0:05

Hello again everybody . This is Fred Crans from

0:07

St Onge . We're here today with another

0:09

episode of Taking the Supply Chain

0:11

Pulse . Today we

0:14

have a first . Today we have the first

0:16

time that I've ever had someone

0:18

on the podcast for the second time

0:20

, but there has to be an asterisk by

0:22

it , because you could not possibly

0:25

have heard the first recording

0:27

because I forgot to press the record

0:29

button . So today , two

0:31

days after our first attempt , kim

0:34

Jones , who is a nationally

0:36

recognized central sterile supply

0:38

expert , is going to be talking with us

0:40

about her experiences in

0:42

life and central sterile supply

0:44

, starting out in human resources and

0:46

all kinds of good things , and she's well

0:48

rehearsed because we did this for 30

0:51

minutes two days ago . Kim , thanks

0:53

for coming back and giving me a second chance

0:55

.

0:56

Well , thank you , fred , and thank

0:58

you for you setting me

1:00

up there . I better not make any mistakes , since

1:02

everybody knows that I already had one try

1:04

at this . So , we'll both

1:06

try to do our best , but I appreciate the

1:09

opportunity to join you today . Thank

1:11

you .

1:12

Yep , and if you're not making mistakes , you're not trying

1:14

. Okay , You've got to get out there and get in the fray

1:16

. So I'm glad to have had

1:18

that was a great conversation the other day and

1:20

I really learned a lot talking to

1:23

you about central sterile . So why don't you tell

1:25

us about yourself , your background , how you

1:27

got started and how

1:30

you've worked to where you are today ?

