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A Work Systems Analysis of Sterile Processing: Sterilization and Case Cart Preparation
Advances in Health Care Management
|February 21, 2020
Summary
Sterile processing departments (SPDs) can improve instrument reprocessing by analyzing work systems. Key interventions include managing interruptions, enhancing communication, and optimizing workspace design for better safety and efficiency.
Area of Science:
- Healthcare Operations
- Industrial Engineering
- Patient Safety
Background:
- Reliable instrument reprocessing in sterile processing departments (SPDs) requires balancing cost, productivity, and safety.
- Limited research exists on comprehensive SPD work systems analysis.
- SPDs are socio-technical systems where human, technical, and organizational factors interact.
Purpose of the Study:
- To apply work systems analysis (WSA) to an SPD to provide a framework for intervention and improvement.
- To identify factors influencing performance in instrument reprocessing tasks.
- To analyze variances and their impact on reprocessing outcomes.
Main Methods:
- Work systems analysis (WSA) framework applied to two SPD facilities.
- Development of process maps, task analyses, abstraction hierarchies, and variance matrices.
- Direct observations, staff interviews, expert feedback, and performance sampling including interruption analysis and defect data review.
Main Results:
- Variance analysis identified 16 failures and 21 performance shaping factors (PSFs) in sterilization tasks, leading to nine outcome variations.
- Case cart preparation analysis revealed 11 failures, 16 PSFs, and seven outcomes.
- Approximately 1% of cases had reprocessing defects, with 13.5 interruptions per hour during case cart preparation.
Conclusions:
- Instrument reprocessing performance can be enhanced by simplifying sterilization, increasing visibility, managing interruptions, improving OR communication, and optimizing workspace and technology.
- Individual technician skill is crucial but systemic improvements are necessary.
- WSA provides a valuable framework for identifying and addressing performance gaps in SPDs.
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