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.
Loaner instrument sets are ideal for facilities who:
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.
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.
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.
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:
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.
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.
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:
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.
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:
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.
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.