Hello, everyone. It's Daniel Likwin, the voice of B2B, and welcome to another episode of the Consensus Podcast, a Census Podcast. It's good to be here, and I've got a little surprise for you. If you're tapping into this episode, this is actually a part two. That's right. This is part two of two of a larger conversation on Joint Commission three sixty with doctor Ivan Salgo and Sabrina Ford. So if you missed part one, go ahead and click out of here. Go watch part one and get yourself caught up on how Joint Commission three sixty is changing day to day standards and workflows for SPD teams. If you did catch part one, well then you're in the right place. Let's go ahead and dive in and continue our conversation here with Doctor. Ivan Salgo and Sabrina Ford as we continue to peel back the operational, workflow, and culture layers of Joint Commission three sixty on SPD environments. Let's jump in. Welcome to Consensus, a podcast from Census Technologies. Something to kind of get your peak your curiosity after this conference is the five S's in lean, which are sort, set in order, shine, standardize, sustain. But specifically these things actually help. So by doing them as continuous process, can reduce the search time, you can reduce errors, you can improve ergonomics and you improve what's called visual anomaly detection, which is if you set up the whole station, the person working at the station say, Hey, wait a minute, this isn't right. But it's actually second nature. It's easy. And so by actually making it part of the daily process, instead of saying, we know our staff, they're under so much pressure to get things done, but actually we can help elevate our staff with better processes. So by, for example, doing these things, you can say, Hey, yeah, we understand the root cause of why we had a lot of trays that were over the weight limit, but we noticed it was on these days, we noticed it was associated with these kinds of cases. And actually we noticed it might have been with a particular operator. So by untangling all these things, by finding the root cause, can actually address this and say, Hey, we didn't just fix the weight limit this week. We actually improved it from now on because we looked at the root cause. Well, that, one of our practices that we're currently doing now is, you know, not only do we do the trait audit, but with our electronic tracking system, we're able to put the tray weights in, you know, and that tray weight is actually documented on the label. So you know ahead of time what the weight is of an actual tray, but at the same time, anyone is able to add anything to a tray, we have a tool, a tracking tool, where the lead for that specialty will ask and say, Hey, we'd like to add this. So we document it, and then we ask the question, what's the weight of the tray? Right? So you need to make sure that the tray is less than the twenty five pounds before we can add anything, to a particular tray. So that is all part of lean principles as well because we are eliminating the waste of redoing something over and over again, right? And so with the lean principles and doing the five S's, that just falls right in line with what we're doing in SPD currently. And Sabrina, I wanted to ask you as a follow-up there. Are you seeing others in the field deploy similar operational updates, right, and improvements now under the new Joint Commission three sixty standards? I guess I'm kind of curious like what you're seeing from other peers and colleagues out in the field. Well, CommonSpirit, we have the CommonSpirit SPD collaborative group, and we meet with all of the CommonSpirit SPD leaders throughout CommonSpirit. And we do share best practices. We communicate recalls. We communicate new equipment. We communicate pretty much everything related to sterile processing. And so with this new three sixty model, we've actually shared this information. And what we do is we have different hospitals that will do like a presentation on their hospital to show us some of their improvements or different things, models that they've implemented to help other facilities within CommonSpirit. So the things that I've seen, we've shared audit tools, we've shared what we call rounding documentation. So a lot of this has been shared within common spirit. So actually when one is instituting this, usually as you're working to elevate your processes, some of the things, Sabrina and I talked about it in strategic views here, is at your institution, how do you start? Well, you can do a gap analysis. What are some of your current practices? Now you've heard Sabrina and myself talk about Accreditation three sixty. Learn about the national performance goals. Learn about what you do and learn about, hey, the last few audits in the last few years, months, weeks, what have been the recurring themes? So I would say understanding and making it routine to do a gap analysis with milestones and key performance indicators that you want to improve are key. You heard us talk about data assessment. That's where the instrument tracking system is so important. And you want to evaluate your current data collection capabilities. It can only collect the data you generate, right? So Sabrina was sharing a lot of the best practices that she was doing. It's like, Hey, this is the data that I want to go into my instrument tracking system. That's really, really important. One or two other things we talked about, and then you can feel free to build on it, Sabrina, leadership engagement. I know kind of at one hospital that I visited when I spoke to the president, he visited the SPD. He knows what goes on in the SPD. Right? And because he was there, because leadership was engaged and he was engaged because he understood that SPD is part of the