What are loaner instruments?
Surgical facilities around the world have a backlog of procedures that they work through every day. Sometimes the reason for this backlog is complicated: trouble hiring surgeons or facility needs upgrades. Other times the reason can be simply that they don’t have enough surgical instruments on site to perform more procedures.
When this happens, surgical facilities can borrow instruments from manufacturers. These are called “loaner trays” or “vendor trays.” Contracts are made with requirements on both sides for facilities to schedule the delivery of loaner instrument sets. Sometimes these sets are used for routine procedures, but there are times when emergencies happen and the sets are dropped off within 24 hours before the case, or less. Electronic loaner management systems like LoanerLink from Censis help make the process run smoothly for all people involved.
The important thing for sterile processing technicians to remember is that loaner instruments should be reprocessed exactly like in-house instruments. This means being familiar with the manufacturer’s instructions for use (IFU) and following those steps carefully. Skipping steps simply because the sets “aren’t yours” can lead to disaster for the patient on the table.
Benefits of using loaner instruments?
Loaner instrument sets are ideal for facilities who:
- Don’t have the budget to purchase whole new sets of instruments
- Don’t have the storage space to house all the instruments they’ll need
- Have a surgeon who only works part-time at their facility, so the instruments are rarely used
- Want to keep up with surgical innovation so that patients receive the best care possible
Each facility has individual needs and policies, and loaners are a great resource to help fill in gaps where there is a need. A strong loaner policy is needed to ensure communication, delivery, and reprocessing of loaners is a smooth process for all stakeholders.
When surgical instruments are unavailable, this can cause a ripple effect through the entire perioperative loop. It harms the patient, who may have been waiting months for this procedure, and now they cannot have it done. It also harms the facility, from a financial and reputation point-of-view.
Financially, if a facility has a procedure scheduled and cannot complete it, they have now wasted time and money that could have been utilized in a more efficient way. Also, if a facility has a habit of not acquiring surgical instruments and must cancel cases, they will get a reputation as unreliable, and will see a decrease in patient load. Having an agreement for loaner instruments saves the facility in many ways.
Challenges of loaner instrument management
There are challenges with utilizing loaner instruments, especially when it comes to scheduling delivery and pickup. Many sterile processing departments (SPDs) have felt the stress when an instrument vendor rep shows up at the door, unannounced, with 10 loaner trays for the next day. Or they’re knocking at the department door and the trays haven’t hit decontamination yet after the procedure. Most facilities have policies in place that dictate acceptable loaner set delivery and pickup rules, but often those policies are difficult to enforce.
Another challenge SPDs face is decontaminating loaned instrument inventory. Many times, the IFU is not delivered with the instruments, and if the technician isn’t familiar with the set, that could cause a reprocessing delay while SPD tries to track down the IFU. Loaner instrument sets should be reprocessed with the same care and attention that in-house sets are given, especially since the technicians can’t guarantee the previous location followed the IFU properly.
Who needs loaner instrument management?
Not every facility will need loaner instrument sets. Some locations are small enough to obtain their own instruments and have the budget and space requirements to suit their needs. Other locations would have instruments sets flowing out the doors if they had to purchase everything they needed.
Determine if you need loaner instrument management
How do you know if your facility should borrow instrument sets from manufacturers? There are some questions your leadership can ask to determine that answer:
- Are we constantly turning instrument sets over to keep up with the surgical case load?
- Are we already over-stocked on instruments, with no room for more that we need?
- Do we have backup sets for our in-house instruments, or are we constantly worried about having to use the Immediate Use Steam Sterilization (IUSS) cycle?
There are more questions that can be asked to determine if your facility would need to establish loaner instrument set agreements with various vendors in your area.
What do you need to establish a loaner instrument management program?
Once you have determined that yes, you need loaner instruments, the next step is to work with the surgeons and perioperative leadership to determine what vendors would have the necessary sets. The surgeons have preferred manufacturers they like to use, so taking their preference into account is critical.
