ENT Team Leader New York Presbyterian new york, New York, United States
Disclosure(s):
Joseph Masong, BSN-RN: No financial relationships to disclose
Description: Description of Team: Operating Room RN, CSTs, Nurse Leader, Surgical Breast Attendings, CSPD
Assessment: The breast service at a large integrated medical center serves over 1,000 annually. While surgeons operate across five sites and have achieved supply standardization, instrument tray standardization remains a challenge. Even among the individual sites, instrument tray setup varies by surgeon. Recognizing this, the team identified an opportunity to standardize trays at the largest location first, with the goal of expanding to other sites. Preparation & Planning: A team consisting of surgeons, certified surgical technologist, clinical nurses, central sterile processing technicians and perioperative and central sterile processing department (CSPD) leadership was formed. All breast service line trays were reviewed across the five sites. Implementation: All instrument trays were displayed physically side by side for comparison and count sheets were reviewed and cross referenced. Every team member participated in small group sessions to provide feedback on each tray. Additionally, each surgeon was invited to one-on-one sessions perioperative and CSPD leadership. The team leader complied all feedback, which informed the creation of a single draft count sheet. The draft was circulated for further input and once approved, CSPD created a mock tray. Final approval was obtained through additional individual and small group sessions. After all surgeons endorsed the new tray, CSPD produced and deployed the new standardized tray into circulation. Outcome: As a result of the standardization effort, the team successfully consolidated two trays containing a total of 153 instruments into a single tray with 83 instruments. This represents at 49% reduction in the number of instruments, significantly enhancing efficiency and simplifying surgical set up. Implication: Consolidating to a single tray reduces sterilization costs, lowers CSPD and perioperative workload, and minimizes errors in case preparation. Fewer instruments streamline setup time, while standardization eliminates ambiguity and enhances overall efficiency. This has been rolled out in our largest location the Columbia campus and at other sites such as Hudson Valley and Westchester. Avansino, J. R., Goldin, A. B., Risley, R. R., Waldhausen, J. H. T., & Swain, R. S. (2013, September 26). Standardization of operative equipment reduces cost. Journal of Pediatric Surgery. https://www.sciencedirect.com/science/article/abs/pii/S0022346812009657 Dyas, A. R., Lovell, K. M., Balentine, C. J., Wang, T. N., Porterfield, J. R., Chen, H., & Lindeman, B. M. (2018, April 16). Reducing cost and improving operating room efficiency: Examination of Surgical Instrument Processing. Journal of Surgical Research. https://www.sciencedirect.com/science/article/abs/pii/S0022480418302014