1:32

Sure Well , thank you . I

1:34

obviously started

1:37

my career not

1:39

in sterile processing but , as you mentioned

1:42

, I had the good fortune right

1:44

out of college to find a position

1:46

in human resources with

1:49

a very well-known organization

1:51

here in central Ohio . I

1:56

got that position as a

1:58

recruiter in HR and

2:00

my areas of accountability

2:03

were sterile processing in the operating room

2:05

. So I always say of

2:07

my 30-year career , the majority

2:09

of it has been spent in sterile

2:11

processing in

2:16

the operating room in or around those areas

2:18

. So you may ask

2:21

how that goal

2:23

or how that position in human resources

2:25

ended me up in sterile

2:27

processing . I

2:30

worked for a few years supporting the

2:32

operating room and sterile processing from an HR

2:34

recruitment perspective

2:37

, as well as some employee relations mixed

2:39

in there . I went out on

2:41

maternity leave to have my first baby

2:44

and when I came back there was

2:46

an SPD educator position that had

2:48

been writing my position roster

2:51

the entire time I was out . So I

2:53

met with the director , who I had a great relationship

2:56

with , and we walked through the department . I

2:58

was trying to get from her what exactly

3:00

she was looking for so that it would

3:02

help me to better recruit for

3:04

them , and by the end of that

3:06

visit you know I was pretty fascinated

3:09

by all of this reprocessing

3:11

that happened . I obviously knew part

3:14

of the job because I recruited for

3:16

it , but at the magnitude and

3:18

the volume that

3:20

facility was a 32-room OR

3:23

and so it was just an immense

3:25

operation . And so at the end

3:27

of that visit , at the end of that

3:29

conversation , the director

3:31

pitched the idea hey , why don't you

3:33

take this position ? People respond

3:36

well to you , you're teachable , we can

3:38

teach you the business . You

3:40

have the people skills . So that's how it kind

3:42

of started . So my first position

3:45

was an educator . That was back

3:47

in around 2005 , 2006

3:49

. There was a big push , lots

3:52

of lobbying going on to make

3:55

certification mandatory in

3:57

New York and New Jersey at that time , and

4:00

so we were leading the pack

4:03

in central Ohio . I

4:06

became certified , wrote an

4:08

education program and we were

4:10

able to get about 70% of the staff

4:12

certified at that time

4:15

and I really , really enjoyed

4:17

watching people respond

4:20

, as they were learning why

4:22

we do the things we do , not

4:24

just how we do the things that we do

4:26

in sterile processing . So I held

4:28

that position for several years

4:30

and then I really started to get interested

4:33

in operational leadership . So a manager

4:35

position in that very department became

4:37

available , so I threw my hat in the ring

4:39

and I was given that position . I

4:42

had a large number

4:44

of FTEs about

4:46

80 full-time FTEs

4:48

that reported up through me and I

4:50

held that position for

4:52

a few years three to five

4:55

years I believe and then I was actually invited

4:57

to join the OR

5:00

team as a non-clinical manager

5:02

in the operating room , and that was really a gift

5:05

to me being able to

5:07

see the full cycle of how the patients

5:09

come in and how the work that we

5:11

do in sterile processing can affect the

5:13

metrics that the operating room

5:16

uses to remain

5:18

efficient . And so

5:20

I was really able to see how

5:23

that ecosystem of perioperative

5:25

services includes sterile

5:27

processing and I ended

5:30

up having the non-clinical

5:32

team , at first anesthesia techs , or

5:34

techs you know anything non-clinical

5:37

in the operating room reported to

5:39

me . And then halfway through my tenure

5:41

there I was given

5:43

the clinical staff and then halfway through my

5:45

tenure there , I was given the clinical staff . I had off shift clinical teams

5:48

, afternoon , evenings and weekend

5:50

clinical teams , and

5:52

that was great because you know , as

5:54

a sterile processing leader , we often hear

5:57

the complaints of the operating

5:59

room . But

6:06

once I was able to lead those clinical staff I was able to understand how five

6:08

minutes of a wait affects their entire process in the operating room or how delays

6:10

from a sterile processing perspective can

6:12

back the schedule up and the surgeons

6:14

then have to operate with a whole new team

6:17

because their first shift team leaves . And

6:19

so all of that just kind of helped to

6:21

enable my thought process

6:24

and also continue to feed even

6:26

though I wasn't in sterile processing anymore

6:28

. Just the importance of sterile

6:30

processing and a fluid , efficient

6:33

process in sterile

6:35

processing will then translate to the

6:37

same in the operating room . I

6:40

held that position for a few years and

6:43

then I was actually recruited

6:45

to another central Ohio

6:47

health system who is quite

6:49

large . There I

6:51

was accountable for 49 ORs

6:54

and for major

6:56

hospitals under one roof

6:58

, if you will , and then

7:01

acquired a community hospital

7:03

and several same day surgery hospitals

7:06

. And while I

7:08

had my tenure there

7:10

I was able to work with the St

7:13

Ange team and we

7:15

developed an

7:17

offsite reprocessing center . And

7:20

that was really

7:22

kind of taking all of my experience

7:25

and putting it into

7:27

something new and innovative

7:29

, and that was a really

7:32

great experience being able to

7:34

see that process from start to

7:36

finish . So

7:45

then I left that organization and thought you know what

7:47

am I going to do with all of this experience that I've gathered ? And I threw

7:50

my hat in the ring for some consulting and I

7:52

started my own consulting firm

7:54

. And you know

7:56

I've had the good fortune of working with

7:58

several large IDNs

8:01

across the country over the

8:03

last year and a half

8:05

. Projects ranging from process

8:07

improvement with high-level

8:10

disinfection , team

8:13

building , leadership

8:15

, mentoring

8:17

, leadership development , change

8:20

management , had

8:23

some opportunity in the last

8:25

year and a half out on my own to

8:27

be able to contribute to equipment

8:29

planning and some standard

8:31

operating procedure writing for

8:33

a very large IDN looking at building

8:36

an off-site reprocessing center . And

8:38

then I most recently finished up again

8:41

with the good fortune of being

8:43

partnered with St Onge to work for

8:45

another very

8:47

prestigious IDN that's mostly

8:50

here in Ohio

8:53

doing audits on process

8:55

improvements , taking

8:57

a look at opportunities to standardize

9:00

, and that was a very

9:03

large project . We had a tight

9:05

timeline and

9:07

, you know , continued to just be able

9:10

to use the skills that I have

9:12

in partnership really has just

9:14

helped me take all of my experience . And what

9:28

I enjoy the most about what I do now is

9:31

when I go into a new place

9:33

and there's perhaps a director

9:35

that's struggling or

9:37

a director that feels

9:39

like they're at the end of their rope . They've tried everything

9:42

. It's really

9:44

gratifying to be able to say you

9:46

know , I've been in your seat and I've sat

9:48

in your chair and I know how you're feeling , and

9:51

to be able to contribute to their success

9:53

has been something that I've really enjoyed

9:56

over the last year and a half . So

9:58

that's where I am now .

