Building Habits of Improvement: SPD Style

“Quality is not an act, it is a habit.” – Aristotle

Quality is a standard measure of achievement and can be determined by a scientifically determined metric that makes something high standard. Habits are a repeatable practice we put into place to improve the quality of our routines, performance, and ultimately, improve quality.

Work fatigue and eventual burnout can arise from unaddressed gaps in our work environment. Sometimes those gaps are a small nuisance that has been festering, like unresolved repairs, or workarounds from a lack of resources. Work fatigue might also be the result of poor habits and a lack of consistent practices and upgrades. Incremental changes and upgrades can have a compounding result (Mereu & Jordan, 2024) that can improve, or hurt, our departments over time related to work fatigue and burnout. Bad habits compound over time, too.

Below we will explore two different types of work areas that can influence how our team interacts with each other and their work. There are many potential gaps which contribute to negative quality outcomes. By identifying these risks, departments can better form habits & improvements to remove them.

Micro-Issues: Wolves in Sheep’s Clothing  

Keeping up with fluctuating volume and demand is part of the daily grind in sterile processing and endoscope reprocessing departments. Gaps in processes can result in strain, inconsistent quality and staff challenges.

• Automation: This can be automation of processes or reporting. Manual processes can be time-consuming, inconsistent and strenuous on our teams and the entire department. Think of the time dedicated to processes like syringe flushing, or the labor required to manually tally totals at the end of the month for throughput reporting. Manual labor has its time and place. The human aspect of our job is the most crucial, but eliminating manual tasks, where possible, can ease the pressure on staff, and improve engagement and outcomes. Consider the compounding effect on both the tech and quality of our throughput by focusing on manual areas of work.

• Damage Prevention: Instruments can be both complex and delicate making them susceptible to damage. Ofstead and Associates, in a recent study, indicated the infections were also linked to endoscope with damage and residual (2024). This can lead some technicians to hesitate at the thought of reprocessing specific instruments or specialties for fear of their fragileness and potential harm when not handled and processed appropriately.
• Ergonomic Fatigue and Injury Prevention: Ergonomics is a continuous source of discussion and consideration. ANSI/AAMI ST79 3.3.6.1.3.& ANSI/AAMI ST91 4.2.1 both address ergonomics as an injury prevention safety measure. Furthermore, 48.02% of 2024 SPD State of the Industry participants indicated that they had experienced an injury on the job ranging from chemical exposure to bodily injury including sprains, strains and fractures. With long hours and laborious tasks, ignorance of ergonomic considerations can not only injure key staff but make retention of new ones difficult. Scrutiny and distrust from administration can be a side effect of a department frequently putting its workers on worker’s compensation leaves. One neglected area compounds into multiple negative effects costing money and time.

• Inspection Accessories:  ANSI/AAMI ST79: 3.3.5.6 & Annex D &  ANSI/AAMI ST91: 4.3.8 & Annex E provides guidance on the type of lighting, luminosity as well as visual inspection tools for internal inspection of lumened instruments.  Insufficient lighting and a lack of visual inspection tools can lead to missed damage, unidentified bioburden and false security. Much like the risk caused from damage, there is equal concern for undetected imperfections on our processes.

Professional Gaps

Professional development plays an equally influential role in the quality of our outcomes and creating positive habits, or influencing negative ones.

• Communication: Sterile processing departments often have multiple shifts. It’s easy for announcements, process updates and key changes to become muddled over the course of the day and weeks. Inconsistent communication can lead to disorganized work, confused priorities and non-uniform processes. It’s also a ripe area for distrust to be sown amongst our teams.

• Training/Skills Development: ANSI/AAMI Standards ST79 & ST 91 both address training and education as a requirement for onboarding and includes recommendation for incremental evaluations. (ANSI/AAMI ST91 6.3 &  ANSI/AAMI ST73 4.3) Furthermore, 52.36% of participants in the 2024 GI Landscape Report  and 45.37% of 2024 SPD State of the Industry survey participants indicated that they lack adequate training and skills development opportunities. Without consistent education and training, our teams can lose touch with best practices, new technology and time to practice improved skills sets.

• Department Morale: It’s often been said that we spend more time with our work teams than we do with our own families. They see and/or hear of our ups and downs and help us work through high stress situations with us. Our team’s morale can be impacted by both internal or external influences and can greatly impact how they interact with each other and their work. When stress levels are high, motivation and engagement can diminish, leaving our work and quality lacking.

• Rounding: It’s easy as leaders to unintentionally lose touch with the daily grind in the department. The missed huddle, or the forgotten follow-up that was promised can all contribute to communication and preconceived assumptions of leadership by the team. Improper follow-up and environmental awareness can result in tension, unresolved challenges and extended workarounds that impact the team’s ability to perform their task well.

Workarounds and bad habits are rampant, if you know where to look. Those bad habits compound into more significant issues, if they are left to fester. the focus on habitual improvements starts with the awareness these issues exist and assessing your department’s daily habits. Identifying current practices against desired outcomes and understanding the professional growth of your team can start the process to rectifying bad habits and getting back to a focus on quality outcomes. Never underestimate the power of that one change; it can truly alter the trajectory of your department!

References

• https://hbr.org/2024/02/the-restorative-power-of-small-habits
• ANSI/AAMI ST79
• ANSI/AAMI ST91
• 2024 SPD State of the Industry Report
• 2024 GI Landscape Report
• Cori L. Ofstead, Abigail G. Smart, Larry A. Lamb, and Frank E. Daniels, December 2024
• Impact of Borescope Inspections on Endoscope Repair Frequency and Costs