Sterilization Station: A Sterile Processing Empowerment Podcast
Welcome to "Sterile Processing Empowerment Podcast, the podcast dedicated to elevating the field of sterile processing and surgical services! In an industry where precision and care intersect, we believe that knowledge is power. Our mission is to empower, encourage, and motivate every professional engaged in the transformative world of healthcare.
Join us each week as we delve into enlightening discussions that shine a light on best practices, emerging innovations, and the critical role sterile processing plays in patient safety. Whether you're a seasoned expert or just starting your journey, our panels and expert guests will provide invaluable insights through engaging conversations and real-world stories.
From the nuances of instrument handling to the latest in sterilization techniques, we cover it all. Expect thought-provoking interviews, educational segments, and motivating content designed to inspire you to elevate your craft. Together, let’s foster a community that champions excellence in surgical services and celebrates the unsung heroes of healthcare.
Tune in to where expertise meets passion, and every episode empowers you to make a difference in the operating room and beyond.
Sterilization Station: A Sterile Processing Empowerment Podcast
Quality Over Quantity: Patient Safety First
The race for efficiency in sterile processing departments has created a dangerous mindset where speed often trumps thoroughness. When technicians rush through decontamination or assembly to meet productivity metrics, what's really at stake? Carol Malone, with over two decades in healthcare and extensive sterile processing expertise, breaks down this critical issue.
What happens when shortcuts become standard practice? Carol shares alarming real-world examples where rushed processing led to contaminated instrument trays reaching operating rooms, including incidents with beard hair contamination and even sunflower seed shells. These aren't just quality issues—they represent direct threats to patient safety and create costly delays when discovered.
The conversation delves into how modern SPD technicians must be critical thinkers, not just "button pushers." With increasingly complex surgical instruments requiring 27-50 processing steps, consistency and education become paramount. Carol explains how empowering technicians with knowledge of industry standards and the reasoning behind procedures creates accountability and better outcomes.
Most importantly, Carol addresses the leadership challenge of balancing productivity demands with uncompromising quality standards. She offers practical strategies for implementing quality-first approaches, including benchmarking specific issues, collaborating across departments, and building cultures where "stopping the line" for safety concerns is encouraged rather than penalized.
Whether you're an SPD technician, department leader, or healthcare administrator, this episode provides essential insights into transforming sterile processing culture. The discussion extends beyond theory into actionable wisdom that prioritizes what matters most—the patients whose lives depend on properly processed instruments. Join Bill and Carol as they share strategies to ensure quality never takes a backseat to speed.
In sterile processing, every instrument tells a story of precision, care and accountability. Speed may stock the shelves, but it's quality that stands between safety and risk. So we ask, in the race, to be faster, are we leaving patient safety behind? And to dive deeper into this topic, we're joined today by Carol Malone. Carol has 20 plus years in healthcare, with deep expertise in sterile processing and patient safety. Carol has led sterile processing education for 17 hospitals and trained over 200 technicians to maintain high safety standards. Carol is a proven leader in operational improvement and compliance, overseeing teams and system-wide initiatives. Carol is an active industry influencer, serving on advisory board and contributing to AIME standards for advisory processing, and she is dedicated to advancing sterile processing through internship and education, impacting patient outcomes directly. She holds certifications in AAB, csp, dt, cr, csd, cis, chl and CER. She's got a lot of certifications behind her name, so we welcome Carol tonight to the Sterilization Station podcast and welcome Thank you, I'm happy to be here.
Speaker 1:Thank you. We're really looking forward to a great conversation today and, to start off this episode, we really want to dive into understanding the more is better mindset in sterile processing. This is a mindset that we find all the time in sterile processing and I believe this episode we're going to have a great conversation as we dive into this topic. And so, in sterile processing, carol, why do you think there's such a strong emphasis on speed and quantity?
Speaker 2:Well, you know, I've been in sterile processing for nearly 20 years now and you know there's always been an unspoken mindset that the job of cell processing techs do every day is easy and we should be able to do it quickly and at top speed and just keep cranking everything out.
Speaker 2:You know, bill, you and I both know that that's really not true.
Speaker 2:So, especially since medicine and technology has advanced so much since I and probably yourself have been in this field and so has you know due to that, so has the complexity of the surgical instruments that we're now being tasked to process and turn over so quickly.
Speaker 2:So, you know, with that said, sterile processing really now requires really critical thinkers, to be technicians and we have to be able to not only memorize and remember you know, 27 to 50 steps to process something but we have to do it without fail and produce consistent results. So when we're forced to do things quickly, it's not going to have a good outcome. You know, and the other thing I wanted to mention was KPIs, or key performance indicators, are really a hot button topic these days, and I do agree that there are essential tools that help SPDs measure their performance and help with their productivity and allow for areas of improvement to be touched on. But at the same time, what is the downside to that? You know it's safety and making us circumvent our processes and reduce our standards, and that's not good for the patient.