10:00

Great . Well , you have a unique

10:03

collection of experiences

10:05

. Starting out , the HR

10:07

experience really comes into play

10:09

here , because paid lowest appreciated

10:12

, least appreciated folks in the hospital

10:26

. And when

10:29

you see that , there's another thing

10:31

that you understand that many people don't

10:33

, and that is that the dependencies

10:35

. The OR can't do surgery unless

10:38

CS does its job . Cs

10:40

can't do its job unless the

10:43

supply chain fulfills

10:45

their needs to get CS the equipment

10:48

and supplies they need to do their job . There

10:52

are these relationships and yet my

10:54

experience , and as I said

10:56

the other day , my friend Ed Hiscock

10:59

said there are many supply chains

11:01

in health care , not just one . There's

11:04

a supply

11:06

chain , there's a pharmacy supply chain , there's

11:08

a food service supply chain , there's an

11:10

environmental service supply chain . Every

11:13

department or every

11:15

function likes to be standalone

11:17

and take care of its own problems and my

11:20

observation I'll take this off your shoulders

11:22

my observation over the years is

11:24

that OR is always fighting with CS

11:27

, OR is always fighting with the

11:29

regular supply chain . What

11:31

do you see as the

11:35

most frequent disconnects among

11:38

these three organizations OR

11:40

, CS and the regular supply

11:42

chain and how do

11:44

you go about working to

11:46

improve those ?

11:48

I can 100% agree with you

11:50

and I do feel like my experience

11:53

has given me the opportunity

11:55

to see different veins

11:57

of this supply

12:00

chain , you know , when

12:03

they're highly functioning and

12:05

the communication is high functioning , and

12:08

then I've had the opportunity to see

12:10

where there's lacking . And again to your

12:12

point , where there's the finger pointing and

12:14

everyone wants to pass the buck

12:16

, which is human nature . And I think that

12:19

my time in the operating room

12:21

gave me the opportunity , as

12:23

I mentioned earlier , to see

12:25

how important all

12:27

of the supporting departments for the operating

12:30

room truly are , and I

12:32

was able to also see the pressure that

12:34

the OR was under to make things happen

12:37

and to make them

12:39

happen on time . To answer

12:41

your question simply , Fred , I believe

12:43

that a lack of understanding of

12:45

what our independent roles

12:48

actually are

12:50

accountable for and some of the barriers

12:52

that within those independent

12:54

entities sterile processing

12:56

, operating rooms , supply chain some

12:58

of the barriers that exist within

13:02

our own personal sets of accountability

13:04

, are often not articulated out

13:07

. So what I mean by that is what

13:10

I've seen in organizations is a lack

13:12

of partnership in those three major

13:14

entities so the operating room , the sterile

13:16

processing department and supply chain

13:18

and I believe that that happens from the top

13:20

down . So if you

13:23

have collaboration among the leaders

13:25

with operating rooms , sterile processing and

13:27

supply chain , as leaders

13:29

we are accountable to push that down . And

13:31

there we are accountable then to

13:34

stop the blaming , stop the finger

13:36

pointing . And how that happens is

13:38

frequent meetings , frequent

13:40

touch bases , open lines

13:42

of communication , being

13:45

able to have a mechanism to

13:48

proactively let

13:50

the departments that enable

13:52

our success know hey , we've

13:54

had a ton of call offs in

13:56

the last 24 hours . We're

13:58

going to have your first cases ready for you

14:00

. Our manager will

14:03

keep in close contact with you throughout the day

14:05

to let you know what it's looking like for us

14:07

. And then having an operating

14:09

room leader that understands and respects

14:11

that and says what can we do to help you

14:13

? We get that . You're having some

14:16

issues today . The same thing that

14:18

and that's on the frontline level . The same thing can happen . The

14:20

that's on the frontline level , the

14:23

same thing can happen and I've

14:25

seen it function very well

14:27

. Supply

14:34

chain , having a adequate mechanism to inform when we have back stocks

14:36

, when something's been replaced , when locations have been moved . And again

14:39

, I believe that all of that comes

14:41

from the top down . So organizations

14:44

must task their leaders with

14:47

open lines of communication

14:50

, support and

14:52

when and where a

14:54

toxic environment exists . Sadly

14:57

, everyone from

15:00

the top down feels

15:03

that toxic environment

15:05

and that just contributes to the lack

15:07

of accountability and

15:09

the blame game . So I

15:12

believe that the largest disconnect is

15:14

communication , as well as education

15:16

about what the

15:19

enabling departments are accountable

15:21

for , and an openness and

15:23

a willingness to support

15:27

one another in times when we're

15:29

overtasked , we're stressed , we have

15:31

, you know , a lack of resources

15:33

. From a people perspective , I

15:35

think that you know we can't be afraid

15:37

to just reach out and say , hey , I need some

15:40

help .

