Beyond the bottom line
Getting instruments back in service quickly — and cost-effectively — is becoming increasingly important, particularly as many healthcare organizations struggle to meet the facility’s instrumentation needs, and at the same time, keep a close eye on the budget. Even so, sources stressed that the importance of the bottom line should never supersede quality.

"A low-priced provider is no bargain if the level of service is also low," noted Natalie Lind, educational director for the International Association of Healthcare Central Service Materiel Management and central processing department manager for Saint Cloud Hospital, Saint Cloud, MN. Selection of a repair company should be based on quality of work, turnaround times, availability of loaner replacements, processes for handling instruments and billing, communication and cost, she said.

Ken Wilson, vice president and general manager of Cardinal Health’s Equipment Management Services, echoed that sentiment, adding that today’s customers are demanding that repair service providers meet their needs on numerous fronts.

"Some things don’t change for our customers and that’s the critical reliance they have on us to meet all the specifications necessary for quality repairs at a fair price and in a reasonable timeframe," Wilson said.

Extensive knowledge of instrumentation and evolving technology is also a must. CS manager Betty Vaughn, who works at Columbia, MO-based Boone Hospital Center, which is part of the BJC Health System, said the organization chose Aesculap for repairs — not only because the instrument manufacturer is BJC’s primary vendor and could offer a discounted rate, but also because the company is a known leader in instrument craftsmanship and educational training.

"They are very knowledgeable and hands-on, and we’ve seen the number of repairs in our facility go down as a result. Each month, they come and spend the entire day going over each instrument and then provide us with detailed audits of each of our trays," Vaughn explained, noting that Aesculap also services other vendors’ instruments. "A rep also comes on a weekly basis to pick up items that require servicing, which are then returned the following week – or sooner, if necessary."

Some facilities have learned the hard way about partnering with a less than knowledgeable instrument repair vendor. Such was the case for one Houston-area hospital that switched repair companies due to a contractual change and has been paying facing myriad obstacles ever since.

"We have had a problem with instruments being sharpened too low, which obviously makes the surgeons unhappy," said the facility’s CS manager. Another complaint is that the company’s repair technicians lack the training to differentiate among different instruments, she said. "To them, a forceps is a forceps. They don’t know about the many different types, which presents a real challenge."

When it comes to missteps and general lack of understanding about instrumentation, Spectrum Surgical has seen and heard it all. Vrancich said some instrument repair companies don’t know the difference between German- and Pakistan-made instruments – a knowledge gap that can prove quite costly.

"They may wind up repairing instruments, which would have been less expensive to just replace," he noted.

David Narance, manager of sterile reprocessing at Mansfield, OH-based MedCentral Health System, said partnering with providers that stay abreast of changing technology and offer ongoing instrument handling education is a top priority for his department.

"I am always asking, ‘What education can you provide?’ I believe it’s very important to always be looking for ways to educate my staff and even provide continuing education credits," he said, adding that Spectrum Surgical educates MedCentral’s SPD staff for free, whenever necessary. "It’s not enough to just have a good repair company. It’s incredibly important that my techs are adequately trained and knowledgeable on proper instrument handling. That’s an invaluable value-added service."

Detail-driven reports
Another value-added service that appears to be gaining momentum in the instrument repair segment is the addition of reports that give detailed descriptions of instruments’ condition – along with an explanation of what may have caused the problem.

If a CS department knows that several of its instruments have experienced fluid invasion, for example, such a report could enable staff to examine their processes more closely, provide education and practice adjustments, and reduce or eliminate the problem and its associated repair costs, Lind explained.

MedCentral has discovered firsthand the value of such information. When Spectrum Surgical reported that some instruments needed more lubrication – a condition that can cause hinges to bind up — Narance immediately began investigating.

"I wondered how that could be because our hospitals were supposed to be undergoing the same processes," he said. He discovered that a former staff member had decreased the lubrication time to speed up the cycle. "We were able to easily correct the problem, which we wouldn’t have known about had it not been for the report. It was another opportunity to educate staff."

Spectrum Surgical has recently introduced the first digital mapping technology for instrument repair. The solution, Spectra-Scan, is a digital microscope that records images for before and after repair documentation. It also locates and records micro cracks, missing teeth, pitting and the presence of bioburden.

"This technology can magnify 250 times allowing photographic images to be catalogued for liability prevention or printed out for departmental training," explained Vrancich, noting that repair images can be catalogued on CD or emailed for documentation purposes.

IMS’ MileStone service provides a proactive roadmap to help reduce the frequency of equipment repair and the severity of equipment damage. Using comprehensive repair history reports, cost-savings analyses and fee-for-procedure comparisons, IMS can create a personalized trend line for cost-reduction initiatives. Customers can also recognize processes that need redirection before negative trends develop, IMS notes.

"The MileStone process provides education and consistency in competencies for all personnel," Mundy said.

Communication is critical
While value-added services from repair vendors are undoubtedly important, sources stressed that sterile processing and surgical staff must also become more proactive in the instrument repair process if they want to fully benefit from the repair program.

That means not only doing homework and trialing a service provider before making a long-term commitment, but also partnering with the repair company to provide service technicians with detailed information about the instruments.

"Instead of just tagging an instrument as ‘Broken,’ the user can explain what didn’t work. Having that information gives the repair company a reference point and may help reduce time and costs," said Lind.

She also stressed that the key to a solid working relationship between CS and repair firms is communication.