Can We Be Friends?

Better communication between OR and SPD is the first step to working together in harmony.

It’s not unusual for members of operating room teams and sterile processing departments to have strained relationships. Blame games can result, which isn’t good for anyone. Often, the members of the two departments don’t even know each other that well. These dynamics can make a fragile peace even worse, resulting in an environment of mistrust or even outright hostility.

Effects of collaboration

When the two departments get along well, the results can be quite the opposite. A collaborative and respectful atmosphere improves the quality of instrument care, boosts morale and increases the overall efficiency of a surgery center. Fortunately, when relations are strained, there are multiple easy fixes.

• Get everyone in the same room. Leadership should regularly meet with OR and SPD simultaneously. When surgical technicians, nurses and sterile processing technicians are in the same room at the same time, leadership can make it clear there’s only one team and they’re all members of it. Cement the understanding that everyone is going to work together, and no one is going to point fingers at each other.

• Make communicating easy. Our surgical technicians posted a whiteboard in our SPD on which they write their needs for the day. It’s a communication tool, something that’s used if, say, the OR team needs to open an extra set of instruments. They can write it on the board if sterile processing staff is busy with something else, such as washing instruments or running the autoclaves. We also use that board to let the other department know if one of the hospitals in our health system has borrowed a set of instruments. That way, no one is running around looking for something that’s not there.

• Avoid mix-ups that result from third-party involvement. We introduced incoming and outgoing sheets with the sterile processing technicians for our vendor trays. The vendor completes them, listing the case, the scheduled start time, the physician who will be performing it, and the patient’s initials, as well as how they want the trays named and labeled. The forms also designate whether the trays should be labeled “open” or “hold” so unnecessary trays aren’t opened. This is an effective communication practice that incorporates the instruments of the outside vendors into our sterile processing arena, and stops us from wasting time by opening trays that aren’t scheduled to be used.

• Designate liaisons from each department. This is often designed for HOPDs in larger hospitals or large ASCs. At smaller places like ours, we achieve the same result by designating leads from the OR for each service line. There is always a member of the OR team involved when sterile processing builds and configures surgical trays. Recruit natural leaders to assume these roles who have demonstrated a willingness and ability to work with people from other departments.

• Consider a buddy system. An informal version of creating liaisons is to assign “buddies” who can nip interdepartmental problems in the bud. What you don’t want is for a member of the OR team to immediately report an incident of biofilm on an incoming instrument when they could simply call their buddy in SPD instead. If one boss calls the other boss of the department, bad feelings often result, especially when the issue would have been solved with a simple conversation between people on the front lines. Encourage carving out small pre-shift time slots for networking between the buddies.

• Train together, stand together. Operating room RNs, surgical techs and facility leadership (myself and the director of nursing) all do yearly competencies in sterile processing. We do this so, in the event of an extraordinarily busy day or if we have a call-out, any of us can step up and reprocess the instruments.

CULTURE CHANGE

Make SPD Improvement a Perpetual Pursuit

TEAMWORK RULES Designating a member of the OR team and someone from sterile processing as liaisons can improve interdepartmental relations.

Solid communication practices between the operating room and sterile processing department are essential for a solid interdepartmental relationship. But improving the SPD itself is valuable in that regard, too, as a more efficient reprocessing department enhances the OR’s efficiency, which in turn makes it easier for the two sets of employees to get along.

To that end, Monroeville (Pa.) Surgery Center has undergone multiple improvement projects in recent years. The most recent one was the creation of books and lists about the contents of the facility’s instrument trays that are available for all staff to review.

Before that, the department underwent a comprehensive instrument consolidation project. The initiative was led by sterile processing technicians and surgical techs from the OR. Surgeons approved what could be removed from the trays. Instrument tray sizes were reduced by 25%, efficiency of the sterilizers’ loads jumped by 15% and sterilization costs decreased by 10%. Many of the removed items were peel-packed and available if needed.

The center also uses an offsite sterile processing facility for its total joints service line. The offsite facility is about an hour away from the surgery center. Vendors deliver the trays to the offsite location, where they’re processed and wrapped. They’re eventually delivered to the surgery center about 48 hours before the case starts. After the case, they’re prewashed and reassembled in the SPD, then taken back to the offsite facility for reprocessing. The move saved Monroeville from spending mid-six figures on washers and sterilizers with larger capacities, and the arrangement has been seamless to date.

There’s more to come in 2025. A materials manager was recently hired, and their first project is to overhaul the center’s inventory facility-wide, an initiative expected to produce cost savings and illustrate a value that more than justifies the salary of such a position at a busy surgery center.

—Adam Taylor

This type of training offers an added benefit for smaller facilities that cross-train by necessity. It educates those outside of sterile processing each day on the multiple issues that SPD techs must contend with and overcome. Ultimately, this insider education will give people a better appreciation of the job of an SPD technician. SPD techs should also be encouraged to continue their education and get involved with local chapters of organizations such as the Healthcare Sterile Processing Association.

• Solve time-crunch issues. If instruments are arriving at ORs in suboptimal conditions that frustrate the OR team, find out why. There could be a multitude of issues on SPD’s end to explain it, from insufficient equipment to exceedingly cumbersome IFUs. If carts of instruments are showing up at the SPDs of larger facilities all at the same time, find out why. The OR staff could be waiting for a large load of trays before transporting them to save trips. A conversation with SPD will allow them to realize that this practice of “batching” actually makes sterile processing’s job of returning the instruments for a later case on time significantly more difficult.

Keep SPD front and center. Ideally, this starts with putting the SPD somewhere other than the most remote nook and cranny of the building, a place where they’re forgotten until there’s an issue. Sterile processing professionals are a valuable part of the team, so their environment should also be well-lit and inviting.

Of course, location is only part of the equation. SPD employees must take responsibility in this regard; they should work to showcase the critical work they perform. Our SPD staff do this. They are visible, and they want to be part of the team. Whenever they enter a room and it’s appropriate, they introduce themselves to the surgeons and the rest of the staff so everyone knows who they are. OSM