Speaker 1:Yeah, I think that's really great. I mean everything that you said. Those are such great points. I know sometimes, especially in leadership roles, you can almost look at the metrics like it's every day. You're looking at to see where the metrics are, where are we at, but not understanding the steps that can kind of go to help to facilitate those metrics. They're not just bragging rights and managers meetings, but they're actually processes that are impacting patient outcomes.
Speaker 2:Absolutely.
Speaker 1:So another question I really wanted to hear your thoughts on is what are some of the biggest risks when quantity is quantity over quality, especially in decontamination?
Speaker 2:is that the corners that are going to be cut are really going to adversely affect patient care. Because when we're rushing through, we're not doing our three-sink process, we're not soaking instruments long enough before we scrub them, we're not rinsing them long enough, we're maybe skipping the sonic because we're in a hurry to get this stuff into the washer, skipping the sonic because we're in a hurry to get this stuff into the washer. I really think that trying to mess, produce and push things through so quickly is causing us to skip steps and endanger patient safety. So I think you know this is where empowering technicians come in. Which is why I like your messages so much is that we have to empower our techs to speak up and stand up and do what's right and say stop the line. And it's not worth skipping the steps to save those few minutes when the outcome could potentially be a life-threatening, life-altering or life-taking infection on the other side.
Speaker 1:And I think that's really good. I know I'm just working in. I've worked in like single-use medical device as well as reprocessing of a reusable medical instrumentation. What got my attention the most was how, in single-use medical devices, there was like quality check one, two and three from the start to shipping it in, and seeing how it's such a detailed process to how the quality management system operates, and so just understanding that sterile processing, reusable has to have maybe not the exact same setup but at least have where quality is something that's really in the forefront. So, no, I think what you're saying was really really good. Do you think that staffing shortages and productivity pressures contribute to these issues?
Speaker 2:I certainly do believe that staffing shortages and productivity being pounded into the folks that are there and showing up every day definitely affects the quality that we're putting out. If you're being held to the fire to you know, produce, produce, produce and it's forcing you to skip steps and circumvent processes and it's just going to be that spiral that you can't get out of and it's just going to cause damage and detriment to the patient ultimately, it also could cause injury to the technicians, to, you know, our staff, when we're skipping steps and things aren't done correctly because the inconsistency is going to cause an issue as well, you know.
Speaker 2:And then too, when the short staff texts, you know, easily become overwhelmed and then they start looking for shortcuts or they start talking amongst themselves about shortcuts and then all of a sudden, the shortcut is the standard and you've lost all control over any quality that you didn't have. So it's just, it's not. It's not a good cycle to spiral down into.
Speaker 1:Yeah, no, that's so true. I mean, short staff has such a great impact on every process and sterile processing and when you are short, if you don't have your SOPs really in order and you don't have an efficient value stream, I guess we would say you definitely can see that that's something that could have an impact on your department and the processes.
Speaker 2:Shortcuts become the norm. And then you're trying to train new folks coming in to the SOPs, but yet the shortcuts are what's in the field, and then it's just going to create even more chaos amongst your employees and resentment, and you know battles and everything else. So it's just a bad spiral.
Speaker 1:Right, it's like the shortcut operation procedure. Right, the scops? We don't have scops, we have scops, but that was free. That was free. It just hit my mind. I don't even know where that came from, but that was free. Scott, have you seen real-world examples where cutting corners led to serious consequences?
Speaker 2:Unfortunately I have. I've seen that it's definitely led to a rise in bio-burden occurring. I had a location that brought travelers in and they happened to mostly be male. There's nothing wrong with male travelers. However, a majority of them, for some unknown reason, seemed to have facial hair Again, not a problem to have facial hair.
Speaker 2:However, the problem came in where the beard cover was not enforced in this facility and all of a sudden, there was a huge uptick in hairs and trays. It doesn't take a whole lot of figuring out to figure out why, all of a sudden, there's this uptick of hairs and trays. And so we brought in travelers to help alleviate the shortage in staff, because we were trying to get trays assembled and sterilized, and yet it caused an even bigger problem, because now we were redoing trays that were done because there was hair in them. So you know it's. It was just crazy. You're trying to fix one thing and you're causing another problem because your processes are out of line. So it so, once we got the beard cover situation going, um, the hairs decreased and, um, you know, we got back on track, but it took a few weeks, wow wow, we had.
Speaker 1:We had a scenario situation one time where they were finding they were finding sunflower seed shells in the trays. I was like I was like how do you, how did that ever happen? So yeah, needless to say, we all knew who was eating sunflower seeds, so it was the quick fix. Oh wow.