15:41

Yeah , you know I'm listening to that

15:44

and I'm thinking of the OR

15:46

environment , if you will , and

15:48

I'm probably showing my age when I talk about

15:51

this , but when I first came into

15:53

supply chain , you know , the OR

15:55

nurse was sort of at the tip

15:57

of the spear , if you will . The

16:01

OR produces a significant

16:04

amount of revenue . Many of the highest

16:06

and best reimbursed

16:08

procedures are done in the OR

16:10

, so they got to get them done . That

16:13

OR director is working with people who

16:15

have egos that don't fit in most buildings

16:17

and who historically

16:20

, up until recent years , have

16:22

always had the leverage to get

16:24

what they want when they want it , not

16:27

get what they need when they need it , which is an entirely

16:29

different thing . So it becomes

16:31

really important

16:33

to build relationships and

16:35

to educate the clinicians and

16:38

the doctors . How have you gone about doing that

16:40

?

16:41

You know I've had the good fortune in

16:44

the organizations that I worked

16:46

for that you know , the sterile

16:48

processing managers sterile processing

16:50

director , you know , is

16:53

the first line of defense really

16:55

for the team . So I've had the

16:57

good fortune that in

16:59

both of the organizations I spent

17:01

my entire tenure , surgeons

17:04

were very vocal when they

17:06

had an issue . You

17:08

know , in one experience I had

17:11

vocal surgeons

17:13

who would , to your point , go to the OR

17:15

manager , or director , and

17:18

the OR director would come to me give me the

17:20

opportunity to fix it , and

17:22

there was that open line of communication

17:25

and so the surgeons , we

17:28

partnered together and

17:30

that didn't start off in the very beginning

17:32

. I think you have to earn that , you

17:34

have to earn their trust and I

17:37

think by in so doing you

17:40

are then able to have their

17:43

trust that you're handling an

17:45

issue . What

17:47

is very important to make sure

17:49

that that cohesive relationship and

17:52

that trust factor is

17:54

created in a very authentic

17:56

way is that the operating

17:59

room leaders have to support the sterile processing

18:01

leaders , otherwise the

18:04

surgeons , to your point

18:06

, you know it takes a huge ego to take

18:08

somebody into a room

18:10

and essentially have them

18:12

, you know , dead

18:15

on the table really to

18:17

fix their problem , patch them

18:19

up , sew them back up . That

18:22

takes a huge amount of

18:24

confidence and ego . So that

18:28

that takes a huge amount of confidence and ego . So you know , it kind of

18:30

goes with the territory . However , I believe that they're still

18:33

human beings and they still need

18:35

to understand the why behind something

18:37

. If I don't have the support

18:39

of an operating room leader , when I

18:41

go to a surgeon and try to explain the why

18:44

in my department , he feels

18:46

that I'm just not taking accountability because

18:50

it hasn't been . There's

18:53

not a cohesive relationship between

18:55

the seroprocessing leader and

18:58

the OR

19:00

and the trust is there

19:02

. When that surgeon goes and

19:05

he is complaining again to the OR

19:07

leader , I

19:14

get the call hey , dr So-and-so is upset about such and such . We backed

19:16

him off , but hopefully you can look into this and let me know what's going

19:18

on . End of story . And so I

19:21

think that you know that

19:23

in and of itself is a huge

19:25

challenge . And when I'm out

19:27

in , you know , across the country , working

19:29

with sterile processing leaders , one

19:31

of the first questions I ask them is what

19:33

is the , what's your support like from the OR

19:35

? Because without that support

19:38

we've got a lot of work to do in sterile processing

19:40

and as a sterile

19:42

processing leader . But when , when

19:45

a leader is able to tell me that they do

19:47

have tremendous support , then

19:49

you know half the battle is won

19:51

then , because then it becomes

19:53

process improvement , team building within

19:55

our own entity . That takes a lot of time

19:58

, it takes a lot of , you know , accountability , it

20:25

takes a lot of education .

20:26

So you know , I think the sheer nature of what I do and that that question

20:28

being a primary question , shows you

20:30

how important communication is and and just trust and collaboration , yeah , but that's

20:33

that's the problem that's got to be solved , that's for sure . So , when you work

20:35

with St Onge on a couple of really large projects

20:37

one was the development of

20:39

an off-site processing center and the other one was an audit of a very prestigious

20:42

systems sterile processing

20:44

function when you work on , when

20:46

you walked into these places , places who

20:49

we mentioned their name we go , oh

20:51

my God , that's really something . What

20:53

did you discover in there that surprised

20:56

you ? And what stuff did

20:58

you discover that didn't surprise you ?

