System Optimization for Advances in Sterile Processing

Sterile processing departments (SPDs) clean and pack reusable surgical instruments. They
directly affect productivity, efficiency, safety, and infection control within acute interventional care.
About 15% of surgical instrument trays have missing, broken or dirty instruments, that can lead
to surgical site infections and a range of safety, procedural, and inefficiency problems. Rather
than being the fault of individuals, our prior funded R03 Work Systems Analysis demonstrated a
range of performance-shaping factors and the need for staff and administrators to balance of
multiple interacting system components and resources. We propose to extend or R03 work to
develop interventions, improve data-analytic approaches, and predictive models, across multiple
facilities. The overall aim is to harmonize the SPD work system to create optimized safety and
quality, controlled production costs, and increased efficiency through systems modelling,
interventions, data visualization, and prediction tools. Our first aim is to develop multiple system
models of five sterile processing units across two hospital systems that will provide a
comprehensive understanding of SPD system function, allow the comparison of methods for
representing SPD work and the prediction and evaluation of interventions to improve point-of-use
reprocessing, tray composition, and interruption management. Our second aim is to create data
visualization tools that highlight systems interactions and thus enhance decisions making. Our
third aim is to develop discrete event simulations that predict performance based on system
parameters, providing a tool for making decisions and for understanding how decisions are made.
This will be the biggest program of research in sterile processing ever conducted.

Grant Number: 5R01HS027912-05
NIH Institute/Center: AHRQ
Principal Investigator: Ken Catchpole