HOW TO BUILD HARMONY

BETWEEN OT AND CSSD THROUGH

EFFECTIVE COORDINATION
RATHIYAH AHMAD
UNIVERSITY OF MALAYA
INFECTION CONTROL ASSOCIATION OF
MALAYSIA
 Objectives
To highlight organizational similarity and
difference between Central Sterile Supplies
Department and Operating Room Theatre
To explore professional aspects and gaps
To present essential values who help to
improve relationship and quality between unit
and finally to improve patient care quality and
safety
An operating theater and sterilization
services are as a tandem.
To move forward, both wheels must
turn IN THE SAME DIRECTION
 Entities and Flow
TO STERILIZE- CSSD

TO PERFORM SURGERY- OR
 KNOWLEDGE OF INFECTION
PREVENTION AND CONTROL
There is one thing that never changes -- the
fight against infection. This is the common
goal of all CSSDs AND Operating Room
Theatre.
PATIENTS SAFETY
 RELATIONSHIP CSSD-0RT

DECONTAMINATION & TO PERFORM SURGERY

STERILISATION
 PROBLEMS
Inadequate communication
Culture of blame
Unclear instructions
Inadequate training
a. Frequent changes in technology
b.Shortage of staff
c.Multi tasking and fatique
 PROBLEMS
Management styles intimidating
Shortage of funds- financial constraints
Inconsistent regulations
Time pressure
 Inadequate communication
Lack of communication regarding the turn-around
time at CSSD.
The time schedule for processing of equipments
after returned to CSSD was not conveyed of
displayed in other areas of the hospital.
time schedule was not displayed at every OT
cou ter, ICU, Wards a d OPDs. Operatio theatre
scheduling is a major contributing factor to
enhance the efficiency of operating theatre.
 Culture of blame

missing instruments, trays,

instrument damage and increase of repair
costs,
 UNCLEAR INSTRUCTIONS
Care by end-users are explicitly recommended
by professional organizations wipe
instruments with wet gauze at the point of
use- sterile water and not with saline because
deposits of salt can damage the instruments
on prolong use.
 Inadequate training

Frequent changes in technology

Shortage of staff
Multi tasking and fatique
Shortage of funds- financial constraints
Inconsistent regulations
 Working in harmony

The key to a great work team is co-workers

who show respect for each other, talk through
problems when they arise, and work together
to achieve common goals.
GOOD RELATIONSHIP CSSD-ORT
RESPECT

1. Common safety
procedures
(handling Of
CENTRAL STERILE sharps...) OPERATING
SUPPLIES 1. Permanent training ROOM
DEPARTMENT reciprocal THEATRE
2. Team culture
3. Team learning to
know
GOOD RELATIONSHIP CSSD-ORT

FLOW
CENTRAL STERILE
OPERATING ROOM
SUPPLIES
THEATRE
DEPARTMENT
VIGILANCE
GOOD RELATIONSHIP CSSD-ORT

FLOW

CENTRAL STERILE
OPERATING ROOM
SUPPLIES VIGILANCE THEATRE
DEPARTMENT

COMMUNICATION
GOOD RELATIONSHIP CSSD-ORT
PARTNERSHIP

1. STANDARDIZATION
& UNIFORMITY
2. MANAGEMENT
TRAINING ERROS
CENTRAL STERILE 3. INFORMATION
SUPPLIES SHARING OPERATING ROOM
DEPARTMENT 4. ARRAY OF SKILLS THEATRE
5. JOB SHADOWING
6. PARTICIPATION IN
NATIONAL & INTER
NATIONAL DAYS
7. REGISTER OF
ACTIONS AND
REACTIONS
 KNOWLEDGE SHARING AND
STANDARDISATION
Example of
incorrect
Not closed on first
ratchet. selection of
Risk of impeding air
packaging.
removal and steam
penetration.
This item is
too big for
Risk of causing damage
to the instrument the laminate
under sterilising bag and has
conditions. compromised
the seal.

STEAM Consulting 2010

Openings should be
against the paper side
and not the plastic.
Packaging this way
compromises air
removal and steam
penetration.

STEAM Consulting 2010

Protecting tips by folding over You can see here that
laminate packaging like this will in this department
impede air removal and steam they disassemble
penetration. valves for
STEAM Consulting 2010
sterilisation.
 Job shadowing
Know your job- If you're not sure where your
job fits into the big picture at your practice,
find out.
Set aside some time at a staff meeting to
review the practice's mission statement, and
talk about how daily tasks in the hospital fulfill
that mission.
 RELATIONSHIP CSSD-ORT
TRANSPARENCY

1. Computerized
system and
traceability
2. Choice of suppliers
CENTRAL STERILE 3. Real-time access to
SUPPLIES the operating OPERATING ROOM
DEPARTMENT schedule THEATRE
4. Permanent
inventories,
listings, photos
trays
5. Statistics
6. Inter departmental
meetings
GOOD RELATIONSHIP CSSD-ORT
COMMITMENT

1. Error reduction
tools
2. Contracts on
CENTRAL STERILE equipment
SUPPLIES 3. Internal rules OPERATING ROOM
DEPARTMENT 4. Increased content THEATRE
trays
5. Charter (rights &
duties)
 Tray Checklists / Count sheets
Name of product and identification code
Date of last amendment
List of contents
Written to facilitate assembly and surgical count
Assembler and verifier (if appropriate)
name and/or identification number
Date of manufacture
Other information
i.e. tray weight, packaging size / type or method of
sterilisation

STEAM Consulting 2010

What Does it Take to Accomplish That?

Departmental policies and procedures bases on AAMI Unlimited

pool of potential employees
Training program
Enough instrumentation
Unlimited budget with Appropriate supplies.
Training program that includes certification
Competencies Flawless communication
No surprise loaner instruments
Easy to access IFUs 8
Up-to-date equipment
Continuing education
No distractions
Employees who are super-human But in the real world
Coming together is a beginning.
Keeping together is progress.
Working together is success.
Henry Ford
 Build a culture of safety a d trust is a process
that replaces ...
a culture of blaming individuals for mistakes, ...
by a culture where errors are treated not as
personal failures but as
an opportunity to improve the system and
preve t da age !