On December 21, VA Central Office changed the name of the Sterile Processing and Distribution (SPD) department to Sterile Processing Services (SPS) to accurately reflect the focus of this department and more clearly define the separation of duties between SPS and Logistics at a national level. At the VA Roseburg Healthcare System (VARHS), SPS and Logistics have been organizationally separated for more than fifteen years and continue to work closely together in a collaborative way due to the many overlapping and complementary responsibilities. For VARHS, the changes over the last couple of years within SPS have been much bigger than a name change.
In 2009, VA Central Office published two Directives (2009-001 and 2009-004) that changed the practice, reporting structure and oversight of the SPS department, realigning them directly under the Nurse Executive (Associate Director Patient Care Services) throughout the nation. This increased the visibility of the processes and more directly involved the Executive Leadership in the discussions facing SPS and the processing of Reusable Medical Equipment (RME). Oversight is provided by the VA Office of the Inspector General (OIG). This includes unannounced site visits at random intervals, internal quality monitoring in all areas where RME items (instruments and equipment) are cleaned, and random unannounced site visits by the regional office for Veteran Integrated Service Network (VISN) 20. These site visits are quality performance checks to ensure we are following the manufacturer’s recommendations for cleaning, sterilizing, or disinfecting RME items. One misconception is that only SPS employees perform the functions associated with cleaning RME. In fact, dentists, surgeons, nurses, physicians, nurse practitioners, and x-ray technicians may have direct responsibility for cleaning RME and complying with the Directives from Central Office. The site visits look at these areas and personnel as well as reviewing the practice of the SPS employees. As a facility, we have done exceptionally well with all the site visits to date and anticipate this trend continuing for the future.
Due to national changes in the requirements for the physical space in which SPS functions are performed, VARHS is undergoing two construction projects. One, the short term resolution of immediate concerns, is taking place currently and renovates the existing space with significant upgrades in equipment, instruments, and space to promote more efficient workflow and through-put. The second construction project due to start in a few years will relocate the entire department into new space that will allow all elements of SPS, which are spread throughout the building, into one area and expands the capability and volume of items which can be sterilized, disinfected, and cleaned. A future enhancement includes an electronic real time locator system to allow for remote tracking of instruments throughout the facility.
The backbone of SPS, and the key behind the success of our site visits, safe patient care related to RME, and ongoing compliance with the Directive, is the employees who work in the department. The SPS staff have a great deal of pride in their work and it is reflected daily in the quality of their product, the positive interactions they have with internal customers (surgery, ambulatory care, dental, etc.), and in the findings from the quality reviews performed by internal and external reviewers. Their leader, Pat Sudds, has extensive clinical expertise (as a former LPN) and years of experience within SPS. Pat is certified as an International Association of Healthcare Central Service Materiel Management (IAHCSMM) instructor. Under her leadership, the department has grown to include a Lead, Robert Harden, with responsibility for ensuring employees within SPS remain competent to perform all the essential duties of the department, ensure accuracy of instrument and equipment supporting documentation throughout the facility, and providing training for employees outside SPS who have responsibility for cleaning RME. The newest addition is an administrative support assistant, Fred Suggs, who will assist with the administrative functions such as document control, document research, and managing the schedule for the SPS Chief. As the facility has grown clinical programs, the front line SPS employees have grown in number and skill set. The current SPS personnel who have been in the department more than 60 days are all certified Medical Supply Technicians and the two newest employees are working on their prerequisites to become certified within the next six months. The SPS employees have direct responsibility for cleaning, disinfecting, and sterilizing scopes, equipment, and instruments, for educating others about the RME regulations and process, and for ensuring the departments have adequate number and type of equipment and supplies necessary to perform direct care activities.
For SPS, the evolution has been more than just a name change