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Kim Jones on Sterile Processing Improvements That Drive OR Efficiency · Taking The Supply Chain Pulse

• 0:03
  Welcome back to Texas Applychain Health.
• 0:06
  I'm Edward Shout Company and thanks for tuning in.
• 0:09
  Today we're visiting a powerful conversation from season one second to head home.
• 0:14
  Fred connects with Sue Jones, one of our own and naturally recognized federal processing experts, to unpack what's happening across the central part of healthcare operations.
• 0:24
  If you miss it the first time or want to fresh listen, the insights are just as timely as ever.
• 0:29
  And here's your host, Fred Franz.
• 0:33
  Why don't you tell us about yourself, your background, how you got started, and uh how you've worked to where you are today?
• 0:40
  Sure.
• 0:40
  Well, thank you.
• 0:41
  Um I um obviously um started my career um not in sterile processing, but as you mentioned, uh I had the good fortune uh right out of college to find a position in human resources with um a very well-known organization here in central Ohio.
• 1:01
  Um uh I uh got that position um as a recruiter in HR, and um my areas of accountability were sterile processing in the operating room.
• 1:13
  So I always say um of my 30-year career, the majority of it has been spent uh in H or in uh human or sorry, sterile processing um in the operating room, in or around those areas.
• 1:27
  So um you may ask how that uh goal or how that position in human resources ended me up in uh sterile processing.
• 1:37
  Um I worked for a few years supporting uh the operating room and sterile processing from an HR recruitment um uh perspective, as well as some employee relations mixed in there.
• 1:48
  Um I went out uh on maternity leave to have my first uh baby.
• 1:52
  And when I came back, there was an SPD educator position that had been writing my uh position roster the entire time I was out.
• 2:00
  So I met with the director who I had a great relationship with, and we walked through the department.
• 2:06
  I, you know, was trying to get from her what exactly she was looking for so that it would help me uh to better recruit for them.
• 2:13
  And by the end of that visit, um, you know, I was pretty fascinated by all of this reprocessing that happened.
• 2:20
  I obviously knew part of the job because I recruited for it, but at the magnitude and the volume, um, that was uh that facility was a 32-room OR.
• 2:31
  And so it was just an immense operation.
• 2:34
  And so at the end of that visit, uh at the end of that conversation, uh the director pitched the idea: hey, why don't you take this position?
• 2:43
  Uh people respond well to you, you're teachable, we can teach you the business, um, you have the people skills.
• 2:49
  So that's how it kind of started.
• 2:51
  Um so my first position was an educator.
• 2:54
  That was back in around 2005-2006.
• 2:57
  There was a big uh push, um, lots of lobbying going on to uh make certification mandatory in New York and New Jersey at that time.
• 3:08
  And so we we were leading the pack uh in central Ohio.
• 3:13
  Um we uh I became certified, wrote an education program, and we were able to get about 70% of the staff certified at that time.
• 3:23
  And I really, really enjoyed uh watching people respond as they were learning why we do the things we knew we do, not just how we do the things that we do in sterile processing.
• 3:35
  So I held that position for several years, and then I really started to get interested in operational leadership.
• 3:42
  So a manager position in that very department became available.
• 3:46
  So I threw my hat in the ring and I was given that position.
• 3:49
  Um, I had a large number of uh FTEs, about 80 uh full-time FTEs that reported up through me, and I held that position for a few years, three to five years, I believe.
• 4:03
  And then I was actually invited to uh join the um OR team as a non-clinical manager in the operating room.
• 4:11
  And that was really a gift to me.
• 4:13
  Um being able to see the full cycle of how the patients come in and how the work that we do in sterile processing can affect the metrics that the operating room uses to remain efficient.
• 4:27
  And um, so I was really able to see how that ecosystem of perioperative services includes sterile processing.
• 4:36
  And uh I ended up having the non-clinical team at first, anesthesia techs, OR techs, um, you know, anything non-clinical uh in the operating room reported to me.
• 4:47
  And then halfway through my tenure there, I um I was given the clinical staff.
• 4:52
  Um, I had off-shift clinical uh teams, uh, afternoon, evenings, and weekend clinical teams.
• 5:00
  And that was great because, you know, as a sterile processing leader, we often hear the complaints of the operating room.
• 5:07
  But once I was able to lead those clinical staff, I was able to understand how five minutes of a wait affects their entire process in the operating room, or how delays from a sterile processing perspective can back the schedule up and the surgeons then have to operate with a whole new team because their first shift team leaves.
