Examining the trade off between keeping sterile processing in-house and contracting it out

Preventing Infection

Does It Make Sense to Move Reprocessing Off-Site?

“In theory, you’re at the mercy of the third party to come through for you, but we haven’t had any issues yet. There is a lot of trust involved, however. There are tight windows involved when vendors deliver trays less than 48 hours before we’re scheduled to use them.”

Adding procedure volume and reducing delays at outpatient facilities are some potential advantages of off-site reprocessing. Those benefits, however, are countered by the challenges of transporting delicate instruments, plus the accompanying compliance and timing issues.

As ambulatory surgery centers (ASCs) and other facilities weigh sterile processing management decisions, experts interviewed by Outpatient Surgery Magazine (a division of AORN) offer insight in a point-counterpoint.

“In theory, you’re at the mercy of the third party to come through for you, but we haven’t had any issues yet,” Jesse Hixson, administrator at Allegheny Health Network’s Monroeville, Pennsylvania, surgery center tells Outpatient Surgery Magazine. “There is a lot of trust involved, however. There are tight windows involved when vendors deliver trays less than 48 hours before we’re scheduled to use them.”

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Related Content: What Happened When This Health System Centralized Instrument Reprocessing?

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Outsourcing was challenging at first. Administrators had to prove to doctors and staff that they were on top of the new strategy by quickly addressing issues as they arose.

Since their off-site facility is at capacity, any expansion into new service lines is limited. They currently use the third-party facility exclusively to handle loaner sets for joint replacements cases, Hixson added. Their total joints program never could have launched with the sterilization they had in-house.

Smaller facilities may not find transitioning to off-site sterile processing as cost effective as they’d hoped it would be, Casey Czarnowski, a sterile processing consultant and clinical educator from Rochester, Minnesota, told the publication.

The biggest challenge is making sure that Department of Transportation regulations are followed — a transport vehicle “counts as storage,” she said, with the same parameters for heat and humidity and a sterile barrier that must be maintained.

Some factors to consider as you weight off-site reprocessing include:

  • Can your endoscopes handle daily transportation?
  • Will the off-site facility be able to manage additional work if you expand service lines?
  • Do you have the support of sterile processors, physicians and nurses?
  • Is there an adequate plan to comply with federal transport regulations?
  • How will you nurture culture and communication with an OR team and SPD in different buildings?

 Another option is transitioning to single-use endoscopes and other disposable products like those invented by Ambu, which eliminate the need for reprocessing (and repairs) entirely, while enhancing patient safety and workflow and efficiency for staff.

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