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Winning the OR Culture Wars: Sterile Processing & Surgeons . . . How You Can Spread the Love

One bad apple can spoil the bunch. And one mad surgeon can, well, we all know what one mad surgeon can do . . .

And there are few better ways to set off a stressed out surgeon than to consistently fail him or her in the area of surgical instrumentation. Whether it's a set that's unsterile for her first case, a scope that is cloudy for the umpteenth time, or an untimely delay in delivering the additional needleholders he needs to replace the ones that aren't locking properly -- understandable frustration is sure to follow. You may not hear the grumbles down in SPD, but the cultural damage is certainly done and it runs deep.

But there's good news. There's light at the end of this gloomy OR hallway. Frustrated surgeons can be won over, and when they are, they can be one of the most powerful agents of change to propel your Sterile Processing department to the forefront of cultural excellence in the minds of the OR team. Let's talk about some key ways your SPD team can get this done . . .

1) Reality Affirming

It's no secret that in most facilities across the country, there is no love lost between the OR and SPD. There are as many reason for this as there are individual departments, but some common threads include: unrealistic expectations between the two departments, high levels of stress on frontline staff to keep productivity high without enough manpower to get it all done, and a somewhat ubiquitous "us vs. them" mentality between OR nurses and SPD technicians. This is reality for most of us, and SPD leaders ignore it at their peril. But just because it's where we start, doesn't mean it's where we must remain.

2) Commit to Earning

Once you let the reality of the current state of affairs settle in, one thing should become strikingly clear. These OR/SPD challenges are not fundamentally about one department or the other winning or losing. It's actually a cultural battle between excellent patient careand stagnant territorialism that forgets the patients and focuses on the others' failures. Against this backdrop stands your shadow, the driven SPD or OR leader who is committed to earning the trust of your respective teammates once again. One group in particular deserves special focus: frustrated physicians.

As an SPD leader, you must be able to communicate to your facility's surgeons your commitment to overcome the present challenges and how you intend to give them the highest level of customer service. Just come right out and tell them you are committed to regaining their trust. Maybe they believe you at this point, maybe they don't. At this stage it doesn't matter. You just need them to know that you know that it's broken. Only then can you get to work on fixing it.

3) Bring on the Learning 

So that was the easy part. Now we get to hammer our swords into plowshares and get to the real work of becoming the kind of SPD department that surgeons love and respect. In Sterile Processing, as with anything else, you have to know to grow. The world outside your facility is increasingly becoming a certified and credentialed world, both by law and by choice.

If your team doesn't already require an industry certification, doing so will signal to your surgical team that you're serious about bringing a level of professionalism to your department's ranks. In addition to that, make sure you are intentionally carving out time each week to inservice your staff on service/quality issues that impact your physicians. Set a goal each month to invite a surgeon to come speak for 10 - 15 minutes about one of his instrument sets, how it's used, why it includes certain instruments, and what sets are used in conjunction with it. Not only will this give your team critical insider information as to what this physician finds valuable, but it will also give the physician an opportunity to interact with your team in a supportive, rather than frustrated, manner. This can do wonders for instilling confidence in your SPD techs and provide a level of ownership to the physicians for the positive changes that come out of these in-services.

4) Stop Rome from Burning

So you've committed to your physicians that your team is going to put out the service-fires smoldering in the OR, and you've undergirded that commitment with service/quality orientated education that gives your people the tools they need to meet these expectations. But guess what? You're still going to have failures. If you're lucky it won't be the particular issue Dr. Smith covered with your staff last week, but it very well could be. And you will need to be prepared to outlast these flare ups by providing a consistent, long-term context for how -- eventually -- this problem will really be stamped out. Thankfully there are a couple of tools that can help you at this point.

First, key in on your external vendors (reps for the Strykers, Zimmers, Medtronics of the world). These guys and gals work very closely with physicians and see your team on a regular basis. This means they can be a great conduit for communicating real cultural changes directly into the OR suite -- before the culture has concretely shifted across the teams. For instance, if your reps begin commenting on how much easier it is to drop-off/sign in loaner instrumentation or how much more streamlined the communication is with your team, this will further confirm that your commitment toward change is actually taking root.