How to achieve compliance to increasingly robust standards for improved patient safety, risk reduction and staff safety.
February 8, 2010
The trend over the last five years has been a continued, dedicated effort to establishing standards and steps for improving patient safety. Major accreditation agencies have become increasingly active in establishing guidelines and are joined by hospitals and surgery centers in enforcing stricter adherence to practices that advance infection prevention. Despite many challenges, surgical services in operating rooms, sterile processing departments and ambulatory surgical centers are making excellent strides in infection prevention and patient safety.
Challenges impacting surgical services include an increase in the volume of procedures, more technically challenging procedures, more complex surgical instruments, and budget constraints. One underlying factor that presents a challenge to infection prevention and patient safety, is that staff caring for surgical patients comprise a variety of health care personnel. Included are surgeons, registered nurses, surgical technicians, sterile processing staff, orderlies and more. Each of these staff members has a different type of training and experience.
Additionally, standards of care continue to change, making it an uphill battle to consistently follow approved procedures. Tenured staff members often resist making changes, preferring to rely on “the way things have always been done”. Staff with less experience are not provided with enough continued education. The disparate experience, education and lack of firm policy adherence have the possibility of leading to “too many cooks in the kitchen.”
In the last year surgical facilities have seen an increased scrutiny in the infection prevention and patient safety area yet, there continues to be no presiding agency or association regulating surgical facilities. Surgical facilities are often focused on keeping accreditation and not risking Medicare payments, often spending huge amounts of staff resources and money to prepare for facility surveys. These are reactive measures when what is truly needed are proactive initiatives. Additionally the audits that the accreditation firms and Medicare conduct are not consistent from facility to facility, surveyor to surveyor or even day to day. Each state has their own guidelines and their own inspection criteria and rely on surveyors with varying levels of experience and training themselves.
Driving improvement to infection prevention takes a lot of work. Patient safety must start from the top and belief in the mission must resonate through the entire organization. Leaders of surgical facilities must be closely involved, have good visibility of daily tasks and challenges, and must provide proper resources.
Typically it is the small steps which drive the greatest improvement. Each critical function which relates to infection prevention must be reviewed. This includes everything from simple steps like frequent and thorough hand hygiene, to challenging tasks like decontamination and sterilization of an orthopedic surgical instrument set.
Improvements are not just required at the facility level but also for companies that support hospital surgical services and surgical centers. These companies must be vigilant about new and ongoing requirements as for doing business with surgical facilities.
Currently, the single most important requirement for these vendors is knowing and understanding the challenges faced in the surgical services area and providing as much support as possible.
Millennium Surgical is a growing, privately-owned specialty surgical instrument company that has been working closely with staff in surgical facilities for the last 22 years.