because we had to — our instrument inventory couldn't keep pace
with our increasing surgical volume. Fast forward to today: We've
virtually eliminated immediate-use steam sterilization (IUSS). If a 19-
OR hospital that performs 29,000 surgeries per year can get close to
zero, you can, too, by following 4 simple steps.
Set up for failure
Back when we were flashing excessively, it was nearly impossible for
our nurses and reprocessors to turn instrument trays over quickly
enough to keep up with our volume and our surgeons' habits. On the
one hand, many of our cataract and ENT surgeons operated with their
own instruments and wanted them reprocessed between cases. On
the other, we didn't have enough of our own standardized instrument
trays in rotation for our other surgeons.
Besides feeling pressured and rushed, nurses and techs felt guilty,
too, knowing that you're only supposed to flash in an emergency and
we were routinely sterilizing unwrapped items for immediate use. Plus,
when you wash and flash-sterilize instruments between cases, there's a
tendency to cut corners in the cleaning process, not brushing, soaking,
wiping or flushing as thoroughly as you should. Fortunately, the keys
to reducing our IUSS rate were as obvious as the problem.
1
Invest in more instrument trays. One look at our supply
shelves revealed the No. 1 cause of our IUSS problem: There
weren't enough instrument trays sitting on them for the volume
of short cases that we do. Remember, you'll be forced to flash more
often whenever surgical volume outpaces your instrument inventory.
Over the last 10 years, we've invested about $1 million on new
cataract sets, tonsil sets, and other ophthalmology and ENT sets. We
buy based on volume and in sufficient quantity to lessen the incidence
J U L Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 1 3