holistic picture. Right? If trays aren't ready, if trays are late, if trays are contaminated, that's an issue. That can affect surgery. You want the buy in from your perioperative leadership, not just your SPD, not only infection prevention, your surgeons, your anesthesiologists, your perioperative nurse leaders, even all the way to the C suite. And what I would say is, we talked about IFU integration. I would say that's a big theme, IFUs. And I don't know, Sabrina, you may want to also talk about either competency assessment, how you positively incent your staff to do the right thing with this, because if they're doing the right thing all the time, then this is not an effort, right? Right, right. Yeah, for us with competency assessment, you know, we basically have our leadership team, our leads and our supervisors that are on the floor on a continuous basis monitoring every action that the staff are doing. We also have it inside of our electronic tracking system. We have the competencies and what happens in that system is if you are past your due date, it will not allow you to do a tray assembly. So when it comes to competencies, we put that in the tracking system. We validate our staff. It's not where we're just talking about it. You need to demonstrate. So that's the key right there is making sure that your staff are demonstrating competency. And from a leader perspective, we need to validate that our staff are competent with doing tray assembly. And when we talk about the IFUs, how do you get to the IFU? We need to make sure that our staff know how to get to those IFUs because as you said before, they're constantly changing. We have so many different types of equipment that are out there that are changing on a daily basis. And are we up to date with that? Do we have the up to date IFU for our staff to be able to track their compliance with assembly decontamination and sterilization? Do we have the correct IFU for that? So all of these things are key in those areas. And I wanted to add that I think we were talking about as far as leadership, I believe that for leaderships, we have to move away from being reactive compliance, right, to operational compliance and discipline, right? That means knowing our numbers, understanding our gaps, and aligning daily practices with our standards. So not when someone walks in, but because that's who we are. That's what we do on a daily basis. So this is where I think SPD will evolve from a support department to a strategic clinical partner. I think that's key. Yeah, and building the strategic clinical partner comes in. I'm running a workshop next week and actually the title of the workshop is From Reactive to Proactive. If you're reactive, you're always trying to swim against the current. You're always trying to catch up. But if you're proactive, have the wind at your sails and that's what you wanna do. So a big concern that we hear from SPD teams in general, and we've covered this on the podcast before, is the issue of survey fatigue. How do we stay survey ready without burning out teams? This comes from a cultural standpoint, a tools standpoint, a workflows standpoint. Being always on can create sort of a burdensome headspace for SPD teams if they don't have the right preparation, the right foundations. Again, whether that's tools or culture to be survey ready without the anxiety of, goodness, we got to be survey ready. Hence survey fatigue. So I wanted to get y'all's thoughts and we'll start with Doctor. Salgo on this one again. What does doing it right every day really mean under this model? And kind of extract from your study of the Joint Commission three sixty standards for this one? Obviously, Sabrina, would love to hear from you on this one too. Yeah. Well, let me again look at the big picture. I think Accreditation three sixty embraces a philosophy, but I'm going to give you a very, very practical example. So very early on in school, right, I used to wait till the end of the semester and do the all nighters. And I promise you, I had a lot of fatigue, seriously, right? And then I kind of had to figure out, all right, so how do I buckle down? And so when I buckled down, basically what I did was it wasn't about, Oh, wow, the exams are in fourteen days. I better start preparing. Basically what I did to kind of turn myself around is just day one, Oh, here's some homework problems. Oh, let's get some extra homework problems. So it was really easy because I didn't five other exams tomorrow. I was at the beginning of the semester. I could say, Oh wow, let's do this and kind of let's get this going. So that's what Sabrina and I are saying. If you just make this part of your routine life, that this is what you do every day, it's the one percent better philosophy every day, right? And if you're one percent better, it pays back in huge rewards. And so by making it just the natural force of what you do, you won't fall behind. I think that's what frankly, I don't know Sabrina, what you think, but I think probably the biggest thing is this, especially in human nature, it's this, oh, we're falling behind, it creates stress and, there's an audit next week. Not only do we have a really busy OR tomorrow, but I've got to get ready for an audit. And it's just the constant catching up. I would say by shifting the mindset to proactive, it kind of says, Yeah, things are busy, but I've done this before. So now specifically for three sixty, this is where I'm going to, punt it off here to Sabrina. We already talked about it. How do you have your processes instituted so that it's actually part of daily routine that you do what we call sometimes daily visual management. And actually you have standard work. Like you're not trying to figure this out three weeks before the