• 5:27
  And so all of that just kind of helped to enable my thought process and also continue to feed, even though I wasn't in sterile processing anymore, just the importance of sterile processing and a fluid efficient process in sterile processing will then translate to the same in the operating room.
• 5:48
  Um I held that position for a few years and then I was actually recruited to another Central Ohio health system who is quite large.
• 5:58
  Um there I was accountable for 49 ORs and four major hospitals under one roof, if you will, and uh then acquired um a community hospital and several same-day surgery hospitals.
• 6:14
  And while uh I had my tenure uh there, I was able to work with the St.
• 6:21
  Ange team and we um developed um an off-site reprocessing center.
• 6:28
  And um that was really kind of taking all of my experience and putting it into something new and innovative, and um that was a really great experience being able to uh see that process from start to finish.
• 6:45
  So um then I left that organization and thought, you know, what am I going to do with all of this experience that I've gathered?
• 6:54
  And I threw uh threw my hat in the ring for um some consulting and I started my own uh consulting firm.
• 7:03
  Um and you know, I've had the good fortune of working with several large um IDNs uh across the country over the last uh year and a half, um, projects ranging from process improvement with uh high-level disinfection, um, team building, uh leadership mentoring, um, leadership development, change management.
• 7:29
  Um, had some opportunity in the last year and a half out on my own to be able to contribute to equipment planning and some uh standard operating procedure writing for a very large IDN looking at building an off-site reprocessing center.
• 7:46
  And then I most recently finished up again with the good fortune of being partnered with St.
• 7:52
  Ange to work for um another very prestigious IDN that's mostly here in uh Ohio, doing audits on process improvements, um, taking a look at opportunities to standardize.
• 8:08
  Um, and that was that was a very large project.
• 8:12
  We had a tight timeline and you know, continue to just be able to uh use the skills that I have in partnership with um other sterile processing professionals as well as engineers.
• 8:26
  So I've had a great um last year and a half, um, and I feel like it really has just helped me take all of my experience.
• 8:35
  And um, what I enjoy the most about what I do now is when I go into a new place and there's perhaps a director that's um struggling, or uh a director that feels like they're at the end of their rope, they've tried everything.
• 8:50
  It's uh really gratifying to be able to say, you know, I've been in your seat and I've I've sat in your chair and I know how you're feeling.
• 8:58
  And and to be able to contribute to their success has been something that I've really enjoyed over the last last year and a half.
• 9:06
  So that's where I am now.
• 9:08
  Great.
• 9:08
  Well, you have a you have a unique um collection of experiences.
• 9:14
  Starting out, the HR experience really comes into play here because oh, you're looking at you have uh perioperative experience, you have uh central sterile processing experience, and you have the people experience.
• 9:26
  So you know, for example, that uh folks in CS are usually among the lowest paid, lowest appreciated, least appreciated folks in the hospital.
• 9:35
  Uh and when you when you see that, there's another thing that you understand that many people don't, and that is that the dependencies.
• 9:43
  The OR can't do surgery unless CS does its job.
• 9:48
  CS can't do its job unless the supply chain fill uh fulfills their needs to give CS the equipment and supplies they need to do their job.
• 9:58
  There's there are these there are these relationships, and yet my experience, and as I said the other day, my friend Ed Hitcock said there are many supply chains in healthcare, not just one.
• 10:10
  There's a there's a um supply supply chain, there's a pharmacy supply chain, there's a food service supply chain, there's an environmental service supply chain.
• 10:20
  Every uh department or every function likes to be standalone and take care of its own problems.
• 10:27
  And my observation, I'll take this off your shoulders, my observation over the years is that OR is always fighting with CS, OR is always fighting with the regular supply chain.
• 10:38
  What what what do you see as um the the uh most frequent disconnect among these three uh organizations, OR, CS, and the regular supply chain?
• 10:51
  And uh and how do you go about uh working to improve those?
• 10:56
  I can 100% agree with you, and I do feel like my experience has given me the opportunity to see different veins of the this supply chain, um, you know, when they're and when they're highly functioning uh and the communication is high functioning, um, and then I've had the opportunity to see where where there's lacking, and again to your point, where there's the finger pointing and everyone wants to pass the book, um, which is human nature.
