261 - Instrument Tray Standardization and Reduction at an Oncology Hospital
Description: Description of Team A core team of perioperative frontline staff, OR leadership, sterile processing leads, and the perioperative executive committee was formed to define goals and implement strategies to standardize instrument trays and reduce waste. From this core team there were service specific teams formed to review instrument trays. Each service line team consisted of a frontline OR coordinator, surgical tech, sterile processing supervisor, perioperative leadership, and the surgeons within the service line. It was important that we include all surgeons in each service so they can give input and come to a consensus of tray contents. Preparation and Planning The development of the instrument tray reduction and standardization project began with a thorough assessment of the organization’s strategic initiatives; this allowed the department to align the project to the vision of the enterprise. Once the project was defined as an important organizational and department initiative, a critical step was to gain buy in from the surgeons and perioperative staff. Data was collected from an instrument tracking system to create a report of all trays and instruments. This project was introduced to the perioperative executive governance committee. The perioperative nursing leadership engaged the division chiefs by presenting data and opportunities. The presentation included data as well as real life experiences related to instrument availability and surgical delays. In engaging the surgeons we were able to tell “the story” and for them to see what was in it for them. A project plan was created to identify the steps, timeline, and desired measurable outcomes. Implementation Once a project plan was developed and approved, dates were determined for teams to meet. Because there are multiple patient care related priorities, it was important for nursing and sterile processing to be flexible to meet when the surgeons were available and when trays to be reviewed would not be needed for surgical procedures. During the identified time of surgeon availability the service line coordinator, sterile processing supervisor, and nursing leadership team member met with all surgeons within the service. The trays were opened and the team reviewed each item together. Trays were combined, reduced, and decommissioned. Following agreement from the team members, instrument tray lists were updated and trays converted to the newly revised sets. Outcome There has been a significant reduction in instruments and associated reprocessing costs. This project is ongoing and a complete quantified analysis will be completed this year. Instrument tray standardization provides enhanced efficiency in the operating rooms and sterile processing as well as cost savings for the organization. Trays are easily located and there is a streamlined process in stocking trays and case preparation. Reprocessing and the instrument counting process is more efficient. A satisfaction survey has shown increased staff satisfaction. Implications for perioperative nursing Surgical instrument availability and reliability is critical to delivering high-quality care to our oncology patients. When nurses participate in decisions that impact their day to day work they have autonomy and feel their opinions are valued by the perioperative team. This involvement leads to a have a higher level of engagement and satisfaction.