Speaker 1:Yeah, you never know what you're going to see. You never know what you're going to see. Yep, this is good. So I definitely want to transition into having some discussion around the benefits of prioritizing quality in sterile processing, which is so important. And so what do you think are some of the biggest benefits of focusing on quality in instrument reprocessing? You know, from patient safety to staff efficiency.
Speaker 2:I have to say, the biggest benefit to the patient is, you know, when we're correctly processing instruments through DecanTAM, properly going through prep and pack, inspecting them, testing them, assembling them correctly, making sure there's no broken instruments in there, replacing missing things in that, and we're providing a complete working tray to the OR every time for every patient. So it's again, my favorite words are organization and consistency, and if we can get that consistency on a regular basis, a consistent basis, you'll have a better product that you're turning out and you'll have the trust of the OR and you'll have a better outcome for the patient, because you know they're not running around like, oh my goodness, this tray is missing this scissor and that's the scissor we need to cut this artery, you know. So it's efficiency, and then that creates a trust with your OR, so it kind of all goes hand in hand and then the staff efficiency is greatly affected. You have the staff that's all doing their own things and you need to have that again. Consistency my favorite word.
Speaker 1:No, yeah, and I think that might be. You know we haven't confirmed a part two, this is part one, but I think organization and consistency is a pretty big topic. I know Carol's pretty. She's excited about those ones, so we'll see. You never know what might happen, but that's great. Can you share an example of a department or facility that successfully shifted to a quality-first approach?
Speaker 2:Sure. So in my former hospital system we had switched from one tracking system to a different tracking system. I don't really remember the reason why, but we switched tracking systems and when we made that switch, the system that we switched to we had also created a quality policy and the system we switched to has a way in there that we were benchmarking quality issues. So you have a handful of issues that you are tracking. So, for example, anything that went to the OR, they were looking for bioburden, foreign objects and trays, which those are actually two different things. You know, bioburden is tissue and blood and things left behind. A foreign object is a Sharpie, a paperclip, a fingernail, a hair, what have you? So we're tracking those things. We were tracking missing indicators, puzzle wrappers, some other items, missing critical instruments and things like that. So whatever went to the OR, if there was something wrong with it, it had to fit into one of those categories because we were tracking it at all the locations. And then the same thing when the items came down to sterile processing after the case, we had a handful of things we were tracking. Did they do the point of use cleaning? Did they separate unused from used instruments but still put everything back in the tray. Did they clean it, did they open it, did they spray it, all those things we were tracking?
Speaker 2:But what we found was that because, as we know, when instruments are not properly put through the point-of-use cleaning process, you know it degrades your instruments. When the fluid dries on them, you know you start to get the pinning, the rusting, all those horrible things that destroy your instruments. So what it did was it allowed us to have those conversations with the OR, like, okay, this month, you know, 18 trays came down. They weren't sprayed, they weren't separated, they were still grossly soiled and so on. So we're trying to work together by identifying these items that are occurring. But it did, you know, in certain places it caused a little frustration. I'll call it frustration. No-transcript I still put this tray up. Do we have an amnesty shelf? We hold it on until we get it replaced. You know all these. So it helped us put some more processes in place to provide that end tray that was consistently assembled every time and ready for the patient.
Speaker 1:Yeah, that's really good. I mean a quality policy, quality plan, quality initiative, all that that's so important, especially in sterile processing, where everything we do has to be documented, and challenges that come up are really just a way for us to tighten our processes and, of course, add an education when needed. So I think that's great. Those were all very good points and the experience that you had there was definitely a real full experience, definitely.
Speaker 2:Yes.
Speaker 1:How does proper instrument processing impact surgical outcomes and infection control?
Speaker 2:So I touched on it a little bit, but you know it impacts it. You know, like I said, if a clinical instrument is missing, you know I mean sometimes you can have an entire tray and if one instrument is missing, that whole tray is no good because you can't use it without that one instrument. I know there's definitely some ortho trays like that. I'm sure there's some cardiac trays like that. So we really need to be on our game and make sure the stuff comes down from the OR, that we're processing it in a timely manner and that we have necessary backup for some of those critical items. And then the infection control part. You know if contaminated instruments are discovered, you know when they're opening up the room on the back table. Well, we all know the answer to that is you have to tan on that back table. You have to reprocess those instruments, right. So this is when infection control is like this is not good. And if that's something that continuously happens, you know you're delaying cases it's. You know they.
Speaker 2:I've heard a lot of times anywhere from I don't even I don't even have a number of 50 to $300 a minute. You know it's some crazy number out there. And just think about all that because we missed a chunk of something on an instrument and it made it all the way through sterilization. It made it out of the tray onto the table. So and then, what about if that instrument actually makes it to the field? You know, it's never happened to me personally, but I've heard horror stories of what? Oh, we had this lumen or whatever it was, and the doctor did something and blood poured out of it. You know it's like this puts the patients at risk when chunks of bone or cement are left behind and it's all of a sudden discovered when that instrument is like on the OR table or near the patient. Infection trauma is a little upset with us no, you're no, that's, that's so true.
