Nov 7, 2023 | Article

Productivity and Quality: A Match Made in Reprocessing Heaven

  1. Understanding the clinical benefits of quality and quantity.
  2. Improving quality and quantity by creating SPD efficiencies.
  3. Connecting productivity, quality, and repertoire size.


What wins in your sterilization department: quality or quantity? 

It should be quality, right? That seems instinctive given that quality should be paramount in sterile processing departments. And it is—quality is critical. 

But patients will schedule surgeries, you’ll need tools available, and if you have five colonoscopies scheduled and only four scopes ready, then the problems start to have a ripple effect across departments and organizations. So maybe quantity is important too.

Is there a way to make them work together? If you can believe it, we think there is. And the data backs this idea up.  

Quality and quantity can and should be complementary to one another in your sterile processing department. And we believe that it’s the mark of a high-functioning sterile processing department (SPD) that achieves both in equal measure. 

So, let’s look at why they matter and how your team can achieve reprocessing nirvana.


Understanding the Clinical Benefits of Quality and Quantity


There has long been a belief that productivity and quality are opposing forces in the realm of sterile processing departments. The assumption was that as technicians completed more trays, errors would inevitably increase. 



We certainly heard that feedback from our clients at hospitals and clinics. However, when we dug into the data, it actually proved the opposite. Data from real SPDs showed a surprising trend that productivity and quality can indeed go hand in hand.



Contrary to expectations, the data demonstrated that as throughput increased, there were fewer errors per tray. Technicians who excelled in completing the most trays per day also proved to be the ones making the fewest errors. This counterintuitive trend had us delving deeper into the data.



What factors are responsible for this unexpected outcome? And what happens at hospitals or clinics when quality and quantity are working together?



The latter question was pretty easy to answer.



When productivity and quality are successfully balanced, the result is increased overall efficiency and numerous clinical benefits:


  • On-Time Cases: The seamless coordination between SPD and the operating room ensures surgeries commence as scheduled.
  • Compliant Instrumentation Processing: Teams find better adherence to instructions for use (IFU) guidelines and are guaranteed the availability of high-quality, safe instruments for every procedure.
  • Reduced Reprocessing: Avoid errors and minimize unnecessary reprocessing, saving time and resources.
  • Improved Inventory Utilization and Supply Stocking (IUSS): Optimal utilization of inventory leads to cost savings and streamlined operations.
  • Updated Records and Quality Audits: Maintaining up-to-date records enables efficient tracking and verification of quality audit results.
  • Facility Survey-Readiness: Having the records available to provide quality audits ensures teams are ready and well-prepared for any inspection or survey.

Putting both quality and quantity as high-level goals for SPDs ensures that teams perform better across many of the important metrics for their department. 

So now it’s time to figure out why quality can increase as quantity does. 

Creating Efficiencies in SPD to Improve Quality and Quantity

A key factor in ensuring successful throughput and minimizing errors is the proficiency of technicians. But how can we accurately measure technician proficiency, and, more importantly, how can we enhance it?



One way to do this is by establishing effective processes throughout the SPD to improve quantity without sacrificing quality. These include:  


  • Up-to-Date Preference Cards and Count Sheets: Ensuring technicians are aware of the specific preferences and needs of the operating room is essential. Having accurate and up-to-date documentation available where teams need it empowers the team to prepare trays efficiently.
  • Thorough Instrumentation Knowledge: Comprehensive knowledge of cleaning protocols and instrument functionality is vital. This expertise allows technicians to promptly initiate cleaning and recognize when additional information is required, avoiding mistakes and the need for repeated reprocessing. Make IFUs available at each stage of reprocessing.
  • Staff Orientation and Training: Given the scarcity of experienced staff, developing a well-structured training plan for new hires is crucial. Efficient training helps the team become familiar with the instruments they handle, promoting proficiency.
  • Quality Feedback Program: Establishing a two-way feedback mechanism between SPD and the operating room is indispensable. This fosters communication, enabling both teams to report quality events, track trends, and manage efficiency collaboratively.

Once departments have processes in place to improve quality and quantity simultaneously, we can start to look at how individual technicians can do the same thing. 

As we dug into the data, one plausible explanation for reducing errors among technicians is increasing their level of proficiency. Highly skilled technicians are more likely to make fewer mistakes, leading to smoother and safer surgical procedures. The question that arises then is: How do we gauge technician proficiency?


We looked at several different metrics, such as years of experience and the number and types of competencies acquired over a technician's career. However, one metric emerged as particularly insightful: the concept of "repertoire size."

The Connection Between Repertoire Size, Productivity, and Quality

Although it may sound complex, repertoire size is a simple concept. It refers to the variety of different types of surgical trays a technician can proficiently assemble. 


Inexperienced technicians typically start with a limited range of trays, usually with more straightforward general instrumentation. This is because they lack the necessary skills for handling complex instrumentation.



As technicians progress in their careers and gain more experience, they naturally expand their repertoire. This growth entails adding more complex instrument sets to their skillset, thereby enhancing their proficiency.


The importance of repertoire size lies in its correlation with work performance. Proficient technicians, with a broader repertoire, tend to complete more trays per day and demonstrate a reduced error rate. This data not only validates the significance of repertoire size as a metric but also highlights its potential as an actionable indicator. And most importantly, it’s an actionable data metric for SPD leaders. They can actively influence and enhance technician proficiency by focusing on repertoire size.


Increasing technicians’ repertoire size involves implementing training programs that encourage technicians to branch out into different service lines. By identifying areas where technicians lack exposure and expertise, coordinators can prioritize specific training to boost repertoire size.


A larger repertoire offers several advantages for both technicians and the healthcare facility. Firstly, it reduces bottlenecks in the workflow since technicians can efficiently handle any tray that comes their way. This eliminates the wasted time caused by less proficient technicians searching for appropriate tasks and helps meet the facility's current needs more effectively.


Secondly, an intimate knowledge of various instrument functions enables technicians to test and identify deficient instruments before they reach the operating room. This proactive approach prevents low-quality instruments from causing potential complications during surgeries.


Finally, we found a diverse repertoire allows technicians to develop a keen eye for potential hiding spots for bioburden. Exposure to various instruments enhances their ability to spot hidden problem areas, thus bolstering the facility's overall infection control measures.


By recognizing repertoire size’s potential as an actionable indicator, healthcare facilities can invest in targeted training programs, encourage skill diversification, and ultimately cultivate a more skilled and efficient SPD workforce. This in turn ensures safer surgeries, lower error rates, and improved patient outcomes.

Want to learn more about the data behind these findings? Get in touch with a Censis expert today.


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