• 11:26
  And I think that my time in the operating room uh gave me the opportunity, as I mentioned earlier, to see how important all of the supporting departments for the operating room truly are.
• 11:39
  And I was able to also see the pressure that the OR was under to make things happen and to make them happen on time.
• 11:48
  To answer your question simply, Fred, I believe that a lack of understanding of what our independent roles actually are accountable for, and some of the barriers that within those independent entities, sterile processing, operating room, supply chain, some of the barriers that exist within our own personal sets of accountability are often not articulated out.
• 12:15
  So, what I mean by that is what I've seen in organizations is a lack of partnership in those three major entities.
• 12:23
  So the operating room, the sterile processing department, and supply chain.
• 12:26
  And I believe that that happens from the top down.
• 12:29
  So if you have collaboration among the leaders with operating room, sterile processing, and supply chain, as leaders, we are accountable to push that down.
• 12:39
  And there, we are accountable then to stop the blaming, stop the finger pointing.
• 12:45
  And how that happens is frequent meetings, frequent touch bases, um, open lines of communication, um, being able to have a mechanism to proactively let the departments that enable our success know, hey, we've had a ton of call-offs in the last 24 hours.
• 13:06
  We're going to have your first cases ready for you.
• 13:08
  OR manager will keep in close contact with you throughout the day to let you know what it's looking like for us.
• 13:15
  Um, and then having an operating room leader that understands and respects that and says, what can we do to help you?
• 13:22
  Um we get we get that you're having some issues today.
• 13:25
  The same thing that uh, and that's on the that's on the frontline level.
• 13:30
  Um the same thing can happen, um, and I've seen it function very uh well, supply chain um having a uh adequate mechanism to inform when we have backstocks, when something's been replaced, when locations have been moved.
• 13:45
  Um and again, I believe that all of that comes from the top-down.
• 13:50
  So organizations must task their leaders with um open lines of communication, support, um, and you know, when and where a toxic environment exists.
• 14:04
  Um, sadly, um everyone from the top-down feels that, uh, feels that uh toxic environment, and that just contributes to the lack of accountability and the blame game.
• 14:18
  Um, so I believe that the largest disconnect is communication as well as education about what uh what the enabling departments are accountable for and an openness and a willingness to uh support one another in times when we're over tasked, we're stressed, we have you know a lack of resources from a people perspective.
• 14:43
  I think that you know we can't be afraid to just reach out and say, hey, I need some help.
• 14:49
  Yeah, you know, it's uh I'm listening to that and I'm thinking of the uh OR environment, if you will.
• 14:56
  And I'm probably showing my age when I talk about this, but when when I first came into supply chain, you know, the OR nurse was sort of at the at on the tip of the spear, if you will.
• 15:08
  Uh the the OR produces uh a significant amount of revenue.
• 15:13
  Many of the highest and best reimbursed um procedures are done in the OR.
• 15:19
  So they got to get them done.
• 15:20
  Uh that OR director is working with people who have egos that don't fit in most buildings and who historically, uh up until recent years, have always had the leverage to get what they want when I when they want it, not get what they need when they need it, which is an entirely different thing.
• 15:38
  Uh so it becomes really important to build relationships and to educate the clinicians and the doctors.
• 15:46
  How have you gone about doing that?
• 15:49
  Um, you know, I've had the good fortune in the organizations that I worked for that, you know, the sterile processing manager, sterile processing director, um, you know, is the first line of defense really for the team.
• 16:04
  So I've had the good fortune that in in both of the organizations I spent my entire tenure, um, surgeons were very vocal when they had an issue.
• 16:16
  Um, you know, in one experience, I had uh vocal surgeons who would, to your point, go to the OR manager, OR director, and the OR director would come to me, give me the opportunity to fix it.
• 16:30
  And there was that open line of communication.
• 16:33
  And so the surgeons we partnered together.
• 16:37
  Um, and that didn't start off in the very beginning.
• 16:40
  I think you have to learn earn that.
• 16:42
  Um, you have to earn their trust.
• 16:44
  And I think by in so doing, um you are then able to have have their trust that you're handling an issue.
• 16:54
  Um, what is very important to make sure that that cohesive relationship and um that trust factor is is created in a in a very authentic way is that the operating room leaders have to support the sterile processing leaders.
• 17:10
  Um otherwise the surgeons, to your point, um, you know, it takes a huge ego to take somebody into an into a room and essentially have them, you know, dead on the table, really, to fix their problem, patch them up, sew them back up.
