IT revolution that is coming to healthcare can change the outlook of managements towards our department by turning it into a revenue center rather than a cost center.
I work in the health care industry, heading CSSD since last 3 years at a 207 bedded, paediatric multi-specialty hospital in Mumbai, treating infants, children and young adults. There are a huge number of instruments from very small sizes to much larger ones in our inventory. To keep accurate count of all instruments is a difficult task for us. As our hospital is growing, expanding to transplant surgeries among others, new instruments are being purchased regularly. It becomes difficult to track old versus new, which is required since newly purchased instruments are covered under warranty. There are continuous demands from surgeons to keep adding instruments in the set, so master lists keep on changing, which makes it difficult to track instruments and keep accurate inventory data.
The processing environment in Central services is always stressful and time bound as inventory needs to be quickly available for next use. Staff is continuously busy in communicating with OT for searching misplaced instruments, checking set locations, work-flow status, taking hand overs verbally about damaged, repairable instruments. Documentation and record keeping processes are manual. Incomplete “Transactions documents” make traceability an issue. Conflicts arise between users and CSSD about instruments missing or mismatched, unnecessary sets opening, errors in packing and labelling. The process tasks are highly person dependent, which leads to human fatigue and causes errors and wastage. Manually checking sterile expired items, keeping cleaning records, reuse policy tracking of patients are very complex jobs. While we face a shortage of manpower, there is no handy data on staff productivity to convince management of the need for extra manpower. These are common challenges in CSSD operations.
To overcome these challenges, we expect new technology to reduce human fatigue by automating some tasks, bringing measurability and accountability in the process. A system which can track and trace entire inventory, cover all manual documentation by digitalising, giving proportion data of slow-moving inventory, frequency of damages/missing items, cycle data, repair management so that we can focus on value added services such as inspection and quality checks.
Software features for CSSD
Now in health care sector there are software solutions available for CSSD. Digitalisation is replacing manual documentation. Unique identification of each instrument gives all data about purchase warranty of instrument, tracing every instrument, standardized names, proper checklists for sets with instrument images, total available inventory and its data of reprocessing, cycle count and its repair and care management, tracking of task volumes and processes, data on productivity of staff, work flow or status of sets, stocking availability of sterile sets for further case schedule. System itself gives alert about expired items. In the event of recall, we get handy data for fast action about when it was dispatched and on which patient it was used.
Software generated reports can help in inventory movement, identify slow moving sets, instrument ageing, life cycle reprocess number. Incidence reporting through the system, productivity report of CSSD operations, sterilization data incidents, turnaround time reports and other such features guide us regarding manpower management.
Data matrix, RFID tags, Algorithm based Technology are some basic types of automated inventory tracking systems that are used in health care facilities. Each of these has its own pros and cons so we need to analyse and decide what fits best for our requirements.
Infection Control Policies:
SUD re-use tracking is a big challenge for the Hospital in terms of infection control and patient charges. Digitizing System can track cycle count for re-use with patient details on whom it is used. It gives transparency and helps to define re-use policy and patient’s charging.
Sterilization cycle data stored digitally for each set helps in access and retractability in the event of recall. With auto-expiry of items through system, users are alerted if they are trying to use expired sets.
Software can be integrated with the sterilizer to give better control over sterilization practices by keeping load information related to batches. Surgeons and other users always think before opening unnecessary new consumables as patient will be charged but there is no control on unnecessary opening of sterile sets as they unaware about what is the reprocessing cost behind each sterile set. System can help to trace such data to control wastage.
Digitizing Central service allows to raise incident reports and share with concerned departments through the software and track its closures. Also, it can raise repair tickets and manage repair jobs.
In terms of decision making, OT Scheduling will be simplified as OT user have full visibility of sets. Cycle data for each instrument and set enables clear decision making on slow moving inventory, condemnation practices, replacements, product evaluation etc. Decisions on manpower can be taken with clear volume and productivity data.
Software system will enable CSSD become data-driven and transparent. It can change the outlook of management towards our department, turning it into a revenue center rather than a cost center. Integrating patient consumption data of sets and other sterile goods can enable charging for CSSD services. It will help in skill development of CSSD practitioners and prepare us for the IT revolution that is coming to healthcare.
