimmer Biomet
- Rick Martz, sales representative of ONE TRAY® and EZ-TRAX™ at 3T Medical
Each representative shared their perspective on how ONE TRAY® and EZ-TRAX™ — a combination of an efficient rigid sterilization container and a new generation custom surgical set organizational system — can overhaul SPD workflows for increased efficiency and improved staff satisfaction.
The excessive operational burden on crucial SPD staff often goes unacknowledged by surgical and administrative teams
“It’s a well-known fact in hospitals that busy ortho days are going to clog up every aspect of the sterile processing department,” Mr. Pistone said. He painted a real-world scenario in which a busy surgeon performs up to 10 total joint replacement surgeries a day. “That’s great for everybody in the hospital, except for sterile processing that’s constantly turning [surgical instruments] over; it adds a big burden on them.”
This burden originates in part from the reprocessing workflow, which involves washing, decontaminating, cleaning, hand-inspecting, prepping, wrapping, and sterilizing the surgical instrumentation sets. The demands on throughput are often aggressive due to the fluctuating volume of surgical interventions and how limited the number of available sterilization trays and autoclaves there are. “On average, it takes about four and a half hours to process a surgical instrumental set using traditional sterilization containers,” Mr. Pistone explained.
The limited number of instrumentation sets elevates the need for faster processing between surgeries. “The biggest challenge is keeping up with the throughput of instrumentation and making sure that we have the volume of surgical instrumentation we need for the volume of cases that we’re doing,” Mr. Fries said. Mr. Martz agreed. “[SPD staff] have to make a decision on adding additional sets versus seeing if there is another way to get more utilization out of the current number of sets that they already have,” he said. Both Mr. Fries and Mr. Martz noted that SPDs across the United States are often short-staffed, which also inhibits throughput.
Another reason SPD staff are overwhelmed stems from the highly specialized nature of the surgical instrument sets which manufacturers design to cater to surgeons regardless of intervention techniques. For example, a total knee replacement procedure requires six to eight standard trays, even though the specific instruments used in most operations may only need three. Therefore, any unused instruments in an open tray must still be decontaminated, cleaned and re-sterilized.
“Total joint vendors designed their trays that way because otherwise they would have a billion [customized] trays and it would be too complicated on their end. But that’s not the best tray design for hospitals because it means surgical facilities are burdened with a bunch of trays and a bunch of instruments that will never be used,” Mr. Pistone said.
Improving efficiency is a top priority for SPDs – ONE TRAY® and EZ-TRAX™ provide options
As noted, conventional sterile processing workflows are inefficient because of limited staff and materials coupled with increasing workloads. Innovative Sterilization Technologies rigid sterilization container, ONE TRAY®, incorporated with their EZ-TRAX™ organization system, optimizes efficiency by saving approximately 2hrs+ per case throughout the reprocessing cycle.* This includes savings in decontamination, cleaning, washing, sterilization (dry time not applicable), and in the OR.
The EZ-TRAX™ modular system optimizes surgical set organization and offers better prioritization of total joint sets to reduce the number of trays from 6-8 to approximately 2-3. “That’s a big deal for the ortho scrub tech to have a lot less on his or her back table, as well as per SPD. [The impact on] throughput is that you’re able to get many more things done in one washer or sterilization load versus two,” Mr. Martz said.
Orthopedic ASCs and other similarly specialized surgical facilities have smaller SPD teams, despite the ever-increasing case volume. As a result, maintaining efficiency and quality assurance may be especially difficult using traditional trays in a traditional workflow.
“For a smaller organization like ours, it’s very hard to get approval to hire more people in the SPD, even if surgical volumes are growing. That made us look at other ways to be efficient and one of those was to reduce the number of trays we were sterilizing,” Mr. Fries said, explaining how OrthoIndy leadership made the decision to begin using EZ-TRAX™ for total knee procedures. “That reduced the workload for my SPD techs.”
Mr. Fries added that using EZ-TRAX™ provides a practical, consistent pathway for SPD managers to, “push your vendors to customize their trays which reduces the instrumentation to ONLY what the physician is truly using and reduces the amount of additional trays that just might have one or two things in it.”
The Team Approach
Diversity of facilities, staff roles, and vendor relations allow for a collaborative approach at yielding the best solutions for a specific challenges.
Mr. Martz explained how he approaches such conversations. “Usually, I have an initial meeting with somebody from the SPD to find out if there are any problems that they’re facing on a day-to-day basis. Then I’m able to give them examples of how we’ve addressed [that problem] in other places. Hearing about how a place down the street or in another state [has tackled the same problem] gives them someone to relate to and shows how ONE TRAY® and EZ-TRAX™ may be able to help.”
In tandem with ONE TRAY®, EZ-TRAX™ addresses the problem of instrument prioritization and organization, but solutions begin with the leadership, staff commitment, and early vendor involvement. “As far as what ONE TRAY® and EZ-TRAX™ can do, it’s almost customizable to your needs, but you have to be proactive with education and training so the entire team knows the right way to use the products.”
Mr. Martz added, “The instrument vendor of choice for that hospital or ASC has to be involved in the decision-making process.” He also noted that other relevant personnel are important to that discussion including the SPD manager, an SPD technician who specializes in orthopedic instrumentation sets, and an OR orthopedic coordinator or scrub technician. “It’s great to involve the surgeon, too,” Mr. Martz said. “That’s not always possible early on, but if they would like to be in the conversation, I always obviously give that opportunity.”
Conclusion
With the steady advance of value-based care models, hospital and surgery centers are faced with growing pressures to be more cost-efficient while maintaining high quality of care standards. Surgical centers must, simultaneously, continue to migrate from better-resourced but costlier hospital facilities to ASCs. The confluence of these trends challenges SPDs to process more surgical instrumentation sets without additional staff or sterilization equipment. Adopting innovative solutions, like ONE TRAY® and EZ-TRAX™, will allow SPDs to manage elevated demands more efficiently and maintain operational stability.
