It sounds like you have done a fine job in improving your work area by
updating your equipment resources and improving work techniques and
work flow. Having a well equipped and state of the art work
environment is of course the foundation to providing quality services
to your customers. As you know meeting customer needs encompasses many
other aspects as well. There is only one sure way to measure your
success at meeting customer’s needs and expectations. You must first
know what is important to your customers, what are their needs and
expectations to begin with? Good customer service requires excellent
customer relations and communications. Just as you said "there is
always room for improvement"; good customer service isn’t something
you do once and are done with. It is like a continuous circle which
should never be broken. The healthcare environment is very dynamic –
people, technology, procedures and needs are constantly changing and
as a service provider we may have to adjust our processes and
procedures to meet the ever changing needs of our customers. As
service providers we must focus on continuous quality improvement (CQI).
This
entails staying well informed of any anticipated and/or planned
changes in your customers operations which may require you to modify
the manner and scope of the services you provide to them. It is
important to stay abreast on how the customer views the quality of the
services you are providing to them. The best way to accomplish this is
through conducting periodic surveys which are focused on getting
feedback on key aspects of services you are providing. Like a report
card, the feedback ratings will alert you of areas which may be in
need of adjustments and/or improvement. Based on the results of your
survey together with your users you can identify process improvement
initiatives which can improve your level of service provided and
enhance customer satisfaction. While every CPD is unique, some
commonly used questions in surveys include the following;
• CPD staff present a professional image
• Communications are timely and accurate
• CPD staff are resourceful, helpful and responsive
• Instrument sets are well organized and complete
• Instruments, equipment and supplies are delivered on time
• Instruments are clean, assembled properly and function properly
• Labeling is clear and accurate
You can develop survey questions relative to your specific
operations or aspects of particular services you render and would like
to evaluate. For each question customers will indicate a response or
score such as satisfactory or unsatisfactory or a number
range rating on a scale of 1 - 5 with 5 indicating the highest level
of satisfaction or excellence. Based on the survey results you can
identify areas for improvement, establish priorities and an action
plan to attain process improvement initiatives.
Q
I know that AAMI standards state that count sheets are not supposed to
be placed inside of instrument sets, but I am having a difficult time
coming up with a suitable alternative. We tried securing the folded
sheets to the container handles but found that the sheets often became
torn and very difficult to read. Often sets were missing the count
sheet by the time they reached the OR. While we all still prefer
placing the count sheet inside of the sets we are eager to comply with
the standard. Would it be acceptable to place the count sheet in a
peel pouch and secure it, with autoclave tape to the outside of the
instrument set?
A
AAMI recommendations do not address the issue of count sheet placement
within instrument sets. Thus AAMI guidelines do not recommend against
the practice. The 2008 AORN recommendations did advise against the
placement of count sheets inside of instrument sets based on the
unsubstantiated potential that printer inks used on the count sheets
might be toxic and could be transferred on to the instruments posing a
threat to patient safety. However since that time AORN has conducted a
very detailed study and research project on the potential cytotoxology
of toner inks, the transference of the ink on to instruments during
steam sterilization and the inherent risk factor. The results of this
study appeared in the March AORN Journal vol 89, NO3 page 521.
In summary the results of the study revealed that
placing count sheets and printed labels inside of instrument sets
during steam sterilization did not appear to generate any significant
cytotoxicity and thus did not pose any immediate health concern.
However there was no guarantee the practice is safe. The study did
demonstrate that ink can be transferred to instruments when placed
in direct contact with count sheets. The study did utilize grossly
exaggerated printed count sheets consisting of heavy ink (entirely
blackened page). The ink-stained instruments, while non-toxic, were
very difficult to clean. AORN guidelines now recommend placing a
count sheet in a medical grade all paper pouch inside the instrument
set to prevent transfer of ink to the devices. AORN Center for
Nursing Practice recommends only validated products be used and
states the practice of placing count sheets into sets needs to be an
individual decision for each healthcare organization. There are
medical grade paper bags validated for sterilization which are readily
available and would allow you to comply with the latest AORN research
findings and guidelines.
Ray Taurasi is Eastern Regional Director of Clinical Sales and
Services for Healthmark Industries. His healthcare career spans over
three decades as an Administrator, Educator, Technologist and
Consultant. He is a member of AORN, AHA, SGNA, AAMI and a past
president of IAHCSMM and has served on and contributed to many
national committees with a myriad of professional organizations,
manufacturers, corporations and prestigious healthcare networks.
Taurasi has been a faculty member of numerous colleges teaching in the
divisions of business administration and health sciences. In addition
to this column he has authored several articles and has been a
featured speaker on the international scene.
