In SPD environments with washer and sterilizer interfaces, electronic documentation of results serves to streamline work, eliminate opportunities for human error and improve the ability to handle internal Joint Commission audits, Cannady added. "With a biological monitoring interface, you get real-time status information, tools for managing recall down to the individual device, and the means for providing notifications to surgeons and infection control in the event that unfit instrumentation comes into contact with patients. Operationally for the department and clinically for the hospital, this continues to be huge."

And the benefits don’t end there. Connectivity with other software applications in the OR further enhance operational efficiency and clinical outcomes, Cannady continued, noting that capabilities that eliminate the need for manual tray scanning, while preserving the traceability of the uniquely identified instrumentation to the patient or procedure, continue to demonstrate significant benefits to all involved.

System integration could come in other innovative ways, as well. Patterson predicts that hardware technology advancements will push tracking system functionality, capabilities and ease of use even higher. "As tablet utilization, such as the iPad, increases, we believe tracking solutions will be required to function on these hardware devices in the near future," he reasoned, adding that as access to applications through this type of hardware increases, utilization will increase as the electronic medical record initiatives advance. "Integration with EMR data will become a requirement for the instrument tracking process. Also, data mining and utilization analysis will become easier and more prevalent."

The move to improve

SPD professionals from all different backgrounds, locations and facility sizes are finding that stepping up their instrument tracking capabilities can pay off handsomely.

When Carmen Ferriero III, MBA, sterile processing manager for Albany Medical Center in New York, assumed his position roughly three and a half years ago, he quickly determined that the instrument tracking system in use, Getinge’s T-DOC, wasn’t being tapped to its fullest potential. In fact, he estimated that only 20 percent of the system was being implemented. Fortunately, shortly after his start date, he was able to travel to Rochester to attend a T-DOC user training group to familiarize himself with all that the system could offer and formulate a strategy for bringing his department up to speed. In short order, virtually all features of the system were implemented and the benefits began rolling in.

"We have been able to increase overall process efficiency and improve instrument set accuracy, which has led to greater overall product quality," Ferriero said, adding that the ability to quickly locate instruments throughout the entire process, while also greatly reducing time and headaches associated with product recalls, has helped significantly improve customer service.

Prior to assuming his role as the SPD’s manager, the staff would scan the barcode and then print off a component list. "I turned to the pack on-screen function where a component screen pops up and staff now have to actually click through each one before the barcode is given. It’s about improving quality and accuracy." Photos and notes are also being incorporated into the system to help technicians ensure instrument and process accuracy, and promote staff education. Currently, more than half of all instruments in the facility’s inventory have an accompanying photo incorporated into T-DOC. Ferriero also plans to work with a training specialist to develop videos that can pop up for certain instruments or sets, and steer technicians to proper practices.

"I might be on the video saying, ‘Remember, this is how you do this,’ or ‘don’t forget this step.’ I’ve found that instrument tracking systems can serve as a valuable training tool – you just have to be willing to be creative and take the time to explore the various features."

The scores of data collected by the system can also prove invaluable for creating productivity reports and even justifying staffing levels. Ferriero creates monthly productivity and quality reports, and individual productivity reports – and he also posts errors to serve another educational purpose. "Everyone in my department knows where they stand. They know that quality and accuracy is the focus here, not how fast they can get something done. Using our tracking system in so many different ways has helped keep everyone focused on quality and following good practices."

Even smaller facilities are reaping the benefits of instrument tracking systems. When Valley View Hospital in Glenwood Springs, CO, adopted TGX Medical Systems’ Alex Gold instrument tracking system in early 2011, it, too, discovered that the solution could do far more than pinpoint instrument set location. Currently, the SPD tracks all sets and also uses the system to scan in all peel pouch items. "We also use the system for all our loaner instruments, which has been really helpful for keeping track of that process," said clinical coordinator Michelle Long. "We’ve also started incorporating sterilization processes into the tracking system and we’ll begin adding photos, too. We’re also scanning in our load receipts that come off the sterilizers [with an actual scanner, not a barcode scanner], so we can know the parameters and see exactly what was in a load." An added perk: the facility is also using Alex Gold for tissue tracking, allowing the materials coordinator and circulating nurse to easily scan it in upon receipt. Prior to this, circulators relied on an archaic sticker-based process that was time consuming and highly inefficient.

"Tissue tracking has become a very big Joint Commission issue. When we had a surveyor come, he really concentrated on the tissue tracking component," Long noted. "We are very proud of our progress with our tracking system and we actually wanted the surveyor to come into our department."

Broadening the scope

Although the exact extent that surveyors’ focus, as well as GS1 barcoding standards and unique device identifier regulations, will have on the instrument tracking segment – particularly in regard to instrument-level tracking – remains to be seen, some predict that the impact will be significant. That push will likely begin with providers and manufacturers of surgical instruments and then flow throughout the supply chain. Food and Drug Administration regulations are also on the horizon, and not as far away as some might expect.

"From our discussions with the FDA, we know the timeline is within five years from the regulations becoming final for Class III medical devices," said Patterson, noting that, ultimately, it will be the Joint Commission or the hospitals themselves that will help push the requirement to track instruments to the patient level. "This capability already exists and we have many Censitrac customers utilizing it now."

More hospitals are showing an interest in instrument-level tracking, with some vendors seeing the greatest push from multi-facility organizations that aim to embrace instrument-level tracking at the corporate or regional level. "These organizations are seeing the value brought by standardization on a single solution that enhances information about the assets used during surgical procedures. [That] results in greater patient safety, while generating a return on investment," added Patterson. "These for-profit and government-owned multi-hospital networks are investing in tracking capabilities by budgeting dollars at the individual facility level for the purchase and implementation of instrument-level tracking solutions."

Mancebo, too, is seeing more hospital networks getting on board, as opposed to just individual hospitals buying for themselves. "They want one database, so they can have that visibility and transparency across their different facilities," he said. "If there are three hospitals in a network, for example, and they have to share instruments, they can see exactly where those instruments are – plus, they can have the record to show where and how those instruments were last processed, and by whom," he said. Alex Gold also features new document scanning technology, allowing any PDF document to be scanned into the system, thereby giving staff easy, at-a-glance access to processing instructions and other pertinent information on virtually any item in inventory.

While Albany Medical Center isn’t yet tracking to the patient level, it’s one of Ferriero’s top goals. "From an infection control standpoint, this is an invaluable capability because you can trace the instruments all the way to the patient and you can establish whether there were any anomalies in the processing of instruments for that particular patient," he explained, noting that this could be a particularly valuable tool for hospitals facing lawsuits associated with infections or other adverse events. Another goal, which will soon become a reality by 2013, is tying T-DOC to the OR’s scheduling system, he said.

Advanced tracking with T-DOC at Albany Medical Center improves process efficiency, accuracy and customer service.

Tony O’Hehir, product manager for T-DOC and Getinge Online, further pointed out that the opportunity to eliminate lost instruments and enable full traceability back to the patient and procedure is invaluable – especially when managing a process failure or instrument recall. "The time, cost-savings, level of detail, and confidence that the SPD and OR teams gain with these benefits enables them to focus on other key areas that improve patient safety," O’Hehir said. In addition to ensuring that procedures are met and that effective washing, disinfection and sterilization occurs, it also helps prevent the skipping of required steps, added O’Hehir.