How Lean can create a safe Operating Room (OR)
What is if you or your love one were having open heart surgery, and the surgical instruments were dirty? What if the anesthesiologist had to keep you unconscious longer than expected because the instruments that were needed to complete your surgery had to be cleaned for an additional hour or there were not enough instruments in the building? There is a machine known as an Autoclave, it uses high temperature, steam and pressure to clean medical instruments and to perform sterilization. When the Autoclave is used it is known as Flash Sterilization. The worst case Surgical instruments can be cleaned at (132 C, 270 F for a max of 30 minutes). The goal for all hospitals should be for ( 0%-.5% ) of surgical instruments go through flashing, I have seen some hospitals at ( 4% – 6.6%) ! The dangers that this can cause could result in death. Surgical instruments are sent to what is known as SPD (Sterile Processing Departments) In an SPD, the purpose of the department is designed for one thing: the preparation, assembly, and sterilization of instruments for surgery. This process is human manual. It reminds you of washing very complex dishes and assembling very complex puzzles. Thus, the staff has to be very knowledgeable of cleaning and assembly. Also with access to the autoclaves only a few SPD staff have this privilege. The autoclave zone is not visited by staff who have patient contact. This minimizes the potential for contamination. How can Lean help reduce or eliminate this situation? Here are a few high level steps that have been personally proven.
- Complete an analysis on the top 5 types of surgeries per surgeon
- Determine the volume per surgery type per surgeon
- From the volume and, on an as needed frequency you can create a stock replenishment schedule for instruments
- Using a Lean tool known as 5S complete an inventory assessment of current instruments per surgery type per surgeon. These instruments will be neatly stored in visible sterile packages
- Using a Lean tool known as Kanban create a visual signal to show when and instrument needs to be replenished
- Using a Lean tool known as standard work, train the SPD staff as to how to clean the instruments repeatedly the right way every time
- Monitor the Autoclave usage and complete a needs request form before and after the use of the Autoclave for flashing. You need to know why there is an unplanned need to have the instrument cleaned If your Operating Room is Flashing more than .5% please contact us !
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