Benchmark Data

 

Data collection has been long talked about as though it was difficult to collect let alone credible once obtained.  What you can gain from data collection is the ability to support increases in staff, equipment, and instrumentation.  The fact is that data collection is a somewhat of an easy task to accomplishment given that the information is documented in many forms nowadays.

Collection takes minutes a day, not hours and can be part of the closing procedure for any sterile processing department.  Sterilizer logs, print-outs from both sterilizers and washers along with accounting reports all provide data when a computerized tracking system is not available.  The OR scheduling system is also a source for a number of valuable data reports that count many different aspects of the instrument management process.

 

Start with a simple collection form that begins with the AM shift to include space for cycle numbers for washer and sterilizers from the printouts.   Include rounds to the nursing floors, both pick-ups and deliveries.  Establish defined hospital rounds to include time of day and number of service locations.

The number below for "Equipment Decontaminated" is reported to the Infection Preventation Committee and has justified addition PRN staff during our peak season.

 

If you manage the OR EVS staff you may want to include trash bag collection.  May sound strange but each data collection category provides useful historical data information for many reasons.  Do not look at them as extra work when they can support extra help.

Build your Excel data files to follow the forms so that data-entry is orderly and in sync.  Keep consistent Excel spreadsheets from year-to-year with summery worksheets to allow annual reporting much simpler.

By better instrument management and enforcement of consignment instrumentation processing the following two graphs should speak for themselves regarding flash sterilization.

 

When looking at the above “Items Sterilized” one may think that the volume is going down in 2007 and 2008, but in fact the opposite was the case.  In 2005 and 2006 the cost of peel-pouch both labor and expense drove up the items sterilized.  Some was contributed to the volume increase for the assembly of items that could be purchases pre-sterilized the other was due to increases caused by single instrument packaging.

By looking at the cost associated to peel-pouching along with labor, including increases in overtime the decision was made to add additional instruments to trays and address purchasing of pre-sterilized items.

The outcome was employee satisfaction with less peel-pouching (something that no one wants to do) and better increased through-put of surgical trays.  The data indicated a volume increase directly related to increase labor and disposable expense including a process that caused a slowdown in through-put.

See "Managing Flash Sterilization" page for a complete understanding of how this data collection was accomplished. 

 

In the “Items Sterilized by Service” graph the overall volume for all methods of sterilization except System-1 were going up yet we continued to experienced delays in sterile processing.  Some due to the lack of scope inventory and the addition of new surgeons, others due to time associated to sterilization.

By evaluating the inventory and increasing the use of System-1 were we able to keep up with volume increases without cost of new scopes.  However the added volume over time resulted in more scope handling and a higher potential for damage due to faster turnover.

The faster you go, the higher the incident of repairs, delicate scopes can only handle so much.  We are now reviewing the cost of sterilization and repairs to justify additional scopes to offset the sterilization costs.

The below “Annual Disposable Wrap Cost” indicate and supported a shift to metal containers.  In 1993 the decision was made to implement containers over a period of time.  The initial cost of $37,000.00 was equal to that of wrap purchases in 1993 and through 2003 provided substantial savings over ten years.

The expense rises as volume related to wrap trays for ortho procedures in 2004 increases.  The consignment/loaner market cost hospitals in many ways, most notably in wrap expenses.  In the coming year we will be converting loaner trays to containers to offset the increases.

Due to Aesculaps efforts in getting solid bottom trays validated for loaner trays we will start with our primary vendor with all standard knee and hip sets.

We have already converted all power instruments to solid bottom trays eliminating the hassle of wrap and the never ending hole-in-the-bottom dilemma….bookwalters will follow.

Again, this may seem like useless data but when CMS wants a hospital to provide data that supports the cleaning of mobile hospital equipment and you can provide it, what a plus for your institution and your CS departement.