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Making & Taking the Initiative: How to Get the Most out of Your CS/SPD Process Improvement Project

Updated: Oct 22, 2023

If a tree falls in a forest, but there's no one around to hear it -- does it still make a sound?
If a CS leader completes a process improvement project, but no one notices -- does it still matter?

I'll let the philosophers answer the fist question, but let's tackle the second one here. Yes, if no one notices your new department process improvement, it still matters -- either to your team, your bottom line, or your facility's patients.

But the bigger question is this: How can you get the biggest bang for your process improvement buck? If you're going to spend all the time, blood, sweat, toil and tears on fixing a broken process at your facility, how can you ensure you get your team and work noticed and why is it important to do so? Here are a few answers to these questions, as well as a few secrets on how to market your marvels of CS/SPD success...

1) Winning the Name Game and Making it Stick

As I mentioned in the post on The Power of Words and the Wonder of Wit, how we say things sometimes matters just as much, if not more, than what we say. This is particularly true when we are talking about process improvement projects in the SPD space. Nothing gets the troops excited and holds the attention of a gathering surgical throng like a good "initiative." Training initiatives, leadership initiatives, cost-savings initiatives, communication initiatives -- whatever the angle, I think an initiative mindset is a great place to start.

Allow me to parse this idea out a little more for the unbelieving. One of Webster's definitions for initiative is "an act or strategy intended to resolve a difficulty or improve a situation; a fresh approach to something." Initiatives are new, they're fresh, they signal a parting of ways with the past, a stretching out to take hold of a new future. And that is why an aptly named initiative can:

  1. develop internal department excitement over a change

  2. provide a quick catch phrase for reminding staff of the new project

  3. provide a common talking point for external communication of the change to your customers

  4. promote branding for the project in your department publications

  5. prompt questions from outsiders about the particulars of your project

Just one quick example of this is an educational initiative we drove at our Jewish Hospital SPD last summer that we called "12 by June." Didn't rhyme, no alliteration; it was short, punchy, and easy to share. And it described our goal of obtaining 12 Triple-Certified technicians (CRCST, CIS, CHL) by June of 2015. The excitement was palpable, the signage was fun, the buzz in Surgical Services was over-flowing. And a few months later we ended up on the front page of Communique magazine in an article entitled, "Triple Crown Certification: How One CS Department is Winning the Race for Quality, Safety, and Professionalism." Now not every initiative you do is going to land your team on a national publication, but there's no reason why you shouldn't think, talk, and plan big when you work on internal improvement.

2) Inertia is Irritating, Momentum is Magic

I have never seen a CS department that had zero opportunity for improvement in either its processes, people, or end-product. If we're honest, we all have room to grow. But as wide-spread as the need for positive change is in the CS world, there is still an uphill battle waged anytime the word "change" is uttered aloud within our walls. The inertia of complacency is all around us and its force is strong. This is one of the reasons why it is so important, once you are able to successfully implement a process improvement in your department, to make the success a big deal. The momentum gained from a department "win" in something like dwindling IUS-rates can work like magic on the morale of your team and the culture of complacency which you are battling against.

But this momentum is only as strong as the force applied to it. What I mean by this is that CS leaders must be cognizant of the need to put on their marketing/cheerleader hat before, during, and after these process improvement projects happen to be bring the power of publicizing to bear on the positive things going on in your CS/SPD. It's one thing for your decontamination technicians to know that turnovers are going a lot quicker now that the new tag-notification system was put in place. It's quite another thing all together if the chief of surgery notices. And how, you may ask, will he notice? Well, you can wait and hope he catches wind of it -- or you can wave a flag, blow your horn, and put it on a PowerPoint slide on the big screen in the surgeon's lounge. Your team knowing is a momentum push, your customer knowing is a momentum pull -- and they will say, "Show me more."

3) Tell, Do, Tell, Repeat

We've talked mostly about the what and why so far, but let's end on the how of successfully marketing your process improvement initiative. Every project you do doesn't have to be a Lean Six Sigma extravaganza with epic charts and a gazillion data points. Something as simple as a "Clean Start" initiative that requires someone to clean out the department refrigerator every Monday morning so you don't experience an episode of ice-box-gone-wild is worth doing, and worth doing right. A helpful pattern to follow goes like this: Tell, Do, Tell, Repeat.


"A clean refrigerator says that we care about our team members and that we value cleanliness in general." Step one in the initiative roll-out process is to contextualize your project with concrete department values. Answer the question of how this improvement dovetails with the broader department mission and vision for growth. This is also the time to stir up excitement with good signage and lots of leadership chatter. Clean start! Clean Start! Clean start!


Although we've focused mostly on the marketing aspect of process improvement initiatives in this post, don't misunderstand. A project done poorly (no matter how well it was publicized and energized) will go no where and take your team backward instead of forward. Commit all your support to ensure the project succeeds first, then worry about the rest of this.


So after you close out the chapter on your newest initiative, then comes the critical part of telling your story of success to your team, your customers, and the watching world. Again, so much hinges on this step because it's where you gain momentum, leadership credibility, and impact the facility perspective of your department. Utilize newsletters, inter-department meetings, email blasts, media snippets, social media posts, etc., to ensure that everyone who would care to hear has the chance to do so.


You’ve told, you’ve done, you’ve conquered chaos and spread your exploits to the East and West of Surgical Services. Now the fun part. You get to, and must, do it all again. Imagine if Napoleon had stopped after his first successful battle, or if Cassius Clay had stopped boxing after his first KO. Champions do not become the greatest because of one win – they rise to the top because they continue to win and everyone notices. Your vision for department improvement should be the same. Tell, do, tell, then do it all again. That's what CS/SPD champions are made of...


Process improvement initiatives are not the only way to make good changes and see progress in your department -- but they can be a great tool for leaders who aren't quite sure how to get the inertia of complacency off to a rolling start. Done well, a project that is contextualized with department values, publicized to your customer base in the OR, and energized by a team who gets the meaning of the mission, can make a major impact on all areas of your CS/SPD.

Take the initiative to make the initiative and start getting the most out of your CS/SPD process improvement projects today...

What say you?

Hank Balch

Beyond Clean © 2021


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