Then you must work with facility finance and leadership to contact the manufacturers and discuss terms of an agreement. Some vendors require an entire set to be loaned together, which can be upwards of 10 trays, even if the doctor knows he or she won’t use more than 2 of the trays. Other vendors allow facilities to determine which sets will be needed for which procedure.
This is where your instrument vendor reps come in as a great resource, especially if they are familiar with the surgeon and their preferences. They can help bridge the gap between manufacturer and facility to determine the best agreement for all parties. They will also become the future reference for IFUs, in-services, and more for your sterile processing team.
Inventory management and tracking
Your leadership team has followed all the steps, agreements are in place, and you’re ready to receive loaner trays. Well, how do you keep track of them? Some larger surgical facilities can receive hundreds of loaners sets per week, and the OR will NOT be pleased if the trays are mixed up.
This is where an instrument tracking system can really shine for your team. LoanerLink, from Censis, provides a digital platform where the facility, surgeons, vendors, and SPD professionals can communicate instantaneously about loaner sets. With an instrument tracking system (ITS), you can ensure your loaners:
- Arrive on time: AORN suggests an arrival time of 48 hours minimum prior to the case. This ensures that the IFU is followed properly, and also gives time to account for mishaps that may occur.
- Are all together: If you’re expecting 10 sets but only 8 arrive, your team can communicate with the vendor to find the other trays, so that your procedure isn’t in danger of being canceled.
- Can be located: When there are 100 loaner sets, it’s critical to know where each one is always located. Sometimes the sets are picked up after a procedure, and other times they are reprocessed for use again at the facility.
Importance of proper instrument processing
If you’ve talked to someone in sterile processing longer than 5 minutes, you’re bound to hear about how important it is to reprocess instruments correctly. There are statistics and bad stories everywhere surrounding improperly cleaned and sterilized surgical instruments. Hospital-acquired infections (HAIs) have the potential to ruin a patient’s life or even kill them. Nearly 1.7 million hospitalized patients acquire infections while already being treated for other health issues, according to the US Center for Disease Control. The work in sterile processing is the difference between a life-saving procedure and a life-changing event.
Risk management and safety
To quote Harvard Business School, “Risk management is the systematic process of identifying, assessing, and mitigating threats or uncertainties that can affect your organization.” Every business has risks, and the health care industry is no different. Sterile processing departments should be part of the team who identifies surgical risks and plans how to address them.
Loaner instrument sets bring multiple risks to a facility:
- Unfamiliar instruments may be broken, and technicians don’t know,
- Improperly decontaminated loaners bring risk of infection to patients,
- Loaners delivered too close to the time of surgery are at higher risk of mistakes happening.
There is also the risk of retained bioburden. You’d think this would be obvious to spot, but your team doesn’t know which instruments can be disassembled, they might be unknowingly putting patient lives at risk. One way to mitigate risk related to loaner instruments is to contact the manufacturer and schedule in-services for all staff who will be reprocessing or handling the instruments. Then your team will be empowered to advocate for patients if loaner sets arrive broken, packed with bioburden, or unsuitable in some way.
How Censis can solve your loaner instrument management needs
Loaner instrument management can be more complicated than you would think, but there are resources available to streamline and simplify your process. One such resource is LoanerLink, from Censis Technologies. This solution can be used in conjunction with their broader-reaching instrument tracking system, CensiTrac, or can be used on its own for loaner tray management.
LoanerLink is a digital hub which allows perioperative leadership, surgeons, vendor reps, and sterile processing to come together and communicate clearly on the loaner needs for each surgical procedure. SPD will know how many trays are being delivered on what day and at what time, when the procedure is scheduled for, and when the loaner sets are going to be picked up again.
Unless there is an absolute, last-minute emergency procedure, with LoanerLink, you’ll no longer have surprise visits from reps dropping off loaner trays. If you’re tired of drowning in paperwork and unexpected loaner trays, reach out to Censis today and see how they can help.