Speaker 1:You remind me of when I started at this hospital and they uh, one of the techs was about to go to lunch and they had a small frag that had a you know had a hole, and it came down and we were reprocessing it and he told me, just hey, just just rewrap it and reprocess it. And and I said, oh no, no, I'm like trust, trust but verify. So I took it through the full process and when I was cleaning it in the back and checking those drill guides you wouldn't believe what came out, that drill guide I was like that would have been my job right there, that would have been my job. So I'm so glad that I took the initiative, followed the training that I received when I was precepted and actually went back and reprocessed that the right way. So, yeah, that's so important. I agree, there's been many times like that oh, there's a hole in the wrapper just rewrap it and rerun it.
Speaker 2:It's like, well, it's contaminated, it's got to go through decontam and, just like you said, I'm not putting my name on something that I have not thoroughly processed and so many people will, and that's. You know. That's the sad part of it. Or you know, they'll grab a sterile tray and open it at the control desk. But Dr Smith wanted to see what instruments were in this tray. We just cracked it open. Here you go, just rewrap it. We didn't use it. No, you opened it on a control desk where you've probably had your purse and your lunch and your coffee and a Kleenex, and everybody sat down and used your phone. So you know, 14 people have sat at this desk today and you've put this tray there and you want me to just rewrap it, right. But they don't think about that, they just think it didn't go in a room.
Speaker 2:It was never near a patient, it was never near a surgery, but yet my mind goes all these germy places and they're just like well, we didn't do anything with it, it left my control and it has now come back open and it is therefore contaminated.
Speaker 1:That's my motto anyway. Yeah, and that's a great point, a general seating area, an operating room, maybe a fishbowl or a workstation, like you said, a computer room, control room is. Yeah, definitely you want to reprocess instruments or if, like you said, a doctor wants to look at it or maybe they didn't use it. But it's so true. What you're saying is we always have to make sure we always are thinking about quality first. Right, that's the first thing that comes up. Are there industry regulations or standards, an example like A&E or Joint Commission that reinforce the importance of quality over speed?
Speaker 2:So you know, Joint Commission measures quality through performance measurements, data standards such as A&E. I've seen some recent articles where they've kind of joined teams. There's quality through performance measurements, data standards such as AMI. I've seen some recent articles where they've kind of joined teams. I need to read those more thoroughly but they're kind of working together. You know, the AMI standards tell us basically how to run our departments from setting it up where the sink should be, where the splash guide should be, where your sterilizer should be. You know everything to how to load it, how to unload it, how to store your stuff, how to you know everything to how to load it, how to unload it, how to store your stuff, how to you know verify all your testing for your equipment. So the AMI standards has pretty much soup to nuts, how to run your department. And that's how we based all of our internal policies off of the guidelines. And I do understand that they're voluntary. But when you have joint commission or DMV coming in and surveying your department against those guidelines, I strongly recommend that they are referenced. And then we also have just the manufacturer, ifus, so manufacturers of not only the instruments that we're using but the equipment that we're using.
Speaker 2:I can't tell you how many sites I would walk in and people had no idea the capacity of their sterilizer. They had no idea what the total weight was that could go in it. They didn't know if they're everyone's like, oh trays have to be 25 pounds or less. That's actually not true. There are sterilizers out there that say the trays can only weigh a max weight of 17 pounds. People don't even know that because nobody really reads the IFU for the sterilizer. You know, what cycle are you running? I don't know. I just press button number one. Well, what are the parameters? Aren't you checking, like when that load is done? Aren't you logging that? You it met temperature for those? Well, I do draw lines on the tape, but I don't know what that's for. So you know, people really need to read their IFUs. And you know, the biggest thing, since we're talking about quality and things like that, is that nowhere in the IFU does it say fast about quality and things like that is, that nowhere in the IFU does it say fast.
Speaker 1:Fast is not in the IFU. That's so good, that's really good. So I'm a technician or I'm a leader and I'm listening in to this podcast and I'm pondering in my mind, like what are the first steps to shifting from a quantity first mindset to a quality focused approach? Like where do I even start? That's a good question.
Speaker 2:Hopefully you've been precepted to the department you're working at and they actually have a policy on. You know standard operating procedures, quality Some do, some don't but you can always go to the A&E standards. I'm a big advocate of every technician knowing where the A&E standards are housed in their department and actually having them look at them. I'm also a big fan of actually more than just once a year, but at least yearly review of everyone reading the department policies and signing off that they read the policies.