21:02

I think that what surprised

21:04

me was that

21:08

these prestigious organizations are

21:10

still working under a very archaic

21:12

assumption that sterile

21:14

processing is simply washing

21:17

items

21:21

. You know Toyota Lean

21:23

, six Sigma . You know , if

21:26

we implement Lean

21:29

processes then we should be perfect

21:33

. And I believe that in

21:35

one scenario that was the

21:37

belief of one of the health systems

21:39

. And what happened in

21:42

that scenario was , you

21:44

know , making a car with the Toyota

21:46

Six Sigma prescription

21:48

is much different than

21:51

getting a tray down from

21:53

the operating room with 100 parts and pieces

21:55

and having to sift through that

21:58

. There's no assembly

22:00

line because there's no

22:02

taking into account that the peripheral

22:04

processes that enable sterile

22:07

processing success have not

22:09

been addressed prior to implementing

22:12

such a system . That

22:14

is believed to be assembly

22:16

and foolproof . And

22:19

if we just do it the way it's prescribed

22:21

, then we should be able

22:23

to be deemed

22:25

successful . And I

22:28

was surprised that one

22:30

of those organizations still felt

22:33

that that was the answer to the issue

22:35

, without looking at the

22:37

peripheral processes . Was point

22:39

of use cleaning happening in the OR

22:41

? Was the OR sending trays back

22:43

complete to sterile processing ? That

22:47

was not a consideration , and

22:49

so sterile processing was set

22:51

up to fail in that

22:53

scenario because we had

22:55

not made sure that our

22:58

customers were held accountable to

23:00

do what they needed to do . And

23:02

the other idea and I was

23:04

surprised to see that , you

23:06

know , compensation rates are still so

23:08

low . The infrastructure

23:10

of the department is lacking in

23:13

the areas of education

23:15

, onboarding , educational programs

23:17

, adequate

23:19

numbers of FTEs being

23:21

assigned to a singular leader

23:24

, and that

23:26

still many of the departments

23:29

did not have the adequate resources

23:31

to handle the daily volume . Use

23:33

a metric of procedures performed in surgery

23:36

. That will dictate how many FTE we need

23:38

to process instrumentation

23:52

and sterile processing . And

23:54

what I have struggled

23:57

with for years to try to help administrators

24:00

understand is volume does not equal

24:02

volume . So if have

24:05

30 GI

24:07

cases or general GU

24:10

cases and I have 30 ortho

24:13

cases , there is a vast

24:15

difference in the

24:17

amount of parts and pieces that

24:19

sterile processing is going to be accountable

24:22

for , and so it just

24:24

surprises me . I think , that across

24:26

the country we see that while

24:29

surgery has advanced

24:31

and become very technical

24:33

and very complex

24:35

, and instrumentation has

24:37

also become very complex

24:40

and very innovative

24:42

, we have not taken a look at

24:45

the educational component for

24:47

our serial processing techs . We have

24:49

not taken into consideration how

24:51

much they're actually making . These

24:54

people are under a tremendous amount

24:56

of pressure , tremendous

24:59

and they're still making

25:01

an entry level wage that's

25:03

not much higher than the housekeeper

25:05

in the hospital

25:08

environment . So

25:10

I think those are the things that surprised

25:12

me . I believe that you know , working

25:14

with these two very prestigious organizations

25:17

, that I would see oh , you know

25:19

they got it . They understand that

25:22

. You know , in order to have a successful

25:24

operation , we have to appreciate

25:27

and retain and incentivize

25:29

our sterile processing team , and

25:32

that just was not the case . So

25:34

I think , in a nutshell , that

25:36

was my experience .

25:38

Yeah , and you know , the other day in our conversation

25:41

, when you're talking about the

25:44

low level of pay and the low

25:46

level of appreciation for the difficulty

25:48

of the task in sterile processing

25:50

, you mentioned the fact that folks

25:53

are going outside for other jobs , one of which

25:55

was you can make $19

25:57

an hour at the car wash and you're lucky

25:59

to make $15 an hour at the cart wash , which

26:01

is only one letter difference when you look at it . But the difference is if you screw up at

26:03

the car wash , which is only one letter difference when

26:05

you look at it . But the difference is if

26:08

you screw up at the car wash , you may put

26:10

a scrape on the side of a car . If

26:12

you screw up in the cart wash , you can kill people

26:14

, and it's that

26:16

simple . So that

26:19

sort of transitions to two

26:21

things , sort

26:23

of last part of this conversation . Number

26:25

one is where do you see robotics

26:28

coming into sterile processing

26:30

to assist the people there ? Do you see that

26:32

something that's happening ?

