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The Dangerously Dirty Secret of Sterile Processing Contract/Traveling

This is not a hit piece. But I am going to say some hard things.

I have many close friends involved in the Sterile Processing temporary staffing industry, as both recruiters and "travelers" -- and I'd be the first to defend them as the epitome of professionalism, honesty, and high quality work ethic.

This article is not as much about individuals as it is about a slice of this industry that is out of control.

HR Failure: How We Got Here

Here's a quick generalization of where we are today. Sterile Processing departments across the country are struggling to recruit and retain high quality, experienced, and certified technicians. Much of this has to do with the pitiful compensations levels associated with the job grade (as low as $10/hour in some places). Hospital administrators and HR leaders are extremely reticent to go above the "market wage average" for these positions or provide any compensation incentives (such as sign-on bonuses or retention bonuses for certified technicians) -- resulting in high vacancy rates, high turnover percentages, decreases in total department experience, and near inability to recruit experienced certified SPD technicians.

The Emergent Solution: Travel Advisory

And this is where countless OR and SPD leaders across the country find themselves today, confronting unrelenting surgical volume with growing numbers of vacancies, turnovers, and dwindling years of experience in their Sterile Processing departments.

Many times their only options are to reach outside their permanent staffing pipelines (as nonexistent as they may be), and bring in temporary contract travelers to plug these holes in their day to day workflow.

Expectations vs. Reality

Now I'm going to say something most Sterile Processing leaders already know: there are far too many SPD travelers on the market today who do not meet expectations. These employees are marketed by their agencies as experienced, competent, and certified Sterile Processing professionals, when in reality many of them are none of the above. Facilities are paying a premium to bring these folks in for emergent staffing situations, only to find their expertise, productivity, and compliance are patently lacking. Too many facilities are willing to settle on somebody rather than nobody, when the only alternative is case delays and burnout.

Practically speaking, weeks can be spent by departments waiting for a new traveler to arrive, and when they do, it can take some time to realize they do not meet expected standards. By then, leaders are confronted with another challenge: terminate the contract (if possible) and wait additional weeks for another (hopefully) better candidate, or manage the mediocrity as best they can. Having been in those positions myself, with those kinds of choices, I understand the difficultly of that decision.

The Real and Present Danger

So what does all this mean? A flood of inexperienced (albeit freshly certified) SPD travelers coming into our facilities every week, processing instruments for our surgeries, and taking the safety of our patients into their hands?

Unfortunately it can mean real, tangible danger for our patients and measurable noncompliance regarding industry standards, best practice, and state/federal regulations. Again, I'm not saying every SPD traveler falls into this category. But too many do. Department leaders know it. Contract agencies either know it, or have no excuse for not knowing it. If a traveler is canned at one hospital, they are allowed to resubmit to another. If their agencies get tired of a traveler, there are other agencies who will gladly pick them up.

This leaves facilities and Sterile Processing leaders open to all types of risks when utilizing agency staffing, AND increases their burden to quickly validate the competency of these temporary personnel at the same level as their permanent employees. But don't take my word for it. Take a look the findings from a recent 2018 State Department of Health and Federal CMS survey at a hospital out west:

Of special note:

1) the contract stated the agency would supply certified technicians (which it did not uphold),

2) the contract employees were witnessed being noncompliant with IFUs and were unable to speak to the situation, and

3) the facility was cited for not completing full competencies on their travelers.

Where to Now?

So, what are facilities to do?

Short term: Develop clear procedures for how potential agency candidates will be interviewed, and the process under which their competencies will be validated once onsite. Department leaders and HR executives must collaborate on accountability measures for dealing with contract personnel who do not meet premium levels of minimum expertise and compliance.

Long term: The facility-level compensation issue for permanent SPD technicians must be addressed if departments have any hope of recruiting or retaining the best (and safest) talent on the market. It makes zero financial or economic sense to save $50K a year on salaries, if you are consistently spending $75K a year for premium contract staffing that carries with it all of the dangers mentioned in this article.

So then, what's it going to be?


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