Breakdowns in communication are the single largest cause of sentinel events within healthcare each year, per The Joint Commission. In fact, it is estimated that over 70 percent of sentinel events are a direct result of communication issues. Ineffective communication also leads to other adverse events such as improper medication administration, delays in care, increased costs, and patient dissatisfaction. In healthcare, cultural and language barriers can also exist, which can cause difficulty when interpreting messages between healthcare colleagues. Now more than ever, collaboration and effective communication is critical to improve patient safety between the Sterile Processing Department (SPD) and the Operating Room (OR). Medical equipment and devices continuously become more complex and deliver innovative and life-saving care for patients, but this complexity requires coordination and cooperation between SPD and the OR team. As with any interaction with healthcare delivery, there is inherent risk, but in most instances, this risk can be mitigated through the application of evidence based practices and effective teamwork. Healthcare Associated Infections (HAIs) continue to plague the U.S. healthcare system as a significant source of patient mortality, morbidity, and costs. Together, as a team, SPD and OR healthcare professionals can not only reduce the incidence of HAIs, but also decrease associated costs, mortality, and improve patient satisfaction and operational efficiencies.
Here are five opportunities to make improvements that would help reduce HAIs:
- Plan for Complexity: Healthcare is one of the most complex fields in modern times, and the acuity of patients can vary widely between inpatient and outpatient settings, particularly within the OR. Medical devices, equipment, and instrumentation continues to increase in complexity, requiring advanced knowledge for handling and reprocessing. Specialized technicians in the SPD department play a critical role in not only reprocessing this equipment, but also in the healthcare-associated infection (HAI) prevention strategy. In many instances, additional reprocessing time may be required to safely and effectively reprocess medical instruments and devices, which can have an impact on OR turnover times. This potential impact must be factored both into the workflow of the SPD and OR personnel, but also into the surgical schedule. To ensure sustained success with compliance with these best practices, it is necessary for the executive suite to be fully engaged and supportive of adhering to these practices. Medical Staff Services is an additional stakeholder that must be considered so that physician/surgeon colleagues are aligned and understand the importance of these practices.
- Collaborate across disciplines: There are many different disciplines involved in the care of a surgical patient, but two of the most important are nursing and sterile processing professionals. Surgical procedures cannot take place without instrument sets and other medical equipment which is necessary for delivering safe care to the patient. Improper instrument reprocessing can lead to not only equipment failure, but more seriously the transmission of a healthcare association infection due to the equipment contamination. Regardless of one’s professional discipline or role, nurses, physicians, SPD professionals, and the patient all must play an active role in preventing HAIs.
- Center communications around the patient: The healthcare team should direct all its efforts towards improving the quality of care and the patient experience. The patient should be the center of healthcare communications. When communicating about the patient’s care, special attention should be taken to ensure that message is conveyed at the appropriate level for the patient and their family. Especially with post-operative care, patient education can easily mean the difference between a positive and a negative outcome. It is also potentially helpful to use multimedia methods to communicate complex messages to the patient. These methods can include the use of video, audio, and other interactive modalities. Patients are more educated than ever, and the SPD and OR team must appeal to their sense of learning and self-education.
- Empower patients to speak up: Patients are the most important stakeholder in patient safety, and throughout the surgical process, the patient must be actively engaged in their own care. Healthcare providers, however, must educate the patient about their role in the prevention of HAIs and feel safe in speaking up when they see potential errors taking place during the delivery of their care. Many patients, unfortunately, are afraid to speak up and question their professional healthcare team, which potentially, could lead to unintentional risk to the patient. Patients must be educated about their surgical procedure, understand their care process, know the associated risks and how they can be best mitigated, and be aware of how the SPD and OR team will work to reduce the potential for HAI transmission. While healthcare providers are certainly taxed from a time perspective, it is important to not let this obstacle become a hindrance to effective patient engagement.
- Train together: Healthcare providers must continuously plan for the next potential situation to improve overall preparedness, safety, and readiness. U.S. healthcare facilities learned this lesson during the recent Ebola outbreak. Because the country had never faced such a threat before, many went into a massive panic. The event provided many lessons, including the critical importance of training as a team, not in individual, professional silos. SPD and nursing must train for their critical tasks such as instrument transport, reprocessing, immediate-use sterilization, etc., together, and make a conscious effort to fully understand the roles of each member of the team.3 This situational awareness is important to maintaining support of the team’s overall function and is also a key tenant of the Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS program. TeamSTEPPS is an evidence-based training program that helps healthcare professionals effectively communicate and collaborate across disciplines, communicate patient information effectively, and deescalate conflict professionally. TeamSTEPPS training is available both online and in person at AHRQ training centers across the U.S. at no charge. Another available resource to enhance cross functional training is the use of healthcare simulations. Simulations allow healthcare professionals to experience the effects of a real problem without the cost, expense, and true patient risk associated with an actual event taking place. Simulation debriefing can help the entire healthcare team explore opportunities for improvement and build on strengths. Training as a team not only enhances patient safety, but it also helps the SPD and OR teams more effectively work as a unified team and build professional comradery.
Planning, teamwork, and focus key to success
Both the SPD and the OR teams play unique yet equally critical roles in improving patient safety and reducing the incidence of HAIs. Ongoing training, simulations, and collaboration will improve and sustain a positive culture of patient safety. HCAHPS scores will also improve because of a coordinated effort to improve patient-centered communication and transparency. Only together as a team can the SPD and OR departments be successful. Executive leadership and management are important elements of a successful collaboration as well. As healthcare continues to evolve, so must the respective roles of SPD and OR professionals so that they can effectively meet the needs of the patient. hpn