26:35

You know I do a lot of reading , I

26:37

try to stay up on the latest

26:39

technologies and so on and you know

26:41

, in my experience I think

26:44

I shared with you the other day I

26:46

have never managed a

26:48

small operation or directed a small

26:50

operation . I

26:53

believe that you know the

26:57

vast variation

26:59

in tray size and weight

27:02

and movement of our

27:04

own human resources , people actually

27:07

doing the job . I

27:09

have seen where , especially

27:12

in decontamination , where

27:14

there's lots of twisting and turning to get

27:16

things in the sink out of the sink , get

27:23

things in the sink out of the sink Some of that automation using robotics . You

27:25

know there's opportunity to move trays using robots . There's automation

27:28

for trays entering into

27:30

the washer and coming out of the

27:33

washer . I think those

27:35

types of ergonomic robotic

27:38

assistance is going to really

27:41

take off over the next few years . You

27:43

know , as an operational leader with

27:45

a lot of years under my belt

27:47

, seen so many injuries

27:50

or so many ongoing , you

27:53

know individuals that

27:55

can't work in a certain place because they've

27:58

hurt their back too many times , so on and so

28:00

forth . So I do believe that that

28:02

component is

28:04

taking off and I think larger

28:07

facilities are going to start using

28:09

that because ultimately it saves

28:11

the human resources from injury and harm

28:13

. From an AI

28:16

perspective and I don't know if

28:18

that's kind of what we're thinking

28:20

as well being able to dump an entire tray

28:23

out on a pad of

28:25

technology , if you will , and it's able

28:27

to sort of spit out if all

28:30

the contents of the tray are there , that's all well

28:32

and good is

28:46

advanced to this degree , but they'll , in my mind , never be in my lifetime a

28:48

replacement for actual human expertise to take

28:50

a look at these instruments to see if

28:52

their efficacy of the instrument

28:54

is adequate , if the cleanliness is

28:57

adequate . I

28:59

think that we will always rely on people

29:01

to do that job

29:03

. But I do think that technology

29:06

and robotics have grown

29:08

leaps and bounds , and so

29:10

I make that statement

29:12

loosely and could very

29:15

likely be proven wrong in my lifetime

29:17

, that there would be , you know

29:19

, a robot that could do anything

29:21

that a human can do . It's , you know , at this

29:23

point in our history we're

29:26

seeing so many advances , but

29:29

right now I believe strongly

29:31

that the human element of sterile

29:33

processing is very important from

29:37

an inspection perspective .

29:39

So would it be fair to say that

29:42

the shortest list in the world

29:44

might be healthcare

29:46

systems that have sterile processing , in

29:49

which the sterile processing operational

29:51

process couldn't be improved ? And would

29:53

it also be fair to say that

29:55

if you're considering doing anything , you

29:58

start with an assessment and get a real

30:01

good look at what the options are , what the opportunities

30:03

are where your organization's going

30:06

with a strategic plan , and tie

30:08

all that together ? Would that be fair to say ?

30:10

Absolutely , and I think that there

30:12

are technologies that

30:15

could you know , for the

30:17

benefit and the bottom line of an organization

30:19

, if they're going to invest , you

30:21

know , several hundred thousand dollars in robotics

30:24

and a sterile processing department , would

30:26

that yield any savings as far

30:28

as human resources . I believe

30:30

that that is certainly something that

30:33

, from a strategic plan

30:35

, would come into play . Come into play , I do

30:37

believe that , exactly what you said research

30:40

, and you know doing

30:43

some , you know true , evidence-based

30:45

research . Who's using this , how's it working

30:48

for them ? What's the repair rates look

30:50

like ? You know all of that because we know

30:52

that when we rely on , even

30:54

when we rely on our electricity and we're

30:56

hit with a thunderstorm , we got to figure it out

30:58

. Well

31:07

, when you're running an operation that's feeding forty , nine , fifty , two , thirty two

31:09

operating rooms , and you have a piece of equipment go out and sterile processing , it's not

31:11

as easy as just running to find a candle , you know . So I think that all of that has to be

31:14

taken into consideration when we go with

31:16

with new technologies and

31:18

new advances

31:21

in technology . I think we really need to take

31:23

a look at what's that downtime look like

31:25

and how are we going to compensate for

31:27

that If we cut healthcare , human resources .

