Getting loaned instruments on time requires planning & communication

Orthopedic and spine surgical procedures are seldom performed without having to take on the high price of purchasing sophisticated instrument sets. Often, multiple sets simply sit on storage shelves while not in use. To lower costs and minimize waste, facilities may opt to use vendor-loaned instrument trays. While this option offers a number of benefits, there are unanticipated consequences that can arise if they arrive later than expected.

Fortunately, taking a few steps can improve the process of getting required instrumentation to the operating room on time, and HealthTrust’s Medical Device Management Team (MDM) can help assess the workflow and costs associated with using vendor-loaned trays.

Assessing the logistical challenges

Chris Stewart

One of the biggest issues with using vendor-loaned instrument trays is communication and coordination with medical device reps, says Chris Stewart, VP of Medical Device Management at HealthTrust. “When a patient is on the table, every minute counts. Instrument sets are supposed to be delivered at a minimum of 24 hours in advance of elective surgical procedures, but often that’s not the case,” he says. This can lead to significant delays in the operating room and sometimes cancelled procedures.

“Most facilities have a 24-to-48-hour arrival deadline in order to give sterile processing technicians time to prepare the instruments before the scheduled surgery,” explains orthopedic spine surgeon Adam Bruggeman, M.D., Chief Medical Officer at PSN Affiliates and a HealthTrust Physician Advisor.

Adam Bruggeman, M.D.

Shipping problems can arise, causing vendor-loaned instrument trays to arrive late at the intended hospital or ambulatory surgery center. Since the instrument trays are shipped around the country via carriers such as FedEx and UPS, they can be delayed due to bad weather within the routes.

A problematic chain of events

“When surgical instruments do not arrive on time, an accelerated chain reaction can disrupt critical workflow and processing,” says Stewart. The loaner-trays are hustled to the sterile processing department (SPD) where technicians are under pressure to get the instruments ready for surgery. The SPD is the front line of defense for patient safety and requires multiple steps and procedures, which can take several hours to complete. Processing delays can negatively impact surgery block time and patient care.

Even though procedure start times may be compromised—a frustrating situation for the surgical team and the patient—the most alarming result of interrupted workflow and process is potential harm to the patient. “In an environment that is constantly in motion and under pressure, bioburden could go undetected,” explains Stewart. Such mistakes could result in a post-op infection or sentinel event.

“Late arrival of vendor-loaned trays also impacts employees at the facility, particularly sterile processing technicians,” says Dr. Bruggeman. When instrument trays don’t arrive on time, technicians may end up working longer hours or odd schedules. The increased pressure also adds a great deal of stress to staff, adds Stewart.

When looked at altogether, these employees face a high level of burnout, and turnover in the SPD can increase. This is particularly problematic for facilities, explains Dr. Bruggeman. “There is currently a shortage of sterile processing technicians nationally. A facility may lose their most experienced technicians and end up with a department staffed by more inexperienced technicians, which can lead to errors and slowed workflows.”

3 steps to improve loaner-kit processes

Facilities can take steps to minimize or mitigate some of these challenges with loaner instrument kits. Stewart and Dr. Bruggeman suggest these three steps to ensure a smoother process:

“Proper communication between the facility, physician and supplier is the most important step in reducing clinical, financial and environmental waste, and most importantly, patient safety risks,” Stewart notes.

Typically, 75% of surgical instruments in a tray go unused, hemorrhaging costs. Just talking with surgeons is not sufficient, as they rely heavily on their rep for bringing in the necessary instrumentation. Stewart recommends collecting relevant data points to determine which tray and how many specialty instruments will actually be used during surgery. Borrowing fewer instruments reduces costs for the healthcare facility and supplier. This also means less processing work in the SPD, which leads to a reduction in unnecessary labor, supply and risk.

Engage the MDM team to assess policy and costs associated with using vendor-loaned surgical instrumentation and to learn how to optimize your vendor management process.

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