Objectives:
- Learn what loaner and consignment sets are.
- Identify how to effectively track and manage loaner sets in your facility.
- Understand how to enhance the loaner management process for technicians and vendors.
For most facilities, loaner sets are an integral part of the perioperative environment. Many times facilities do not have the financial means or storage space to purchase sets that are not used on a regular basis. “True” loaners frequently fall into this category whether they are trauma, neuro, spine, or orthopedic sets.
You may be asking yourself, “What exactly is a “loaner?” The answer – it depends. Most facilities define a loaner set as any set brought to the facility that is not owned or stored at the facility. Other facilities divide these sets into separate groups of “Consignments” and “Loaners.” Consignment sets are vendor sets that are not owned by the facility but are stored or “live” at the facility. Generally speaking, facilities that have consignments treat these sets as their own. If utilizing an instrument tracking system, they will have barcode labels on the containers and should have a count sheet. Many times, facility staff will reassemble consignment sets during the assembly process, and they are less dependent on the vendor to maintain these sets.
Loaners that are not owned or stored by the facility will be what is referenced today. These sets will be dropped off by a vendor a couple of days before a procedure, utilized during the case, and then picked up after the sets have been decontaminated and deemed ready for release. Facilities typically have policies in place related to when the sets must be at the facility prior to a case and how long they can remain at a facility after the completion of the procedure.
The CensiTrac Loaner Module can be used throughout the process to capture all valuable information about the sets being utilized starting at check-in. Many facilities choose to check-in their loaners in a dedicated loaner ante room or in the decontam area. The advantage to this is being able to capture the decontam process and the mechanical washers in the history of the sets.
When staff check-in newly arrived loaners in CensiTrac that have never been at the facility before, the sets first need to be entered into the Loaner Service. Each subsequent time the sets are utilized at the facility, the techs will start at the second step of creating the case in the Loaner Module which has three mandatory fields: Case Date/Time, Physician and Location. The information from these fields print on the loaner label along with the number of sets, i.e. 1 of 10, 2 of 10, etc. There are additional fields available, one of which is a great time saver, especially for cases with many sets. This is the Case Procedure Field which when used, will auto-populate the previously used sets for the same procedure. This will save your staff the time of entering 15 sets for that next big spine revision.
Other valuable information that can be entered in CensiTrac on the case creation page is the set weight and photos. Weights are important to ensure the sets are following AAMI standards, weighing no more than 25 pounds, helping to ensure your sterilizers do not become overloaded. Overloaded sterilizers can lead to inefficient sterilizing, failed biologicals, and wet loads.
Photos are a great tool to document what the set looked like upon arrival at your facility. This is useful for reassembling a set once it comes out of the washer. Additionally, if items are claimed to be missing when the set is picked up at the completion of the case, the photos from arrival can be reviewed to ensure it was in the set when it first arrived at the facility. This can save the department the cost of replacing “lost” items that were never actually in the set when it arrived for processing.
By scanning the loaner label when assembling the set, the assembly process is captured, which also gives staff productivity credit for their time. The next and most crucial step in the process is sterilization. Those same loaner labels will be utilized to build sterilizer loads adding additional traceability to the sets.
After sterilization is complete and the sets are cooled, their journey to the OR begins. In CensiTrac, staff can scan sets to a case cart for use on an upcoming procedure or to a storage area awaiting use. The OR Scheduler or Case Tracking Module can be used to link the loaner sets to the procedure for tracking back to the case.
Upon completion of the case, the labels that have been used throughout the process should be scanned back to the Decontam area and to the washers. This completes the cycle of the loaners. Loaners can then be scanned to the holding area where sets are placed awaiting vendor pick-up.
All information put into CensiTrac is easily accessible by utilizing the Reports Module. Reports can be created to show loaner usage history, current loaner location and my personal favorite, Vendor Lead time which will show trends with sets being delivered not in compliance with facility policy (i.e. Less than 24 hours).
In many cases, SPD may first become aware of loaner sets when the vendor rep arrives at the Decontam door or loaner check-in area. One problem that arises out of this situation is not having adequate staff on duty to process the sets in a timely fashion. Another problem that occurs is staff spend their time completing loaner paperwork and creating loaner cases in the Loaner Module.
LoanerLink is a solution that helps eliminate this problem by returning the responsibility of loaner scheduling and delivery to the Surgery Scheduler and the Vendor Rep. When a facility uses LoanerLink, the surgery scheduler creates the loaner case, which then electronically notifies the vendor representative of the upcoming procedure. The rep then enters which sets will be brought to the facility and will then receive notification reminders of when they are due or overdue and when they are ready for pickup. The loaner sets auto-populate in CensiTrac so there is minimal work in SPD and leadership can schedule staffing based on incoming loaners. With LoanerLink the main responsibility of SPD staff is to process the sets, as it should be.
By utilizing the tools available to you with an instrument tracking system like CensiTrac, all information can be documented and provide analysis reporting which results in your loaner program being as effective and efficient as possible.
