3 Dangerous SPD Staffing Myths

Why do some of our facilities end up with sterile processing leaders who have checked out, frontline staff who have lost their passion and customers in the operating room who feel the pain? There are at least 3 dangerous staffing myths that can lead facilities to fall into traps.

A common misconception about creating an excellent sterile processing department is the idea that they can revolve around one leader who "has all the answers," one all-star who can come in and flip the switch from struggle to success. But the truth is, there are no lone ranger superstars in the reprocessing industry. Behind every leadership accolade, every department recognition, every publicized process improvement event is a team of CS experts who ensured that the hundred or so steps it takes to properly process a surgical tray got done on time and in good order.

Facilities who place the entire responsibility for hiring, firing, on-boarding, training, coaching, development, supply ordering, process improving, vision-casting, shift supervising, budgeting, quality-assuring and OR communicating on the shoulders of a reprocessing manager or supervisor are setting themselves up for a quality disaster. There are many jacks-of-all-trades in the reprocessing world, but none rise to the level of master. There is no such thing as a reprocessing polymath. Facilities that refuse to acknowledge the necessity of a supporting cast of leaders in their sterile processing departments will consistently experience service breakdowns, quality challenges and leadership burnout. Reprocessing excellence is a team sport.

Against the backdrop of tightening budgets and shrinking reimbursements, it is not uncommon to hear the following questions posed to reprocessing leaders: "Do you really need a day-shift supervisor if you already have a manager there?" "Can we just create a lead tech position instead of supervisor on third shift?" "Why do you need a specialist to do your instrument ordering for you, can't the manager do that?" and on and on.

In the world of surgical services (with admittedly critical OR-RN positions in play), the sterile processing list of FTEs looks mighty enticing for number-crunching finance directors who are looking for cost-saving "opportunities." After all, we're just cleaning instruments, right? How many leaders do you need for that? Well, the real-world answer is: as many as it takes to ensure quality, service and safety to our patients. Because, in actuality, we are not "just cleaning instruments," we are laying the foundation for a sterile, functional surgery.

Even though we can't point to a magic number or a foolproof organizational chart, if safe surgery is our aim, the days of viewing the sterile processing department as the field from which you can harvest excess positions must end. One manager by himself cannot lead a 3-shift, 24/7 reprocessing department well. One supervisor by himself cannot even lead 2 shifts well, without having additional support staff. In fact, both the Association for the Advancement of Medical Instrumentation (AAMI) and ECRI Institute recommend qualified supervision of reprocessing activities on every shift.

Think of it this way: Each set of surgical instrumentation is like a patient for us. Imagine the uproar if your hospital announced tomorrow that there would no longer be charge nurses on the patient floors for third shift. No nurse-to-nurse handoff from the evening to the morning. It would be a complete disaster. And that is the very same every-day disaster that many reprocessing departments are forced to overcome because their support positions were sniped away in the name of cost-savings. We need not even mention the cost of one HAI or SSI to prove the underlying value of this point.

Many in healthcare leadership still don't get that we're not living in the bygone age of sterile processing. Our decontamination rooms aren't like the dish room in the cafeteria. Our washers aren't manufactured by Maytag. Our teams aren't automatons and our instrumentation isn't like a bulk order of simple widgets.

Hard science goes into the chemistries of our detergents and sterilants. There are complex standard operating procedures that must be supervised when processing small-diameter bronchoscopes and delicate eye instrumentation. We have to manage data, track quality assurance programs, and coordinate, document and distribute ongoing education. We have to develop frontline experts. We're not flipping burgers and we're not standing on an assembly line. We need trained specialists to ensure the highest standards and the most consistent quality. We need educators. We need instrument coordinators, OR liaisons, quality assurance and database specialists. In short, because of the complexity of our age, reprocessing departments need support.

There are few challenges as widespread in our industry as the unsupported reprocessing leader being forced to fight the battle for quality, safety and service by himself. And although there are many assumptions behind such facility decisions, most of them are dangerously mistaken. If you want to have the kind of sterile processing department that is defined by excellence — which, in turn, provides the safest patient care — then it must be supported by enough sterile processing leaders to get the quality plane off the ground. Don't believe the lies of the one-man-band, the leadership overlap or the penny-pinchers. It only takes one person to take a stand for safety, but it takes a village to raise a reprocessing department. OSM