• 17:29
  That that takes a a huge amount of confidence and ego.
• 17:33
  So um, you know, it kind of goes with the territory.
• 17:37
  Um however, I believe that they're still human beings and they still need to understand the why behind something.
• 17:46
  If I don't have the support of an operating room leader, when I go to a surgeon and try to explain the why in my department, he feels that I'm just not taking accountability.
• 17:57
  Um, because it hasn't been uh there's not a cohesive relationship between the sterile processing leader and the OR.
• 18:05
  When there's a there's a cohesive relationship and the trust is there, when that surgeon goes and he is complaining again to the OR leader, I get the call, hey, Dr.
• 18:18
  So-and-so is upset about such and such.
• 18:20
  We backed him off, but hopefully you can look into this and let me know what's going on.
• 18:25
  End of story.
• 18:26
  And so um I think that you know, that in and of itself is a huge challenge.
• 18:34
  Uh, and when I'm out in, you know, across the country working with sterile processing leaders, one of the first questions I ask them is what is the what's your support like from the OR?
• 18:44
  Because without that support, we've got a lot of work to do in sterile processing and as a sterile processing leader.
• 18:52
  But when when a leader is able to tell me that they do have tremendous support, then you know, half the battle is won then, um, because then it becomes process improvement team building within our own entity.
• 19:05
  But when we have to work on correcting that relationship with the operating room, that takes a lot of time, it takes a lot of um, you know, uh accountability, it takes a lot of education.
• 19:18
  So um, you know, I think the sheer nature of what I do and and that that question being a primary question shows you how important communication is and just trust and collaboration.
• 19:33
  Yeah, but that's that's the problem that's got to be solved, that's for sure.
• 19:38
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• 20:05
  So when you worked with St.
• 20:07
  Ange on a couple of uh a couple of really large projects, one was the development of an off-site processing center, and the other one was uh an audit of uh a very prestigious uh systems sterile processing function.
• 20:20
  When you work on, when you walked into these places, places who if we mentioned their name, we go, oh my god, that's really something.
• 20:28
  Uh what did you discover in there that surprised you?
• 20:32
  And what stuff uh did you discover that didn't surprise you?
• 20:37
  Um, I think that uh what surprised me was um the that these prestigious organizations are still working under a very archaic assumption that sterile processing is uh simply washing items, right?
• 20:54
  And that there that it is a you know Toyota lean Six Sigma, you know, um if we implement lean processes, then we should we should be perfect.
• 21:08
  Um, and I believe that in in one scenario, that was um the belief of of one of the health systems.
• 21:16
  And what happened in that scenario was um, you know, making a car with the Toyota Six Sigma um prescription is much different than getting a tray down from the operating room with 100 parts and pieces and having to sip through that.
• 21:33
  There's no there's no assembly line because there's no taking into account that the peripheral processes that enable sterile processing success have not been addressed prior to implementing such a system that you know is believed to be assembly and foolproof.
• 21:53
  And, you know, if we just do it the way it's prescribed, then you know, we we should be able to to uh Be deemed successful.
• 22:02
  And I was surprised that one of those organizations still felt that that was the answer to the issue without looking at the peripheral processes.
• 22:14
  Where was point-of-use cleaning happening in the OR?
• 22:17
  Was the OR sending trays back complete to sterile processing?
• 22:22
  That was not a consideration.
• 22:24
  And so sterile processing was set up to fail in that scenario because we had not made sure that our customers were held accountable to do what they needed to do.
• 22:37
  And the other idea, and I was surprised to see that compensation rates are still so low.
• 22:45
  The infrastructure of the department is lacking in the areas of education, onboarding, educational programs, adequate numbers of FTEs being assigned to a singular leader.
• 23:00
  And that still many of the departments did not have the adequate resources to handle the daily volume.
• 23:09
  And when you drill down in and start to understand that, you know, across the country, across the country, many organizations use a metric of procedures performed in surgery, that will dictate how many FTE we need to process instrumentation in sterile processing.
• 23:30
  And what I have struggled with for years to try to help administrators understand is volume does not equal volume.
• 23:39
  So if I have 30 GI cases or general GU cases, and I have 30 ortho cases, there is a vast difference in the amount of parts and pieces that sterile processing is going to be accountable for.
• 23:58
  And so it just surprises me, I think, that across the country we see that while surgery has advanced and become very technical and very complex, and instrumentation has also become very complex and very innovative.
