Although fans of the hometown Indians might frown on the analogy, The Cleveland Clinic–arguably the central service world’s equivalent to the New York Yankees–used its size and an impressive collection of financial and human resources to its best advantage and came away as the 2002 winner of the Healthcare Purchasing News Central Service Department of the Year award It can rightfully be said that the larger institutions have the means as well as the motive to improve their performance, teamwork, efficiency and the like. But it’s still up to the hospital and its managers and staff to fulfill that potential, and the prestigious Ohio medical center certainly did that. In overwhelming fashion, The Cleveland Clinic finished as the top vote-getter from judges in an outstanding field of hospitals to win this year’s honor. One judge even handed the Clinic a perfect score, the only such accomplishment on the score sheet. Among the leaders in the field were runner-up Virginia Mason Medical Center in Seattle, as well as Women’s Hospital, Baton Rouge, LA, and Baylor University Medical Center, Waco, TX. Congratulations are in order for all entries. Each of these facilities submitted impressive credentials.

“World class care deserves a world class processing department.” In 1998, the surgical processing department (SPD) of The Cleveland Clinic stepped up efforts to improve their delivery of quality products to their customers. In order for the staff of the SPD to achieve their goals, they needed to update their department’s mission statement and plan a comprehensive strategic plan that was sensitive to the needs of their customers. This plan also needed to be communicated to their customer and provide opportunity for customers participation with very little time taken away from patient care.

The fundamental values that form the foundation of the Cleveland Clinic culture: quality, integrity, compassion, collaboration, and commitment. The mission of the surgical processing department: “To provide surgical instrumentation and related hardware which has been decontaminated, inspected, assembled, packaged, sterilized, stored and delivered according to quality assurance procedures for the operating rooms in a manner to support and accomplish the goals and objectives of The Cleveland Clinic.”

Today, the SPD supports 59 surgical operating rooms with an annual caseload of 34,000-plus surgical procedures, performing 16,800 sterilization loads and processing more than 373,860 sets of instruments to include the inspection and handling of over 6.25 million reusable surgical medical devices per year. This type of performance and statistical indicators would not be feasible without the professional dedication of the 70 FTEs in the SPD.

But this story is more than just numbers. It’s about how one SPD achieved success and won this year’s award. “Customer Service is the key,” says Richard Schule, who has led the department since 1994 and sounds as much like a motivator as a department head. “Never get discouraged over the day’s events. Perseverance and a positive attitude will endure.” With that in mind, the SPD has developed and implemented numerous tools to meet and exceed their customer’s expectations.

Innovative ideas

The Clinic developed several resource tools designed to raise the level of efficiency and awareness of the production process. For example, the SPD assisted in the development and implementation of an instrument daily usage report from the OR scheduling system. This report identifies the types and quantities of instruments needed to support the next day’s surgery schedule and to help prioritize the workload.

Inside the department, visual aids were posted throughout the production process featuring oversized graphics portraying the loading of washer loading racks with reusable medical devices, instrument tray assembly, sterilizer loading cart set up, sterile storage and case cart production, to help staff identify with consistent replication of quality production.

Another improvement was the way in which sharps were reported to the staff and SPD customers. The staff took a site visit to Invacare, a large homecare products supplier. Says Schule, “We noticed how a picture of a green safety cross was colored to represent the number of injury free production days for a given month. The SPD created a picture of a syringe with 31 squares to represent each day of the month and to have a colored square for each day that a sharps event takes place.”

Improvements begin with a will to do and knowledge to understand the reasoning. The SPD staff at Cleveland Clinic came to recognize the importance of communicating with their customers as well as with each other. With that in mind, a “communications board” was designed to capture monthly statistics and include production indicators and volume. “This board allowed us to communicate safety issues such as the number of sharps incidents that were occurring each month in addition to what types of sharps the staff were being exposed to,” says Schule. “Such communication has been received favorably by our customers, and the raised awareness has reduced sharps occurrence by 64 percent.”