NHS Sterile Services Department

The NHS Trust had recently consolidated services from neighbouring hospitals to a new facility. The resulting new facility had over 20 operating theatres. Surgical instruments are supplied to the theatres cleaned, packed and sterilized by on site sterile services department. The sterile services department as well as providing a service for the hospital also had external contracts with other NHS and private hospitals.

Initial Observations

• Reactive work from Theatres (telephone calls chasing up)
• Reactive work from CSSD (Fast tracking of packs)
• The progress of activities to meet daily targets was not readily identifiable
• Equipment was not adequately maintained resulting in downtime and lost capacity
• Sterile services technicians were disrupted by frequent interruptions:-
  • Telephone calls
  • Instruments requiring rework
  • Missing instruments
  • Equipment failures & breakdowns
• Equipment that was out of commission long term meant that staff had to perform manual processing and additional inspection
• Poor layout and design of clean room area resulted in excessive motion and transportation

Improvement Strategy

• Install the visual management and create key measurable’s so the department can assess their own performance
• Analyse and improve the flow of sterile packs through the department
• Practical problem solving to identify and resolve the root causes of poor quality

Lean Deployment

• The process flow of sterile packs was mapped by the CSSD
• CSSD staff were asked to identify any issue or concerns they had, that prevented them from carrying out their tasks
• Process data was collected to understand current performance as well as for tracking improvements
• Tag systems to prioritise and highlight packs. This helped speed location of packs more quickly than before
• Team boards were introduced into each area. Department Key Performance Indicators (KPI’s) were then displayed in order for all the staff to understand their performance
• Working with the team, the layout was reviewed and subsequently re-designed to reduce the amount of excessive walking required during the processing of each tray