Bob the (SPD) Builder: More of these Please, Letting it Sink In

(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.)

As most of you know, several major categories or banks of processing equipment are common in all sterile processing departments.

These include:

o   Manual Wash Sinks (manual process)

o   Washer/Disinfectors

• Cart Washer

o   Assembly Tables (manual process)

o   Sterilizers

• Steam

• Low Temp

All but one of these provide in-process instruments downstream to another bank of equipment. Since perfect balance is difficult to achieve, one or more of these banks may be the weak link – unable to keep up. Two of the listed banks indicate a manual process, which inherently has variation. Variation in time and quality.

The type of sterile processing equipment most often under-provided are the manual wash sinks

While not universally recognized, the type of sterile processing equipment most often under-provided are the manual wash sinks in decontamination. During tours I’ve seen ratios of manual wash sinks to washer-disinfectors that are as low as 1:1 or heaven forbid, in one case less than one sink per washer.

Years ago, when washer-disinfectors had lower tray capacities and longer cycle times, a low ratio may have been somewhat more appropriate. However, new models of washer-disinfectors process many more trays per hour, but only IF soiled instruments are pre-cleaned and ready to go when the cycle ends.  If fewer sinks, and/or staff exists than is needed to keep the washers “busy”, the temptation to rush the pre-cleaning process is great. This may explain why the reported number of trays prewashed per hour varies so significantly from site to site.

Decontamination spaces in general are rarely over-sized, so adding a manual wash sink is usually not possible. This is why properly allocating equipment is so important during the design process.  If you happen to be dealing with an “old-school” consultant, educate them on your needs. 

Without an increase in quantities, improving the throughput per wash sink is the only option. This means ensuring staff have everything possible to improve productivity, while meeting the manufacturer’s IFU. If warranted and within budget, replace old sinks. Height adjustability is a desirable option whose value will be most appreciated during the second half of each work shift. Add auto-dose detergent dispensers with water temperature sensors. Make sure your ultrasonics are up to par. Staff training, including tips and tricks to achieve proper results while improving productivity, is nearly always worth the effort. Shorting a manual process to keep pace with automated cycles is not an option.

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For more SPD design questions, you can connect with Bob Baker directly on Linkedin.