Each day, materials management professionals are faced with major purchasing decisions. One such decision involves selecting a provider for surgical instrumentation and on-going maintenance. There are many factors to consider when choosing an instrument supplier. First, take a look at the people, selection, craftsmanship, and solutions a supplier has to offer.

An experienced sales and service team dedicated to a long term relationship with your facility will provide a consultative approach to doing business. The supplier’s collaboration with some of the world’s foremost surgical and scientific thought leaders is critical to the continued innovation of products a supplier can offer.

Is the supplier’s staff experienced?

With thousands of instrument patterns available, an experienced field team is a must. Look for instrument sales, repair technicians and customer service representatives with years of experience behind their product recommendations and services.

Your supplier should offer breadth and depth of products, providing the opportunity to standardize instrument sets. For example, through its V.Mueller business, Cardinal Health carries specialty and general instrumentation, including Snowden Pencer laparoscopic and plastic products, neuro/spine, cardiovascular, bariatric and more.

Can the supplier meet your needs for ancillary products such as containers, trays, cases and detergents that are required to help sterilize, protect, and organize your instruments?

Look for a supplier that can provide virtually everything needed relating to surgical instruments – no matter what procedure is being performed.

It takes an average of 52 steps to make a typical surgical instrument - and nearly all those steps are performed by hand. Look for artisanship combined with solid manufacturing experience. It is important to consider the history and reliability of a supplier. The warranty coverage should also be clear. Look for a company that offers a lifetime warranty against defects in materials and workmanship.

The solutions and services a supplier offers can make managing your investment easier. For example, Cardinal Health offers the following services to ensure on-going quality and value throughout the entire instrument management cycle.

• Hold Shelf customized tray shipping and one line billing process. This service eases logistical and inventory management burdens frequently associated with the procurement and inventory management process.

• OnSite Instrument Management Service improves specialty and laparoscopic instrument performance by having full time on-location expert technicians working collaboratively with the OR and CPD staffs.

• OnSite Instrument and Equipment repair service optimizes instrument performance and longevity, through a preventive maintenance and repair program; featuring same day restoration on 95% of your surgical instruments.

• IMPRESS Instrument Management System is a web-based, hosted software solution that manages instrument tracking, instrument processing, employee and department productivity. Through performance and information visibility, this system improves decision-making resulting in cost savings, operational efficiencies, and patient safety focus enhancements.

• Does the instrument function like it should?

• Under normal care, is the instrument rusting?

• Does the instrument you purchased today function the same as the one you purchased 10 years ago?

• Is your repair/replacement budget out of control?

• Are the patterns consistent - order after order?

• Does the company you work with stand behind the instruments with lifetime warranties?

Does your supplier offer comprehensive maintenance services?

Surgical instrument repair and maintenance costs are merely the tip of the iceberg of underlying costs:

• Excessive repairs

• Replacements for damaged / lost items

• Time opportunity costs

• Risk of liability costs

So, how can your facility select a supplier that will help you implement an instrument maintenance program that identifies issues and provides corrective actions to help decrease future costs? The answer: develop a relationship with a vendor that can help implement a corrective action process.

A strong education program should begin with a thorough assessment of current hospital procedures for handling and managing instruments. Assessment emphasis should include identification of process and logistical inefficiencies, regulatory or patient safety risks, and improper care and handling techniques.

Today, many hospitals understand the usage of their instrument sets much better through instrument management software systems that provide reminders when preventive maintenance is due. Effective preventive maintenance scheduling can reduce excessive repairs and replacement costs.

Documentation is only valuable if the information is presented in a way that can be understood. An added benefit of routine inspection is having another set of eyes watching over instrument sets for trends.

For example, spotting and staining of instruments can provide early clues to an issue related to water/steam quality, detergent selection or equipment. Repair specialists should be trained to look for these types of indicators and work with the hospital staff to identify potential root causes.

Severe staining on instruments caused by high iron content in the local water supply in the Southwestern United States was identified and documented when a repair technician recognized the issue, which was similar to another local hospital.
	Bioburden inside a Kerrison is documented and used to educate staff on corrective action to prevent future issues.

Working with a vendor who will take the time to teach proper inspection and testing techniques is essential. It is necessary that all staff involved in the instrument cycle be educated, including CSPD, OR and anyone involved in care, handling, use and transport of the instruments and equipment.

• Make instruments last

• Controlling maintenance costs