February 25, 2016

Look in the Basement to Reduce Infections

For the past 21/2 years as a hospital operations and quality and safety consultant, conducting a tour of our clients’ central sterile supply department (CSSD) has become a routine part of my job. I’ve seen remarkably high-quality and efficient operations that are clearly best practice. On the other end of the spectrum, I’ve seen some departments that were, quite honestly, frightening.

Before my consulting days, during my 12 years of practice as a busy vascular surgeon, I regret to admit that I hardly ever paid a visit to my hospital’s CSSD. The rare exceptions were a few middle-of-the-night sojourns to find some obscure (and in my view at the time, essential) device that no one seemed to be able to locate, or to complain about an inoperable or soiled instrument.

I’m even more chagrined that in my subsequent 17 years as chief physician executive, while I did pay a number of visits to the departments, it was not nearly often enough to truly understand the systems and potential threats to patient safety that reside there.

The challenges of cleaning and maintaining endoscopic devices that has gotten recent media attention is an excellent reminder of how important it is for end users (surgeons and other proceduralists) to become familiar with how the tools of their trade are maintained, cleaned and cared for. If you are performing invasive procedures, you should take the time to make a trip to your CSSD. You’ll probably find it in the basement (for some unknown reason, many of these departments are located there).

Make an appointment with the department director and ask for a tour. Talk with him or her about the challenges they face and the importance of their work to yours. Trust me, your presence and interest will be noticed and appreciated by the staff who works there. And along the way, you just might learn something.