• 24:18
  We have not taken a look at the educational component for our serile processing techs.
• 24:24
  We have not taken into consideration how much they're actually making.
• 24:29
  These people are under a tremendous amount of pressure, tremendous.
• 24:35
  And they're still making an entry-level wage that's not much higher than the housekeeper in the hospital environment.
• 24:44
  So I think those are the things that surprise me.
• 24:48
  I believe that, you know, working with these two very prestigious organizations, that I would see, oh, you know, they they got it.
• 24:56
  They understand that, you know, in order to have a successful operation, we have to appreciate and retain and incentivize our stereo processing team.
• 25:07
  And that just was not the case.
• 25:09
  So I think in a nutshell, that was my experience.
• 25:13
  Yeah, and you know, the other day in our conversation, uh, when you're talking about the um the low level of pay uh and the low level of appreciation for the difficulty of the task in stereo processing, uh, you mentioned the fact that uh folks are going outside for other jobs, one of which was you can make$19 an hour at the car wash, and you're lucky to make$15 an hour at the cart wash, which is only one, which is only one letter difference when you look at it.
• 25:42
  But the difference is if you screw up at the car wash, you may put a scrape on the side of a car.
• 25:47
  If you screw up in the cart wash, you can kill people.
• 25:50
  And and it's it's it's that simple.
• 25:52
  So that sort of transitions to two things.
• 25:57
  Um, and the sort of last part of this conversation.
• 26:00
  Number one is where do you see robotics coming into sterile processing to assist the people there?
• 26:07
  Do you see that uh something that's happening?
• 26:10
  Um, you know, I do a lot of reading.
• 26:12
  I I uh try to stay up on the latest technologies and so on.
• 26:16
  And you know, in my experience, I uh I think I shared with you the other day, I have never managed a small operation or directed a small operation.
• 26:28
  Um I believe that uh the vast um variation in tray size and weight and movement of um our own human resources, people actually doing the job.
• 26:44
  Um I have seen where, especially in decontamination, uh, where there's lots of twisting and turning to get things in the sink, out of the sink.
• 26:54
  Um, some of that automation using robotics, um, you know, there's there's opportunity to move trays using robots, there's automation uh for trays entering into the washer and coming out of the washer.
• 27:09
  Um, I think those types of ergonomic um uh robotic assistance is going to really take off over the next few years, you know, as an operational leader with a lot of years uh under my belt, seen so many um injuries or so many ongoing um, you know, individuals that can't work in a certain place because they've hurt their back too many times, so on and so forth.
• 27:35
  So I do believe that that component is taking off, and I think larger facilities are going to start using that because ultimately it saves saves the human resources from injury and harm.
• 27:50
  Um, from an AI perspective, and you know, I don't know if if that's kind of what we're thinking as well, being able to dump an entire tray out on a pad of uh technology, if you will, and it's able to sort of spit out what's if if all the contents of the tray are there, that's all well and good.
• 28:08
  However, um, you know, I don't know if the technology is advanced to this degree, but there'll in my mind never uh be in my lifetime a replacement for um actual human uh expertise to take a look at these instruments to see if the efficacy of the instrument is adequate, if the cleanliness is adequate.
• 28:33
  Um, I think that we will always rely on people to do that job.
• 28:38
  Um, and um, but I do think that technology and robotics are are have grown leaps and bounds.
• 28:45
  And so I I make that statement loosely and could very likely be proven wrong in my lifetime that there would be um, you know, a robot that could do anything that a human can do.
• 28:58
  It's you know, at this point in in our history, um we're seeing so many advances, um, but right now I I believe strongly that the human element of uh sterile processing is very important from an inspection perspective.
• 29:15
  So would it be fair to say that um the shortest list in the world might be uh healthcare systems that have sterile processing in which the sterile processing operational process couldn't be improved?
• 29:28
  And would it also be fair to say that if you're considering doing anything, uh you start with an assessment and get a real good look at what the options are, what the opportunities are, where your organization's going with a strategic plan and tie all that together?
• 29:44
  Would that be fair to say?
• 29:45
  Absolutely.
• 29:46
  And I think that there are technologies that could um, you know, for the benefit and the bottom line of an organization, if they're going to invest, you know, several hundred thousand dollars in robotics in a sterile processing department, would that yield any savings as far as human resources?