Speaker 2:Because it's amazing to me, you walk into these facilities and people, they're like they're robots. They're like, okay, I load this car up, I shove it in, I close this door, I press this button. I'm like they're robots. They they like okay, I load this car up, I shove it in, I close this door, I press this button. I'm like, okay, well, what did you just do? Well, I don't know, that's just what I do, Okay, and then, when it's done, I pull it out and I park it over here and then I go about doing something else.
Speaker 2:Do you go? Do you incubate the BI? Why? Why are you doing these things? Do you even understand what you're doing? And some people do and a lot of people don't. They just know a task and they complete that task and they move on to the next task with no knowledge of why they're doing things, which then leads me to my other peeve is where people are doing nonsensical tasks that make no sense and they don't even know why they're doing them, because because they were told to so if they had the why behind the how and the what, they would make a lot more sense to them no, it's actually very, very excellent.
Speaker 1:Even today I was uh sharing with one of the students that were precepting in our department about not being a button pusher. But really you're not a button pusher, right, but you have to understand what happens when that button is pushed. Or even when I'm precepting students talking about the control, talking about the incubator why, what is the purpose of a control Like, what is the control actually doing? Why do we need to do this for every lot that we're changing or every batch that we're using? Just getting the technicians to understand the why. And in regards to the standard, you know all our technicians know where the standards are located. And then when I'm making changes, because maybe I'm researching something, I'm reading that I like to read the standards when it gets slow, so I pull the standard out and I start reading it, highlighting it, and so when I notice that maybe there's something we can improve on, I make sure I gather the group around and actually show them this is what the standard says, this the group around and actually show them.
Speaker 1:This is what the standard says. This is why I'm doing this. Remember the standards.
Speaker 2:They're like, okay, okay, build the fenders, no, no. So yeah, I think, um, it's great to know. Thank you, that's good because you know, if we don't educate our techs, you know we're not going to be there every day, every single day, every single minute, you know. I mean, we could even just have left the department to go up to your OR and do your rounds or what have you, and something occurs. It's really good to have empowered your staff with the knowledge of the standards. Or what if someone comes down and questions something and again you're not in the department, right, you have things that you do outside the department. It's good to empower our staff and our technicians to know these answers instead of, when someone comes down asking questions, everybody scatters because they don't want to want to be you know wrong, or they don't want to answer, or they don't know the answer. So keep educating my friend well, no, thank you.
Speaker 1:Yeah, thank you. I love that encouragement because education is so important, you know, and it leads right to another question, ties right into it beautifully, which which is like what role does training and continuing education play in improving quality?
Speaker 2:Well, you know, like we were talking, it's huge. Again, my two favorite words organizational consistency. You know, without these factors you don't have the success because you're not running efficiently or effectively. You know your staff, like you said, if they're just button pushers they don't have the why. They don't know really what they're doing, they just know that this is what I do. When this happens or sometimes they don't it takes away their ability to critically think when they feel that you know we're not on an assembly line. I think that's a big misconception.
Speaker 2:Is that sterile processing can be run just like an assembly line. My husband has run a shop for years making automotive parts, so I know what an assembly line is. Sterile processing is not even remotely close to an assembly line because no two days are the same, no two hours are the same. Emergencies coming in, we got add-ons coming in, we got extra trays for this and we have broken things.
Speaker 2:It can be chaotic, but if we're organized and we have broken things and just it's, it can be chaotic, but if we're organized and we have our processes in place, we can deal with those bumps in the road as they occur and it's not going to shatter our world right as they knock things over here. That's just my opinion. But I mean I ran a, ran a couple cs departments for many years almost 10 and we really had our processes down. And there was weeks actually that I was by myself doing 12 to 15 cases a day with no problem because we had processes in place and it really ran just as smooth that way, as if there was two or three of us, just because we had it down.
Speaker 1:Well, that's great, that's really great. I mean education, continuous training, investing in your employees is just really investing in the department. You know it's really a part of culture too. When you have that a part of your culture, that learning is. You know a great CEO that I listen to, michael E Parker at URS CEO. He talks a lot about how culture is what we do consistently, what we allow and what we celebrate, consistently what we allow and what we celebrate.
Speaker 1:And so when you have a culture that values, you know continually training the employees you know doing those those, those in services, or a lot of times I notice when, when something happens, it's not like the one bad apple ruins a bunch, but it's a great opportunity to have an in-service right. Someone didn't do it right, so everybody has to learn it all over again. Right I go? Oh, here we go, but it's great.