31:48

The traveling nurses had saved

31:51

the day in many places , quite honestly , depending

31:54

on where the pandemic went , they sort

31:56

of followed that . How

31:58

are travelers showing

32:01

up in sterile processing , and is

32:04

that a thing that needs to be dealt

32:06

with ? Could you talk about that ?

32:08

I sure can . So you

32:10

know , I believe that the travelers

32:13

, the amount of travelers

32:15

that we saw across the country after

32:17

the pandemic and the years that have followed

32:20

, have largely increased

32:22

for sterile processing techs

32:24

, and that is really

32:26

in part due

32:28

to and I think in large

32:31

part due to the compensation . You

32:34

know they can go and they can do this job

32:36

and they can feed their families . They can

32:38

make enough money to pay down debt . They may

32:40

make enough money to put their kids through college

32:44

. They can , in some very

32:46

sad situations , get off government assistance

32:48

when they go and do traveling

32:51

jobs . So

32:53

I really believe that this is very

32:55

cyclical . Did the pandemic

32:57

highlight it ? Very much so . However

33:01

, I believe that the biggest

33:03

problem with retaining , retention

33:07

and recruitment is

33:09

how much these people are being paid . They're being

33:11

asked to be certified or to become certified

33:13

and again they're just making a few dollars

33:16

more than the guy that's sweeping the floor

33:18

in housekeeping , than

33:22

the guy that's sweeping the floor in housekeeping . So when they're asked to , when they join

33:24

in with a travel agency , the travel agency is sending them to

33:26

places where they're very needed

33:29

and they can go

33:31

there and they can make money . And you know

33:33

, my hope is that they feel appreciated when

33:35

they're there . So they feel appreciated and

33:37

they continue to extend their contracts

33:39

. I believe that this problem

33:41

, the root of the problem , is that

33:44

administrators within healthcare

33:46

have never caught

33:49

up with . If

33:51

surgery is going to be the revenue generating

33:53

engine of your health system

33:56

, then what are you doing for

33:58

the people that are feeding

34:00

that revenue generating engine

34:02

of the hospital ? The surgeon can come

34:04

to work and he can have 10 cases lined

34:06

up for that day . That's going to yield the hospital

34:09

hundreds of thousands of dollars

34:11

. But if he doesn't have his basic

34:13

tools in working order

34:15

and in sterile and

34:17

ready for those patients , he's not making

34:20

anybody any money . And in sterile

34:22

and ready for those patients , he's not making anybody

34:24

any money . And

34:28

the OR staff ? They're not educated to do the work of a sterile processing tech . So I believe

34:30

that the disconnect between the people that are actually

34:33

providing the tools for the clinical team

34:35

to do their job to then be the revenue

34:37

generating engine of the health system so

34:39

that the administrators can make their bottom

34:42

line , I think where they are lacking

34:44

is that fundamental first step

34:47

of making sure that your sterile processing

34:49

techs are adequately paid . They're

34:51

appreciated , there's a retention

34:53

program in place for them . There's an education

34:56

program in place for them and

34:58

so many facilities just

35:00

see it as just do more

35:03

. You have a manager

35:05

in the department , so the manager

35:07

can take an assignment today . The

35:10

supervisor can take an assignment today

35:12

. I believe

35:14

wholeheartedly that sterile processing

35:17

is the place where many

35:20

administrators look at where are we going

35:22

to cut some expense

35:24

so that we can then , you

35:27

know , get more scrub techs to scrub

35:29

these additional cases that we're going

35:31

to put on ? We can get more nurses

35:33

to scrub and to circulate

35:36

. They're

35:43

taking from the wrong place , because what happens , as you all know with the history in

35:45

sterile processing , we get behind in sterile processing and who ultimately

35:47

suffers ? Ultimately

35:49

, our patients suffer , but the

35:51

metrics in the operating room start to crash

35:53

the minute we don't have adequate resources

35:56

in sterile processing . So

35:58

I believe that organizations

36:00

that spend hundreds of thousands of dollars

36:02

on travelers it amazes

36:05

me if they would look inward and

36:07

they would take a look and dive deeper

36:09

into why do we have 30%

36:12

travelers in our organization ? Why can't

36:14

we retain people ? You know , if

36:17

you have adequate leadership in place

36:19

, the question doesn't . The blame doesn't

36:21

fall on the leader , it falls

36:23

on the leader can only do what

36:26

they are equipped to do what the

36:28

organization has given them the resources

36:30

to be successful . If you

36:32

are not given the

36:36

really the respect by the organization

36:38

as their sterile processing leader

36:41

, when you go to your administration

36:43

and you say , I

36:45

see what you're telling me on paper , but

36:47

that's not the scenario , I

36:50

think that's where they're shooting themselves

36:52

in the foot and I think that's why

36:54

the traveler , the traveling

36:56

population has exploded . Population

37:04

has exploded . They're not paid enough , they don't feel

37:07

appreciated and it's a never ending cycle in some organizations

37:09

and sadly I've seen that .

