(This article was written by guest contributor Bob Baker, owner of Back of House Logistics. He has nearly thirty years of experience providing consulting and project planning services, focusing on multi-discipline construction projects in healthcare, corporate headquarters/campuses, higher education, mixed-use retail properties and large venues. Bob is also certified in Lean/DFSS Green Belt.)
Occasionally, sterile processing professionals are invited to collaborate with an architectural design team on a new construction project, or a major renovation. This scenario is notable primarily because SPD’s only have this type of opportunity every fifteen to twenty years. It presents a chance to rethink the SPD environment, workflows, equipment types and locations, and even long-held acceptance of processes.
Important Factors to Consider
Renovations as compared to new construction are usually constrained by existing conditions, construction phasing, and often need to continue operations in some respect. New construction offers a “clean slate” opportunity, but space is a constraint given very high construction costs. Space constraints are a given in new construction because the project was financially justified based on calculations related to revenue and construction cost per square foot. Build too much, and the project no longer works financially. The key is to right size spaces within departments, which means flexing some areas and retracting others.
The concept of off-site sterile processing is likely to arise, especially for larger health systems. That topic warrants a dedicated posting so we won’t dive deep here. Suffice to say, if off-site capabilities exist or are under consideration, the impact on SPD space requirements and operations will be considerable. Note that off-site doesn’t necessarily mean a dedicated facility. It might mean a larger, hospital-based SPD supporting the processing needs of smaller locations.
Stakeholder Participation
SPD stakeholders play an important role in the architectural design process. Stakeholders, often with the aid of a planning consultant, represent the requirements of the department. Their experience with existing operations and preferences provides a valuable baseline for the new department. It is important that stakeholder’s distance themselves from preconceived ideas of how things must be. Engrained processes might be based on workarounds that have become accepted over time. Objectivity is critical as well as avoiding the temptation to customize or personalize the department in a manner that limits flexibility over time.
The following items include tasks that are likely to be part of the collaborative design process.
User meetings
o Typically held once every four-to-six weeks over the course of roughly a year.
o It is important to participate in all meetings, if possible. Catching up is a challenge as things can change quickly.
Conduct a tour of the existing department
o Discuss aspects of operations
o Review equipment preferences
o Review loaner/vendor workflows
o What works well /what doesn’t?
Provide information
o Provide instrument processing data or confirm instrument tray volume estimates.
o Types of cases
§ Heavy ortho or neuro case load?
§ Robotics?
§ Is ophthalmology included?
o Average tray volume per type of case.
o Percentage of trays in rigid containers.
o Number of trays on hand.
o Number of existing staff and male/female ratio
o Scope processing volumes.
Review equipment layouts and equipment details as the design process progresses.
o How does it compare to SPD’s you’ve worked in?
o Does proper separation and workflow exist?
o Have spare racks and accessories been accounted for?
o Verify instrument air locations.
Finishing Strong
SPD stakeholders should remain engaged throughout the design process, even after a design has been agreed on. Why? Because things change. Mechanical or other spaces may need to expand and encroach on space that had been previously shown as SPD. Equipment shifts as the consultant and architects work out details specific to the building.
Accepting that change is inevitable and reviewing layouts with an objective yet critical eye is key to ensuring a solid final design. Team members including infection prevention and endoscope processing stakeholders should weigh in. Conduct web-based design reviews with the design team present to answer questions and provide rationale.
Remember, this process is an opportunity to collaborate internally and externally. Be open to new ideas and take this opportunity to educate yourself on SPD advances made since your last major change. It’s an exciting process that benefits significantly from your input!
For more SPD design questions, you can connect with Bob Baker directly on Linkedin.