Building a new Sterile Processing department (SPD) or endoscopy center—or renovating an existing one—can be fraught with complexities and unforeseen pitfalls. Thankfully, healthcare organizations have an in-house team of subject matter experts to help ensure project success, and these experts must include SP professionals who will bring indispensable knowledge and experience and a keen understanding of their space, equipment and instrument inventory needs to ensure they can perform their many functions safely, consistently and optimally.
Unfortunately, and far too often, SP staff are not invited to the table to provide the necessary insights into their department’s or facility’s construction or renovation plans and projects. When they are brought to the table, it is often in the late stages of the project, when it’s too late to make appropriate changes, especially more significant ones. Knowing what to plan for is essential when designing new or renovated SPDs. A key consideration is ensuring the new or renovated space will meet current and future operational needs (accounting for growth over the next 10 years and beyond). It is essential that the right people are present across all phases of construction, from planning through completion to ensure the department’s and customers’ needs will be effectively met and costly mistakes avoided. SP representation is imperative.
A healthcare facility’s new construction and renovation projects are successful when the outcomes meet or exceed end users’ requirements and expectations. Understanding who the key stakeholders are and ensuring their voices are represented throughout each phase of construction is imperative. Stakeholders are those who not only care about the project but have a vested interest in its success and will be affected by its completion. Involving stakeholders does not mean asking for opinions about wall colors, cabinets or counter tops, for example, but rather engaging them in strategic discussions about how their work is performed. This involves asking key questions, such as: What is the step-by-step process of how work is performed? Where should equipment and workstations be placed so it benefits the work? How can efficiency and ergonomics be considered in design plans and equipment choices? What can be automated? Will the facility be performing new procedures or adopting new technologies? Where is the industry going in the next five to 10 years, and are those changes being factored into the design? Which manufacturers are being considered for the equipment choices—and which suppliers are benefiting or hindering progress? End-user stakeholders should be encouraged to share their unique perspectives, give advice, educate designers about current practices, regulations and standards and changes that could impact future workflow.
Project meetings are another effective way to disseminate information and communicate with all stakeholders close to the project. These meetings are generally held at regular intervals during the project’s lifecycle to ensure all key parties are involved and can address issues, propose ideas, give perspective, and solve problems. This helps ensure the group is versed in critical matters, can reach a consensus about key decisions, and stays on track in terms of time and budget.
Whie on assignment at a large academic medical center in the western U.S., I was asked to approve equipment for a newly designed endoscopy reprocessing space conjoined with an SPD. I was told the space was near completion, but they were preparing to purchase equipment and needed our approval. I pushed back, and a series of meetings took place regarding the space and equipment choices being made without our involvement (none of which met even the basic requirements of daily use). I asked why no one from Endoscopy was involved in the design and planning of the scope processing space (the project began two years prior). I learned that the project management team did not even know how many procedures the endoscopy center would need to support. The team also determined, without any input from Endoscopy, which equipment would be provided [two sinks, one automated equipment reprocessor (AER) and one drying cabinet, with no additional space for more equipment]. I was told little, or no changes could be made at that last stage because they were already painting walls and any changes would delay the project and increase costs. I explained that I would not be responsible for a space that would not meet our needs. In the end, we secured four additional drying cabinets and another AER, although we were unable to add height-adjustability to our sinks. Nonetheless, I wanted my comments about the importance of ergonomics entered into the meeting minutes—and that I opposed the decision to not pursue height-adjustable sinks.
New construction and remodeling are more than architectural drawings. Every aspect must be considered, from proper separation of workspaces (pre-staging, decontamination, assembly, sterilization, sterile storage, and case cart preparation) to storage, ensuring unidirectional workflow, providing proper lighting, workstations, flooring, supplies, equipment, and other employee needs such as break areas, locker rooms and restrooms. Also critical is ensuring the facility can maintain operations during various stages of construction. Plans must be devised to address day-to-day operations and activities, identify which changes and communication strategies are needed when dropping off and picking up items for customers; rearrange workflows as needed to accommodate construction and temporary walls; control dust; and outsource SP functions as necessary.
Successful SPD construction or renovation requires ongoing input across all stages from every stakeholder, which must include SP representation. There are many vital factors to consider, which cannot be done in the absence of SP stakeholders. This multidisciplinary collaboration lies at the heart of successful projects as well as employee, customer and patient satisfaction.
