Collaboration crucial for CS/OR success
by Julie E.
Williamson
Surgical
services professionals rely heavily on the Central Service department to
provide them with properly processed, well-functioning and expeditiously
delivered instruments — and those in CS know that fulfilling those needs is
anything but easy.
The degree of discipline,
commitment and responsibility each CS professional must bear to meet the
many needs of the OR is tremendous. Compounding the challenge further, CS
professionals must also shoulder the weight of meeting ongoing needs and
requests from other hospital departments, as well.
CS departments are bustling,
high-pressure environments. Technicians methodically perform their critical
tasks in an assembly-line-type manner to ensure that patient care equipment
is properly decontaminated, surgical instruments are cleaned and sterilized,
and sterile supplies are dispensed, delivered, and safely stored. CS
technicians may not serve as frontline caregivers, but they are undoubtedly
a vital contributor to infection prevention and positive surgical outcomes.
Despite CS’s critical importance, however, the department and the many
hard-working professionals who comprise it often don’t get the
acknowledgement and respect they deserve — including from those they serve
in the OR.
It’s a topic near and dear to
Deborah Spratt, MPA, BSN, RN, CNOR, NEA-BC, CRCST, 2012-2013 President for
the Association of periOperative Registered Nurses. Spratt, who currently
serves as chief of sterile processing at the Canandaigua VAMC in
Canandaigua, NY, addressed the topic of CS/OR collaboration during her
educational session at the 2013 IAHCSMM Annual Conference in May.
"I’ve been in the OR for 40
years. When I tell you the OR doesn’t always play nice in the sandbox, I
speak from experience," she told a roomful of attendees.
Bridging
the gaps
The actions that take place in
CS have a very real and significant impact on patient safety. As Spratt
explained, interdisciplinary collaboration between CS and the OR goes a long
way toward establishing a culture of worker safety, trust and productive
team-building. Unfortunately, the "OR hierarchy" can get in the way of
teamwork, she reasoned, adding that this can devolve into a trickle-down
effect whereby surgeons yell at nurses and nurses then take their
frustrations out on CS.
"We need to understand that
we’re all there for the same reasons, which is to provide the best patient
care and outcomes." She stressed that effective CS/OR teamwork will help
promote an environment that respects each department’s unique expertise,
capabilities, needs and limitations, while avoiding a culture that passes
blame and pushes for unrealistic expectations.
The pressures CS professionals
face are many, and must be expertly balanced with the demands of the OR and
consistent, to-the-letter adherence to best practice standards. Although
technicians themselves are often up against the clock and faced with
requests to turn around instruments quickly, it’s their responsibility to
ensure that shortcuts don’t happen and that the quality of the devices they
process and deliver is never compromised. "Staff should not be throwing
anyone under the bus when it comes to speaking up on what is right and what
is a realistic schedule," Spratt noted.
Interdepartmental teambuilding
delivers many perks, not the least of which includes better quality,
products and service. What’s more, effective teams result in better staff
education and training, and the ability to attract and maintain the best
people for the job, according to Spratt.
Effective teamwork can be
easily stalled with ineffective communication. Spratt outlined a number of
common communication pitfalls, including advice-giving, making others feel
as though they don’t know what they’re doing, and being defensive or
judgmental. Her tips for success include keeping conversations casual with
each interaction, and sharing thoughts and feelings in a self-revealing way
("I feel…"), as opposed to passing blame. Acknowledgement and praise for the
other person also facilitates effective team-building and collaboration, she
noted, as does taking responsibility for one’s own contributions to a
problem.
"We must suspend judgment, be
sensitive and patient, and pay attention, listening between the lines,"
Spratt explained, adding that actively listening means we must slow down,
seek data and try not to interrupt. "To be understood, we must first
understand."
This is particularly vital in
the realm of CS and OR — two departments with very different roles and
responsibilities, but which nonetheless share the same goal, which is to
provide the very best service to promote patient care quality. The more each
side understands the roles and challenges of the other, the more realistic
the requests and the better the outcomes will ultimately be. "We need to put
ourselves in other people’s shoes," she noted. CS and OR liaisons that can
educate their teammates in the other department is one strategy that many
facilities have found effective, as is engaging in team training activities
with wide representation from both CS and the OR.
Elevating professionalism and
promoting strong ethics through ongoing education and certification is
another sure-fire way to improve collaboration, trust and respect across the
disciplines. "Certification validates professional credibility and
competency," confirmed Spratt.
"If we’re going to elevate
ourselves as the professionals we are, we need a mark. Certification helps
serve as that mark because it requires lifelong learning. And with that
comes a culture of safety."