The hospital’s experience with its electronic system serves as an example of how technology can save money, increase efficiency, improve patient safety and bolster trust between the sterile processing department (SPD) and the OR.
“Things don’t get lost now, we’re more efficient, better educated, our response time is better, the overall satisfaction of the OR is better and we’re more confident,” says Rose Seavey, R.N., director of the hospital’s sterile processing department (SPD). “It’s 100 percent better.”
The program is driven by computer software called Sterile Processing Microsystems. The marking method that enables the software’s tracking capabilities at the instrument level is called the InfoDot, which are tiny adhesive labels containing bar codes that can be read by computer scanners.
The total package allows the SPD to track mobile equipment and the roughly 5,000 instrument trays and 50,000 surgical instruments in use at the hospital, create account sheets that help build instrument sets, automatically update account sheets and quantify labor productivity to determine appropriate staffing levels, Seavey says.
This is a huge improvement over the past. “Every day there were wrong instruments in the set, people couldn’t find instruments, the inventory lists weren’t always accurate—they couldn’t be updated and changed on a daily basis or when need be—they weren’t real time,” she says.
Implementing its current system took the 250-licensed-bed hospital a number of years. It had to research and show administration that the total package offered concrete benefits, Seavey says.
The computer program was implemented in 2000. The hospital added InfoDot capability in 2005.
The computer program, developed by Materials Management Microsystems Inc., runs on any IBM-compatible computer and can be tailored to a medical facility’s needs.
About 200 hospitals run the software nationwide, says Ed Becker, president of the firm based in Mequon, Wis. The cost ranges from $30,000 to more than $100,000, depending on the needs and size of the operation.
The cost can be offset by savings realized from running the software, Becker says. For instance, Denver’s Children’s Hospital cut its equipment rental expenses by $60,000 by being able to more easily locate missing equipment. “After equipment is issued to a floor or to a patient, it may not be sent back to sterilizing right away,” he says. “By tracking it and knowing where it is, they’re able to get that equipment back.”
Hospitals implement the software for other reasons, too. “A lot of it is just in terms of the quality of the product that they produce,” Becker says. “They can track the sterilizer loads, they have electronic records of all their sterilizer loads that they can go back to, and they don’t have to fish through paper records.”
Some users have found the records valuable in court proving that instruments used on a particular patient were sterile and in good working order.
“They can go back and track the instruments that were used, they can track them back to the sterilizer load and know that the parameters of sterilization were appropriate, and if there’s a biological performed, that it turns out right,” he says.
The software also can show how long it takes for a particular instrument set to get from one point to another, and it can compare workloads in different areas, which helps hospitals balance staff workloads. “You can see how many people you need to place in each area, how many people you need to employ on each shift, so you can optimize the flow of the materials through the department,” Becker says.
Incorporating the technology of InfoDot labels into the computer program at the Children’s Hospital began in the fall of 2005.
The update boosted the hospital’s tracking capabilities from the tray level to individual instruments, and it eliminated an ongoing problem of mislabeled instruments caused by different people calling instruments by different names or by nicknames, Seavey says.
The labels are produced by KeySurgical Inc. a surgical supply manufacturer based in Eden Prairie, Minn. Each dot contains a universal, laser-engraved algorithm bar code that works with various software products.
Dots come in three sizes: 3/16 inch, 1/4 inch and 3/8 inch, and are sold by sheets of 100 for between 50 cents and 70 cents a dot, depending upon quantities purchased, Brian O’Connell, company president says.
“Our label is simply one supply element at the end of the process that enables the process to work,” O’Connell says. “Every time an instrument is put under the scanner, the hospital’s computer system knows where that instrument is. The hospital has a working history of where this instrument has been.”
No government regulations require hospitals to track at the instrument level, but as more hospitals adopt the technology, others are following to stay competitive, he says.
The dots have undergone testing to ensure that they can hold up in the sterilization process and are biocompatible. Any staff member can apply them because no special skills or equipment are needed. “If a dot ever doesn’t work, you simply put another one on, and if you change the label, you simply update it in the computer,” O’Connell says.
Although a single label will not last for the life of an instrument, they carry a two-year or 200-cycle guarantee, whichever comes first, and they can be replaced several times before the cost equals that of other marking methods, he says.
The dots have been found durable at Denver’s Children’s Hospital, which tags every individually wrapped item with an InfoDot.
Each dot is linked to a computer file that can contains a wide range of information, including the manufacturer’s name, part number and instructions; a description; picture; purchase date; cost; sterilization and maintenance records; and the tagged item’s location. This eliminates guesswork and improves patient safety, Seavey says.
Because staff members now scan items to a specific case cart, operating room and patient, they know where to find items when they are not returned, and having items when needed has raised the trust of the OR. Scanning stations already have been increased from seven to nine and plans exist to add six more when the hospital moves to a new building in September. Seavey says she also hopes to have steam sterilizers at the new building integrated into the system.
Being able to generate real-time reports that prove instruments are used efficiently has allowed Seavey over time to increase the instrument budget. “We can help with deciding what kind of instruments we may need to purchase, so we don’t have to do turnaround cases,” she says. “We can flag instrument sets when we do need to turn them around.”
If a tray is missing instruments, it is flagged when scanned, and a label that names the missing instrument is created. This makes it easy later to replace instruments in incomplete sets, Seavey says.
The system also allows staff to use a flatbed scanner to scan sterilizer tapes and imbed the information into the automated reference, eliminating the need to keep the rolls of tapes. Plus, after tracking staff productivity, the hospital created some split-shift positions to even out the workload, she says.
As a bonus, the system earned the department kudos from the Joint Commission during its 2005 on-site visit. “Sterilization was able to pull up records for them in an instant,” Seavey says. “They were thrilled.”
Nancy Torner is a freelance writer based in Roseville, Minn.
To respond to this article, please click here.