37:09

Yeah well , just to sum up , because once

37:12

again we get back to this whole idea of an assessment

37:14

. You know most of my

37:17

experience in health care and probably

37:19

most of yours has been people

37:22

that our

37:25

cases are made narratively

37:27

, without data . I

37:30

need more people in CFs and

37:33

you try to tell a doctor hey , you don't understand

37:35

. There's a difference between this case

37:37

and this case is what it requires , between this case

37:39

and this case is what it requires , Unless you have

37:41

someone in to help you gather the data

37:43

and build the case . All

37:46

you appear to be doing to the people

37:48

in the C-suite is making excuses

37:50

and whining and

37:56

what your recommendation that I've gotten out

37:59

of what we've just been talking about is

38:01

number one for the organization to respect the function

38:03

about . Is number one for the organization to respect the function , uh , number

38:05

two , to provide enough resources to do the job and number three , to

38:07

pay those resources enough so that they won't

38:09

have to become travelers to make money

38:11

to live their life normally . Is that , was that fair

38:14

to say ?

38:15

very fair to say and you know , I understand

38:17

that . You know from an administrative

38:20

C-suite perspective , they

38:22

feel that they should not be

38:24

in the weeds . That you know , sterile processing

38:27

leaders should be able to

38:29

tell the story and , to your

38:31

point , you know , have data to

38:33

back that up . In my experience

38:36

that's 100%

38:38

true . Data is wonderful to tell the

38:40

story . It

38:53

tells part of the story . It doesn't tell the part of the story that point of use , cleaning is

38:56

lacking in our operating room , which requires additional resources in SPD 80 percent

38:58

, 30 percent of what we sent you , you sent it right

39:00

back to us and that took 30

39:02

percent of our resources to

39:05

develop those trays and

39:07

create that case card and

39:10

then it was just basically , you

39:12

know , all for naught , it wasn't needed

39:15

. And so I

39:17

believe that the more we can

39:19

advocate for change

39:22

and assessments and engage

39:24

our administrative C-suite people

39:26

to understand that , while

39:29

some organizations probably you

39:31

know it would be naive to say there aren't

39:33

leaders , that would just , you

39:35

know , pass the buck or blame

39:38

their team or so on there are leaders

39:40

. If somebody has achieved a level

39:42

of director of sterile processing , they

39:45

care about what they're doing and they know what

39:47

they're doing and I believe that they

39:49

need to have the respect of the C-suite

39:51

to sit down and listen the minute the

39:53

problems present and

39:55

they're outside of the realm of that

39:57

director's control or that manager's

39:59

control . The C-suite needs

40:01

to humble themselves and sit and listen

40:03

and not just make

40:06

those assessments from their

40:08

data or historical benchmarking

40:11

. You know all the buzzwords

40:13

that we hear in our industry .

40:16

Well , jim , thank you

40:18

for coming back for the second time Before

40:20

we go . I did

40:23

a big on-site project

40:26

at an organization in the south

40:28

. It must have been around

40:30

2000 , 2002

40:32

. They were returning 45%

40:35

of the stuff that was sent up to surgery back

40:38

unused and that was the stuff that came back

40:41

was sent up to surgery back unused and that was

40:43

the stuff that came back . Remember , what you haven't talked about is

40:45

the stuff that got thrown away because it got opened and had to be thrown away

40:47

, couldn't be used again . But 45%

40:49

was coming back and I was talking

40:51

to those people about three years ago and

40:54

they said that they've worked really hard to implement

40:56

the stuff that we talked about and

40:58

they've got it down to 42% now . So

41:00

they've really made a vast improvement . So

41:02

that's still . The problems are still there

41:04

. But , kim , thanks so much

41:06

for shining the light on sterile processing

41:08

. This has been a great conversation and

41:11

I appreciate the fact that you put up with an old

41:13

guy who is too stupid to press

41:15

the record button and we hope to have you

41:17

back again in the future . Thank you so much .

41:20

I would be honored , fred , and thank you , have

41:22

a great day and we'll talk soon

41:25

.

41:25

Okay , take care , see you Bye .