Speaker 2:That's a good idea and I do like two sites that I've worked with that were very pro-education. Because when you walk into a site that's not pro-education and everybody tackles you at the door, like when I was an educator, do I see emails? We need CEOs, we need CEOs. And it's like well, aren't you guys doing stuff on your own? Aren't you doing stuff monthly? Aren't the vendors coming in? You know the instrument vendors, this and that, and they're like no, and you know you had a leader in that department that was not willing to give the time up to educate the staff the way they should have. And then I had other departments where, like clockwork, every month they had a vendor in for one. You know, late start day they passed out the articles from healthcare purchasing news. Every month they did stuff on their own. And you definitely feel the difference in the atmosphere when leadership is about education versus like you're on your own, we don't care.
Speaker 1:Yeah, you can never talk enough about education. I mean, when situations happen in the OR, it's always I mean, when I was a liaison, they would call me into the OR. One of the new supervisors just started and he said well, bill, you know, you're the liaison, you're up here every day. Like, what should I do? And I said well, the one thing you don't want to do is tell the doctor. Just tell the doctor, you know. Well, thank you, we'll get you another one. Like he wants an actionable plan right now. He said well, what would you do? I said what I would do is I would go in the room, I would apologize, I would tell him that when the tray comes down, you're personally going to change.
Speaker 1:What was happening was they were putting the wrong arthroscopes in the tray, so it was like the scope degrees were off and the doctor was really upset. And in the tray. So it was like the scope degrees were off and the doctor was really upset. And so I told him you should personally change it yourself. And I said hey, man, do you want to reassure him that this is not going to happen again by having an in-service education, having a quick in-service about the tray and showing everyone exactly how the doctor wants it. And so I left the room and he was like. He was like, yeah, you knew exactly how, you knew exactly what he wanted. I said I'm up here every day. I know they want to hear, you know, they want to know like everyone's going to be trained, everyone's going to be in service. And so education I say education is our front line of defense. It's right there in the front.
Speaker 2:It is. We had a similar situation like that. It was the camera, the light cord for the camera. They kept sticking the wrong one in. There was a piece on it that slid across, I don't remember exactly. Something slid across and the text kept sliding to the wrong end. So that was the end. That would get thrown off. The field thing Did it in service, photocopied it, put it up on the board and like with a big X across it, no, don't do this. But yeah, I mean, sometimes that's what you have to do. And once people started doing it correctly, you know, then we like, okay, everybody's got it now. But then you know, six months later it happened again because we got some new people. So we had to, you know, start all over. This is why this picture's up here.
Speaker 2:Don't do this so yeah, education is definitely important.
Speaker 1:No, and that that's really good. I just wanted to add this comment just came to my mind so you know if you are listening in. Remember, sterilization station is an empowerment podcast. There was an episode where I talked about 10 ways to be empowered in sterile processing, and some some of that is through. You know, bill rochelle is always going to give you something to think about, make you think, encourage, encourage you, motivate you. But remember, the definition of empower is to give yourself authority, to have the power to do something, and really you're empowering yourself. So when you are participating in in-services, you're empowering yourself to be able to be that technician that you know A-plus technician. So just wanted to add that in real quick that we're still talking about empowerment. We're empowering you through education. Remember, this is an empowerment podcast, so I hope you're feeling empowered right now. You're learning a lot. This is great. So and then? How can leadership balance the demand for instrument turnaround while maintaining high standards of quality?
Speaker 2:Well, so if the SPD staff, you know, is consistent in doing you know their processes, excuse me then they will consistently be turning instruments over and producing quality trays, right. So the SPD leadership needs to be aware of you know the length that these processes take. What these processes take, you know how many steps and what materials, both of time and then what they need to do in turn is is when it starts coming down from above like, oh, you guys are taking too long, we need this back. You know what is the problem down there. You guys, I hate when I always hear the words you always, you never those are big words.
Speaker 2:Those are big words and it's not correct. You know, we may have sent up a tray a month ago that had bioburden in it. They haven't had an issue since. But the next time it goes up with bioburden in it, you guys always send us trays with bioburden. You're always doing this. So the SPD leadership needs to do kind of like what you were saying Apologize, educate, make sure that you're holding your staff accountable. You know, try and make these things not happen by empowering your team to have the knowledge, know the why, know the how and not keep making the mistakes. If it's narrowed down to you know a specific person that continues to make the mistakes, then you know there's other avenues that you can go to correct that as well. But just having the SPD leadership, such as the supervisors and managers and things, do the education but then stand up to the other side, I think is very important to maintain our quality and our presence.
Speaker 1:Oh, that's great. That's really outstanding. I'd be like to say that's outstanding. What are some challenges that departments face when trying to implement quality first policies and how can they overcome and get to the other side of that?
Speaker 2:What are challenges do departments face? When I first started at SPD, I walked in to run an SPD department. I didn't even know what SPD was. I didn't know anything.