• 30:05
  I believe that that is certainly something that from a strategic plan would come into play.
• 30:13
  I do believe that exactly what you said, research and um, you know, doing some, you know, true evidence-based research, who's using this, how's it working for them, what's the repair rates look like, you know, all of that because we know that when we rely on, even when we rely on our electricity and we're hit with a thunderstorm, we got to figure it out.
• 30:34
  Well, when you're running an operation that's feeding 49, 52, 32 operating rooms, and you have a piece of equipment, go out in sterile processing, it's not as easy as just running to find a candle, you know.
• 30:46
  So I think that all of that has to be taken into consideration when we go with new technologies and new um uh advances in technology.
• 30:57
  I think we really need to take a look at what's that downtime look like and how are we going to compensate for that if we cut our human resources?
• 31:05
  Where does our compensation then come from?
• 31:08
  Right.
• 31:08
  Well, that sort of brings me to the last sort of formal question here is uh the pandemic really was uh really cut a path through healthcare um human resources.
• 31:22
  Uh the traveling nurses had uh uh saved a day in many places, quite honestly.
• 31:28
  Uh depending on where the pandemic went, they sort of followed that.
• 31:32
  Uh how is tra how is how are travelers uh shown up in sterile processing and and uh is that a thing that needs to be dealt with?
• 31:42
  Could you talk about that?
• 31:43
  I sure can.
• 31:44
  So um, you know, I believe that the the travelers, um the amount of travelers that we saw across the country during uh after the pandemic and and the years that have followed have have largely increased uh for sterile processing techs.
• 32:00
  And that is uh really um in part due to, and I think in large part due to the compensation.
• 32:08
  Um you know, they can go and they can do this job and they can feed their families, they can make enough money to pay down debt, they may make enough money to put their kids through college, um, they can, in some very sad situations, get off government assistance when they go and do uh traveling jobs.
• 32:27
  Um so I really believe that this is very cyclical.
• 32:31
  Uh did the pandemic highlight it?
• 32:34
  Very much so.
• 32:35
  Um, however, I believe that the the biggest problem with retaining uh retention and recruitment is how much these people are being paid.
• 32:46
  They're being asked to be certified or to become certified.
• 32:49
  And again, they're just making a few dollars more than the guy that's sweeping the floor in housekeeping.
• 32:55
  So when they're asked to, would they join in with a travel agency?
• 32:59
  The travel agency is sending them to places where they're they're very needed and um they can go there and they can make money.
• 33:08
  And you know, my hope is that they feel appreciated when they're there so they feel appreciated and they continue to extend their contracts.
• 33:15
  I believe that this problem, the root of the problem, is that administrators within healthcare have never caught up with if surgery is going to be the revenue generating engine of your health system, then what are you doing for the people that are feeding that revenue generating engine of the hospital?
• 33:39
  The surgeon can come to work and he can have 10 cases lined up for that day that's going to yield the hospital hundreds of thousands of dollars.
• 33:47
  But if he doesn't have his basic tools in working order and in and sterile and ready for those patients, he's not making anybody any money.
• 33:57
  And the and the OR staff, they're not educated to do uh the work of a sterile processing tech.
• 34:04
  So I believe that the disconnect between the people that are actually providing the tools for the clinical team to do their job to then feed the revenue generating engine of the health system so that the administrators can make their bottom line.
• 34:18
  I think where they are lacking is that fundamental first step of making sure that your sterile processing techs are adequately paid, they're appreciated, there's a retention program in place for them, there's an education program in place for them, and so many facilities just see it as just do more.
• 34:39
  Um, you have a manager in the department, so the manager can take an assignment today, um, this the supervisor can take an assignment today.
• 34:48
  Um, I believe wholeheartedly that sterile processing is the place where many administrators look at where are we going to cut some expense so that we can then get more scrub techs to scrub these additional cases that we're gonna put on.
• 35:07
  We can get more nurses to scrub and to circulate.
• 35:11
  They're taking from the wrong place because what happens, as you well know, with a history in sterile processing, we get behind in sterile processing and who ultimately suffers?
• 35:24
  Ultimately, our patients suffer, but the the metrics in the operating room start to crash the minute we don't have adequate resources in sterile processing.
• 35:33
  So I believe that organizations that spend hundreds of thousands of dollars on travelers, it amazes me if they would look inward and they would take a look and dive deeper into why do we have 30% travelers in our organization?
• 35:49
  Why can't we retain people?
