It's been 4 years since I started working with tracking technology that constantly updates the location and sterilization status of the 50,000 instruments circulating through my hospital. Today I view the technology a lot like cell phones and ATM cards: After it became a part of my day-to-day, I have no idea how I functioned without it.

1. Quick and easy scanning. Our tracking system works off durable and sterilizable bar codes affixed to each instrument. They range in size from 1/8th of an inch to 3/8th of an inch in diameter. Central sterile staff scan instruments 4 times during reprocessing, using infrared tabletop scanners before decontamination cleaning, before wrapping for sterilization, as they're placed on cooling carts and, finally, when they're packed on case carts for transport to the ORs. Previous scanners demanded exact placement under infrared beams in order for the instruments' bar codes to register, but newer generations boast more forgiving sensors, making scanning less finicky and much more efficient.

2. Improved identification and speedier turnarounds. Instruments are sometimes known by an assortment of names in different ORs or by various surgeons, which can make assigning the right tools to the right case feel like an arduous game of mix-and-match. Tracking systems take the guesswork out of the process by eliminating human error, putting needed instruments in the right ORs virtually without fail. By customizing bar codes placed on individual instruments, you program them to contain whatever information you choose (the instrument's name, the proper way to sterilize it and how many make up a set, for example). The technology lets you link specific instruments to specialties, cases and surgeons, so staff pulling supplies and constructing trays simply scan an instrument and check a display screen at their stations to confirm which surgeons use it and the cases or specialties for which it's intended.

Scanning technology has dramatically improved our instrument reprocessing efficiency. Staff pull instruments for scheduled cases a day in advance, swiping each tool under a scanner before compiling them into sets. As they scan instruments, the tracking software confirms that the instrument belongs in the set they're building. The process is close to automatic, letting us build accurate instrument sets more quickly than we could without the tracking system.

3. Greater accountability. Because instrument scanning occurs during each reprocessing step, the tracking technology records which member of the central sterile team cared for specific instruments on specific days. When instruments go missing or show up soiled in the OR, I can review the tracking entries to see who cleaned, wrapped, prepped and packed the instrument, and approach those individuals to discuss what went wrong and, if need be, review our reprocessing procedures. I'm also able to set productivity goals within the central sterile department and use the tracking software to conduct reprocessing time studies, examining exactly how long my team takes to complete each step of the instrument turnaround process. Armed with that data, I can identify problem areas and make informed decisions about how best to correct them.

4. Accurate recordkeeping. Surgical facilities must keep sterilizer performance reports on file to earn and maintain accreditation status. Instrument tracking technology can link to sterilization management software to automatically record sterilization indicators met for each instrument load you run. It also takes the human element out of the recordkeeping equation, eliminating the possibility that reprocessing staff forgot to note that biological indicators had been met or techs with poor handwriting filed illegible records. Accurate, readable, time- and date-stamped sterilization records can help you pass your next accreditation survey and let you look back over each sterilizer load you've run to confirm that they were done properly (or, perhaps, unfortunately that they weren't) when investigating the potential cause of a surgical site infection.

You can also link an instrument tracking system to patient operative reports. Here at our hospital, OR staff scan bar codes on patient record cards to register every item and implant used during each case. Hard-copy lists are printed and placed in brown interoffice envelopes that we keep on case carts. They're picked up at the end of each day and filed for a week, enough time for the central sterile staff to read and release the sterilization reports of the instruments used during each day's cases. If sterilization issues arise, we can check which cases the problem instruments were used in throughout the week and inform the operating surgeons. When faced with fears of cross-contamination, having that information at your fingertips is invaluable.

5. Better instrument care. Tracking systems let staff focus their energies on getting instruments back to the OR on time and ready for use without worrying about when they need to be repaired or how they should be properly sterilized.

In our case, an independent contractor visits our hospital twice a month to perform routine surgical instrumentation upkeep. Instead of relying on staff to monitor the number of cases instruments have been used in and which tools to pull for scheduled sharpening or maintenance, our tracking software keeps a running count and flags instruments when they reach their usage limits. For example, we program the system to alert us when a scalpel approved for 20 uses reaches that count so staff can easily set it aside without interrupting their normal reprocessing routines.

We can also program the tracking software to alert our central sterile staff if the instruments and devices they're reprocessing are unintended for certain types of sterilizers. For example, if a staffer scans a sensitive item that can't withstand a steam sterilization cycle, a warning message appears on a system display monitor, reminding her to save it for a run through a low-temperature sterilizer.

6. Scheduling flexibility. You arrive each morning knowing how many and what kinds of cases are scheduled for the day and the number of instrument sets you'll need to construct and cycle through the ORs. But blips in the surgical schedule, especially in a large acute care hospital like mine, are commonplace. Helping you read and react to the unexpected is arguably the biggest benefit of working with an instrument tracking system.

Think about the steps you and your staff take when a case is added to the end of the day. Your priority is ensuring that needed instrumentation finds its way into the hands of the surgical team.

An instrument tracking system can link to your OR and central sterile management software, letting staff in all areas of the surgical circuit monitor instruments' sterilization status, which cases the instruments are scheduled for and which tools are ready for immediate use. As instruments are scanned at each step of the reprocessing process, updates are transmitted and displayed on monitors at surgical and central sterile workstations, meaning you can locate any instrument at any time.

So instead of frantic phone calls to find needed tools, you can quickly and easily see which scissors, hemostats and retractors, for example, are reprocessed and ready for use, and which are in decontamination washing or sterilization cycles. A tracking system also lets you flag instruments that are needed for add-on cases later in the day so staff are alerted to move those tools to the front of the sterilization line, giving them priority over others in the reprocessing cycle, so they're delivered on time to the right OR.

Like a chess master thinking 5 steps ahead of her current move, you can shuffle instrument trays to meet immediate needs while remaining prepared for future demands.