Speaker 2:It was so green. So what I started doing was meeting with all my vendors, finding out what products do I buy from you, what trays do I get from you, what are they used for? To educate me. Then the next hurdle I had to overcome was OR and CPD was like this because of quality issues, you know, a tray's not being done on time. There was a bioburden issue, there was a big missing instrument issue. It was just like every issue you could think of was going on. So here's the main green, as can be with all these issues, and this was 2009.
Speaker 2:There wasn't a tracking system. It was a little messy, so I had to start learning processes. I had to figure out how to navigate the politics and figure out what we needed. You know, start getting someone to open up the coin purse and you know, first thing I did was figure out how many trays we had of everything, like in an actual inventory. There was actually no inventory, like no physical inventory. So started with an inventory. Then we figured out what instruments were missing and tried to fill in the holes there. And then, you know, we only had one washer and one sterilizer and we were doing 25 cases a day. Heavy ortho, I had two techs and myself, so we had a lot of hurdles to overcome.
Speaker 2:But once I started getting some trust with the OR by just working with them to figure out what our inventory was, getting some of those holes plugged with missing instruments being replaced, getting some trust with them, working with them to see if they could fix the way the schedule was laid out. You know, instead of having back to back to back cases where I don't have enough instruments and I can't turn them over fast enough, how about we do a total and then a scope, and then a total and then something else? You know so that I had time to turn over first to third and second to fourth, and you know so we once we started communicating a little bit and they saw that I really wanted to fix things and we started making, you know, the low hanging fruit changes first and things kind of fell into place. So, cause we also had to do all the equipment, we had to round on the floors, we had to deliver stock to the floors and again it was two techs and myself doing all these cases, doing all this other stuff. So I was able to meet with leadership from other teams to hand off some of that stuff. I had the patient transporters start to round for equipment and bring it to us. And then I trained them how to clean it.
Speaker 2:So on weekends, you know, after you come back on a Monday morning, before I did the training with the transporters, we come in on Monday morning, there was so much dirty equipment in the equipment room you couldn't even open the door because all they kept doing was just shoving it in. You know, patient transporters have some time on their hands in between transporting and this and that. So I thought okay, well, let's use that, train them how to clean stuff and bring it back to the floor. So that opened up one thing.
Speaker 2:And then we were processing crash carts. You know replenishing them and you know working with the pharmacy to get the drug drug put in and this and that. So we were able to hand that over to the pharmacy because we don't really need to be in the middle. Same thing with the isolation carts. We handed that off to the storeroom folks because all the stuff was in the storeroom. So then we had the transporters wipe the cart down, take it to the storeroom. The storeroom folks filled it up, put it in the holding area. We we kind of took ourselves out of some of the loops of things to free up our time to focus on instruments again.
Speaker 2:This was 2009, 2010, when we were still doing supplies and all that kind of stuff. I'm happy to see sterile processing is getting out of the supply business more and more, getting out of the equipment business more and more, to let us focus on these more complex instruments and things, which that's where they need our focus.
Speaker 1:Wow, think about, wow, look at all the things that you know, the collaboration that was involved, to look at all the different processes to make sure that really, at the center of everything that you said, what I was hearing was three words patient, patient, patient. Right, it's like everything we're doing is creating better processes so that we can provide better outcomes and more efficiency to impact our patients, and then also efficiency and process improvements also really benefit the employees, right it's? If you're constantly going, I mean employees. Right, if you're constantly going, I mean when I was new you're probably going to laugh when I was new, 22 years old, brand new snow processor and I was delivering equipment.
Speaker 1:I was in the equipment room right across the hall from SPD at a big hospital, a job near a medical center, and I was taking an IV pump up to the 12th floor coming down, taking a feeding pump to the second floor coming down, and I call him this triple OG, old school SPD guy. He said, bill, you're going to kill yourself, man. And he changed my life. He said work smart, not hard. Right.
Speaker 1:I was like oh, wow, ok, I like this guy, that makes sense. So I waited 15 minutes. Get about three or four that would come through, then I would deliver them right. So I, youngblood, had to learn by experience. I was trying this was before Fitbit y'all. This was before I watched as a track in steps. I was putting steps on my shoes and they weren't even counting right.
Speaker 2:But you're right, but you didn't. But right, but it's so obvious to you today. But the 22-year-old girl didn't think about you, were like I'm here to do this job, the call comes in, I'm taking care of it, right? Why wouldn't you think that way? Right, because you're like I'm here to do a job, I answer the phone, I take the call, but someone mentored you, you know, shared with you a process and you probably were more productive because you're, you know, up there doing four different things and you know, probably bringing stuff back down with you as you're going through or what have you.
Speaker 2:And it was the same thing with my scenario. You know that wasn't an overnight process. That took me probably the better part of a year to get that all straightened out and a lot of conversation and a lot of proving myself and mentoring from you know outside, vendors, inside, you know staff and things. So we learn, and that's that's the whole learning process is is making mistakes and learning from them. If you don't learn from the mistakes, well then, that's another conversation for another day, but that's that's. I believe that's how we learn.
