Staff and Leadership Organizational Capacity
While equipment and infrastructure are commonly identified as capacity requirements, staffing and leadership play a vital role in an ASC’s organizational capacity. Staffing capacity calculates staff required to complete the necessary tasks. Best practice is to develop an activity-based staffing model based on work volumes, standard work, and time needed to accomplish tasks following IFU and clinical standards.
Leadership capacity is where ASC leaders wear multiple hats. It is critical that ASC leaders take the time to learn sterile processing operations, industry standards, and where to find guidance and tools to be efficient, and continually monitor the evolving regulatory requirements. This is not an easy job, especially when it is just one of multiple responsibilities. SPD technicians need to be proficient in their role and assist leadership with their expertise.
Training and documented competencies are critical for successful operations as well. A best practice for ASCs is to break their training and competency program into four quarters of the year to improve knowledge retention while minimizing administrative duties. In the first quarter, focus on decontamination with training and competency validation on all aspects of cleaning and disinfecting from point of use through decontamination. Move to inspection and assembly in the second quarter, sterilization in the third quarter, and endoscopy, infection prevention and any other needs in the fourth quarter.
Technology Organizational Capacity
Sterile processing technology solutions, such as instrument tracking systems, can increase an SPD’s organizational capacity while improving throughput, quality, efficiency, compliance and staff satisfaction. While ASCs might not have the need for the same level of instrument tracking that a hospital might require, benefits worth investigating include
- compliance and risk reduction;
- process documentation;
- vendor tray management;
- instrument maintenance; and
- data analytics.
Instrument Inventory and Maintenance Programs Organizational Capacity
Having sufficient instrument inventory to meet surgery schedules is sometimes dependent on an SPD’s ability to reprocess instruments for same-day use. Reprocessing instrumentation for a second or third use the same day improves instrument utilization rates and reduces inventory requirements. This works only if the SPD has the capacity to do so in a timely and compliant manner. No answer fits every ASC, but every ASC should consider its situation and determine whether its inventory is adequate for its surgical requirements while allowing sterile processing to remain compliant and not rushed to turn over instruments.
Maintenance programs for both instruments and equipment must be in place to ensure organizational capacity. Instrument maintenance is required to ensure instruments are fit for use by surgeons, while equipment maintenance is required to ensure an SPD has functional equipment when it needs it.
Organizational Capacity Review
To determine your ASC’s organizational capacity, answer the following questions.
- Does each step within the workflow have adequate capacity to handle hourly requirements while complying with instrument IFU and regulatory standards?
- Does the physical infrastructure meet airflow, temperature and humidity controls for each area?
- Is there a water quality management system in place to manage water quality with regular testing?
- Is the SPD staffing budget based on activity-based standards to perform all tasks in compliance with IFU and regulatory standards?
- Do leaders responsible for SPD operations have the proper knowledge to manage the clinical, regulatory, operational and human aspects of SPD?
- Are SPD staff and leadership competencies up to date, accurate and comprehensive for knowledge required to effectively perform their duties?
- Is technology available to improve SPD operational compliance and effectiveness?
- Is there an adequate instrument inventory for the surgical schedule while minimizing the need for same-day turnovers?
- Are instrument and equipment maintenance contracts in place to ensure instruments meet surgeon requirements and equipment remains operational?
Optimizing SPD Through Organizational Capacity and Operational Performance
Evaluating an ASC’s SPD organizational capacity and operational performance provides direct benefits in starting the discussion around whether an SPD has what it needs to be successful and how well it is performing. As ASCs evolve, consider expanding multispecialty service lines, and perform more complex and higher-acuity procedures, a reliable and effective sterile processing team is critical to operational success.
The advice and opinions expressed in this column are those of the authors and do not represent official Ambulatory Surgery Center Association policy or opinion.