Strategies to optimise clinical sterilisationStrategies to optimise clinical sterilisation

Healthcare providers around the world are all under common pressure known as the “triple squeeze. Rising incidents of chronic illness, an ageing population, and a shortage of clinical staff all mean our heroes are doing more with less. Everyone wants solutions that save these frontline workers time and resources, allowing them to do what they do best, which is to give their time to patients.

And while efforts to get things back to pre-pandemic operational scale have been monumental across the global healthcare community, there remains much more to be done. According to the BMA, in the UK alone, 7.22 million people were waiting for treatment in February 2023, with three million of these patients waiting over 18 weeks. Around 362,500 of these patients have been waiting over a year for treatment, which is 169 times higher than before the pandemic began. 

So how can you and your team make things more efficient to get more procedures done and to alleviate the queues? Let us begin by looking at how operations are done. 

Related: Tech advancements fuel training in infection control

There are many different types of surgical procedures routinely undertaken, and it is likely that cataract surgery and caesareans are among them (they top the list of procedures across Europe right now). Each has a sterile surgical tool kit associated with it, provided to surgeons after they scrub in. Then, once the operation is undertaken, the dirty instruments are packed up and sent back to sterile services, often at a separate location, to be sterilised in autoclaves before being set up again. Typically, the kits are wrapped in plastic to protect them from airborne germs before being catalogued and stored in anticipation of their next usage. 

Though this sterilisation process is great in theory — “reuse and recycle” is always a winning proposition — there is a lot of room for error. Imagine a procedure that has unexpected complications and implements are temporarily lost when the team is moving the patient to a new location. What happens then? What if surgeons must use the same limited equipment for multiple operations? How do you ensure that trays, with their finite shelf life prior to re-sterilisation, get used in an efficient order? How do you trace trays back to patients to check devices were not left internally or to alleviate a disease concern such as CJD?

If items are lost, the initial strategy is probably to look for them, which is smart. But this search is going to probably eat up a significant amount of clinicians’ time daily. In one study, nearly four hours were taken up by eight clinicians searching for assets. That is a 12.5 per cent inefficiency – or a business case for another non-clinical teammate. 

If items are not easily – or ever – found, a 'first do no wrong' approach is probably to buy additional stock so no one must spend a second looking. But is this really the best solution? Surgical devices are sold at a premium, making this a very expensive approach. Factor in the unnecessary cleaning of trays due to poor inventory management, and there are additional energy costs and carbon emissions to add to the equation. Then think about an inability to pinpoint where instruments are located, which, worst-case scenario, can add additional procedures like X-rays and a whole heap of extra anxiety. All these elements combined place a heavy burden on an already stretched team and restricted-capacity system.

Speaking of X-rays, there is another sort of invisible wave called radio frequency identification (RFID). An RFID reader can come as part of a wider tracking solution based on RFID technology. In other verticals, such as retail and warehousing, RFID is used in storerooms, giving instant viewing of whatever stock lies hidden from view. Turn on the RFID reader’s item-finder mode, and via a series of beeps, you can track down specific items in no time at all.

To take away 'yet another task for clinicians' by enabling automation, RFID technology infrastructure can be strategically placed around a healthcare facility. RFID antennas and readers placed around entry and exit points of an operating room, storage room, or where it makes sense – for example, at a processing table or at an autoclave — can report item location, even when in motion. Every time an item leaves or returns, it is automatically logged by a unique identification code placed on it via an RFID label carefully designed to withstand whatever the medical device, surgical instrument or kit endures.  

Related: Sterilisation and disinfection vital in hospital infection control

This base RFID infrastructure links to a database where the interesting bit happens. Each asset you are tracking has data associated with it linked to hospital workflows. In the case of surgical trays, this will include where it was last logged, when it was last cleaned, which patients it was used with, and so on. Suddenly you will have instant visibility, alleviating all the aforementioned pains of not knowing where surgical kits are or what state they are in. You now know the kit is clean, it is being used systematically, and all the pieces are present and where it is.

In fact, one hospital in the UK recently completed a sterile services RFID project as part of a much wider location solutions rollout. As a result, surgical trays can now be searched for on a desktop PC, and RFID is used to locate them in storerooms. Even if they are in the wrong place, they will be found. This is a huge benefit to patients, as their operations will not be cancelled due to missing sterile trays and instruments.

Mitigating risk is key as well. For example, should a heart surgery instrument tray be dropped, another one can be located in a matter of seconds, ensuring minimal delay to vital surgery. The hospital’s clinical team says they are already seeing improvements in patient care, as well as time savings and a reduction in procurement costs.

With RFID, there is less time spent hunting for things, and sterilisation becomes more efficient. Plus, all this freed time and resources can be ploughed back into patient care. 

Wayne Miller is the Director of Healthcare Solutions, EMEA, Zebra Technologies.

References available upon request.

This article appears in the latest issue of the Omnia Health Magazine, read more here