Speaker 1:Yeah, that's great, even taking on projects in the department. When you see something that needs to get done, we always say in church, on one of our service teams, we always say you know, we always say find work. So if someone needs help an elderly sister needs help walking in the church outside, help her. If you're in there and you see the bathroom needs the garbage can needs to be emptied, find work. So we always say you know, just find work. So I think in sterile processing it's the same thing. If you, you know, usually you see something you're like I wonder if someone's going to do that. If you see it twice, if you get to the third time, that means it's up to you, it's you need to. You need to be the one that jumps in and takes on that little project. That could benefit everybody, you know.
Speaker 2:I 100% agree, and there's never nothing to do.
Speaker 1:I know that's a double negative.
Speaker 2:But there is always something to be done in serial processing and there should never be anyone standing around doing nothing. And I used to get that initially was you know, if you are assigned to continue, well, if there's no cards coming down, you don't sit over there waiting for cards to come down. You, you doff your PPE and you come on over to prep and pack and you start putting trays together or you go get equipment or you pick case cards or you do whatever. But you don't just stand there and watch everyone else work because that's not your assignment for the day, you know. So I like that, find work, because that is 100% true. There's always something to do.
Speaker 1:Yeah, I think we all have learned that through our career and our tenure in SPD. So, as we start to kind of get into our final thoughts and to wrap up today, which has just been excellent I don't even want to get off here because I'm just so excited to have Carol here and she's just been excellent. I don't even want to get off here because I'm just so excited to have Carol here and she's just got so much experience. But we'll wrap up with a few final, just questions. We're going to pick her brain, you know, get as much as we can out of her today. If there's one key takeaway for our listeners, what should it be today?
Speaker 2:Well, you know, hard conversations with the departments we work for and work with are not always easy. But you know we're all here for patient safety, and I know we talked about that earlier, but we really are all here for patient safety. Everyone who works in the hospital, you know, in order for us to be good stewards, you know we must stand up for what processes is right and not be afraid to stop the line. So don't be afraid to have the hard conversations, don't be afraid to stop the line.
Speaker 1:That's great. And Don't be afraid to have the hard conversations, don't be afraid to stop the line. That's great. And are there any specific guidelines or resources or training programs you recommend personally for those looking to improve quality in their department?
Speaker 2:We talked a lot about education and I really want to stress that we all have to do CEUs to renew our certifications. And I really want to stress to every technician out there, certified or not certified, you should be doing CEUs on the regular, at least once a month, if not more than once a month. You should be reading articles, you should be getting on CEUs, you should be going to chapter meetings, you should be, you know, educating yourself. It's not up to your department to educate you. It's not up to your manager to babysit you and make sure you get your CEUs. It's really on each of us and it's CEU stands for Continuing Education Unit. That means to continue it. Don't wait until your certification is going to expire in three weeks and then try and jam in all the CEUs you need, because you're not learning anything, you're not retaining anything. You're doing it to take a test and get a certificate and that's really not the right way to do it.
Speaker 2:You know, and I have a soft spot in my heart for Beyond Clean I really love how easy it is. I drive a lot and I listen to podcasts. I listen to an entire season, take the quizzes, boom, I get my certificates. I listen to seasons over again, especially when I've heard something that has really resonated with me or is. I'll go back and listen to an episode. When I have a situation that occurs and I'm like you know, I heard something about this on a podcast, I'm going to go back and listen to it to share that information. Starris University also very amazing place to get CEUs a lot of great education there. Healthmark and even Pure Processing has a nice education platform. So they're all free, they're all accessible 24 hours a day and I really think that you know educating yourself is really important. No one can take the knowledge that you've accumulated away from you. That's something that, wherever you go, you take with you, so I think it's really important to do that for yourself.
Speaker 1:That's great. And now, where can our audience connect with you or learn more about your work?
Speaker 2:Well, you can reach out and connect with me on LinkedIn. I'm under Carol Malone, Carol with no E. A lot of people like to spell it with an E, but it's just Carol Malone M-A-L-O-N-E. My personal email is cmalone7 at gmailcom.
Speaker 1:That's great. Thank you, that's great. Well, thank you, carol, for sharing your expertise. It's definitely clear that in sterile processing, quality isn't just a preference, it's an necessity for patient safety and to our listeners out there, if you found this episode valuable, please make sure to subscribe, leave a comment, share it with one of your technicians. Your leaders continue to follow us and we just really appreciate your support as Sterilization Station is continuing to empower you, and today we did it through having a great conversation about quality versus quantity. And we'll see you in the next episode. And, once again, thank you, carol, for joining us and this was great, and we'll talk to you and see everyone soon.