• 35:51
  You know, if you have adequate leadership in place, the question doesn't, the blame doesn't fall on the leader.
• 35:58
  It it falls on the leader can only do what they are equipped to do, what the organization has given them the resources to be successful.
• 36:07
  Um, if you are not given the uh really the respect by the organization as as their sterile processing leader, when you go to your administration and you say, I see what you're telling me on paper, but that's not the scenario, I think that's where they're shooting themselves in the foot.
• 36:28
  And I think that's what why the traveler, um the traveling population has exploded.
• 36:34
  Um, they they're not paid enough, they don't feel appreciated, and um it's a never-ending cycle in some organizations.
• 36:42
  And sadly, I've seen that.
• 36:44
  Yeah, well, just to sum up, because once again, we get back to this whole idea of an assessment.
• 36:50
  It you know, most of my experience in healthcare, and probably most of yours, has been um people that um our our cases are made uh narratively without data.
• 37:04
  Uh I need more people in CFs, we have some about, you know, and and you try to tell a doctor, hey, you don't understand there's a difference between this case and this case is what it requires.
• 37:14
  Uh and unless you have someone in to help you gather the data and build the case, all you appear to be doing to the people in the C-suite is making excuses and and and whining.
• 37:27
  Uh and what your recommendation to that I've gotten out of what we've just been talking about is number one, for the organization to respect the function.
• 37:36
  Uh, number two, to provide enough resources to do the job.
• 37:42
  And number three, to pay those resources enough so that they won't have to become travelers to make money to live their life normally.
• 37:48
  Is that was that fair to say?
• 37:50
  Very fair to say.
• 37:51
  And you know, I understand that um, you know, from an administrative C-suite perspective, they they feel that they should not uh be in the weeds, that you know, sterile processing um leaders should be able to tell the story and to your point, um, you know, have data to back that up.
• 38:10
  In my experience, that's 100% true.
• 38:14
  Data is wonderful to tell the story.
• 38:16
  It tells part of the story.
• 38:18
  It doesn't tell the part of the story that point-of-use cleaning is lacking in our operating room, which which requires additional resources in um SPD.
• 38:29
  Your preference cards are wrong.
• 38:31
  So 80% of 30% of what we sent you, you sent it right back to us.
• 38:36
  And that that took 30% of our resources to develop um those trays and create that case card.
• 38:45
  Um, and then it was just basically um, you know, for all for naught, wasn't needed.
• 38:50
  And so I I believe that the more we can advocate for change and assessments and engage our administrative C-suite people to understand that while some organizations probably, you know, it would be naive to say there aren't leaders that would just um, you know, pass the buck or blame their team or so on, there are leaders.
• 39:16
  If if somebody has achieved a level of director of sterile processing, they care about what they're doing and they know what they're doing.
• 39:23
  And I believe that they need to have the respect of the C-suite to sit down and listen.
• 39:28
  The minute the problems present and they're what outside of the realm of that director's control or that manager's control, the C-suite needs to humble themselves and sit and listen and not just make those um assessments from their data or historical benchmarking, you know, all the buzz, all the buzzwords that we hear in our industry.
• 39:51
  Well, Jim, thank you for coming back for the second time.
• 39:55
  I just want to, before we go, I did a um I did a big on-site uh project at an organization in the South and uh must have been around 2000, 2002.
• 40:08
  They were returning 45% of the stuff that was sent up to surgery uh back unused.
• 40:15
  And that was the stuff that came back.
• 40:16
  Remember the we what you haven't talked about is the stuff that got thrown away because it got opened and had to be thrown away, couldn't be used again.
• 40:23
  But 45% was coming back.
• 40:25
  And I was I was talking to those people about three years ago, and they said that they've worked really hard to implement the stuff that we talked about, and they've got it down to 42% now.
• 40:35
  So they've really made a vast improvement.
• 40:37
  So that's still the problems are still there.
• 40:40
  But Kim, thanks so much for shining the light on sterile processing.
• 40:44
  This has been a great conversation, and we hope to have you back again in the future.
• 40:48
  Thank you so much.
• 40:49
  I would be honored, Fred, and thank you.
• 40:51
  Um, have a great day, and uh, we'll talk soon.
• 40:57
  Well, that's all for today.
• 40:59
  Thanks so much for joining us.
• 41:00
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• 41:07
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• 41:12
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• 41:13
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• 41:19
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