audit. What am I supposed to do? Your standard work is in place. Your daily visual management is in place. You have your dashboards and everybody's just doing it because that's how they do it. You know, I'm I'm Sabrina, I I I kinda put that, I hand that off to you there, but do you kinda find that philosophy if people aren't constantly trying to come race from behind that if it's up to date, it's okay if it's busy because we haven't fallen behind? So I'm gonna kind of take this in a different direction. So for what we're doing now, because we talk about the lean principles, right? Things that we're currently doing now. So I'm looking at it, a picture from my point of view with SPD in my department. So we talked about this previously being this is what we do, right? But it is more of like what we're currently is we're huddling in the mornings. We have our huddle board with our matrix on the board, right? We're tracking sterilization, biologicals, how many trays did we not have errors on? Those are the types of things that we're looking at, right? So in that event, we're giving the staff the opportunity to speak up, to say what's needed within the department, but also knowing that this is part of our daily routine, what it is that we're doing on a routine basis, it gives them not to where they're getting fatigued because they're taking ownership of what's happening within the department. So giving them that opportunity to take ownership, I believe, is where we get rid of that fatigue. If everyone is accountable for what's happening within the department, It's not leaning on just one person. It's leaning on the team. Collectively, we are the team, and we are the ones that are preventing the risk for our patients. And so when we're talking about documentation, auditing, different things like that, all of that information is there visible because if there's no data, if you can't track it, how can you hold someone accountable? How can they see what's actually happening within their department? Where are our successes? You know, and that's all part of the lean principles as well. We need to track that data. We need to show our staff what they what are we doing well in? What areas do we need to improve in? And it's not people driven, it's process driven. So as you spoke about with having the, standard of work, you know, the SOPs, we definitely, as leaders, need to validate that we have those in place and that the staff are definitely educated to those so that they are comfortable in doing their day to day to day. Instead of doing it twice a year or every quarter, every month, you're doing it weekly and you're doing it daily. That's what I meant by just doing it frequently, it becomes second nature. Yes. And we spoke about this previously. We actually increased our auditing. So we have, a weekly department audit. And in that department, we assign it to staff because staff need to know what they're looking for, what Joint Commission is looking for. So we assign it to the staff for them to do. And then as leadership, we come behind and we do a leadership audit so that we're validating that the staff have done exactly what they needed to do for survey readiness. And that's what we call it, is our audit for survey readiness. And you're absolutely correct. We need to be doing this more frequently because that's what basically what the three sixty is saying. More frequently, not just when, it's survey time. And you have that, oh, joint commission's in the house and then everybody scatters. We wanna, what did I say, stay ready so you don't have to get ready. That should be the tagline of today's episode. I like that. And maybe honestly, we're just gonna seal that for the whole podcast. That's pretty good. It's pretty good. Okay, folks. So we're nearing up to the end of the episode here. I wanna real quick make sure we touch on technology. Right? We've talked a lot about expectations now under Joint Commission three sixty standards, but what about enablement? Right? How do we facilitate running these standards and running this playbook and running these improved operations? Technology is obviously critical here. This is where Census plays its major role in improving SPD workflows and operations, right? But technology here under Joint Commission three sixty should bring visibility into process, consistency and standardization should help move away from memory based workflows, manual binders, let's build lanes that we can repeat and scale like doctor was mentioned here earlier. But I wanted to get y'all's thoughts here, whoever wants to chime in. Where have you seen technology actually make survey prep easier for SPD teams? And how do y'all feel that under these new standards, the burden of technology or the role of technology shifts or maybe just sharpens? I'll chime in. I feel that technologies made survey readiness easier in sterile processing because it's replacing that panic, right? You're panicked. So now it's more visible. So under the Joint Commission three sixty continuous readiness model, we don't prepare for survey week, right? We live it. We're ready every day. So what I said before, stay ready so you don't have to get ready. That's what technology has done. So that instrument tracking system allows us to instantly pull sterilization records, biological indicator results, trade traceability within seconds, right? Asking, we can do our KPI dashboards. It lets us trend, our documentation accurately on a weekly basis. And some, I have reports that actually automatically come to me through census, on a daily basis, which is our biological results, Bowie ******. It lets me know that my staff have actually done the process and they've actually documented it. So that will help eliminate the paper documentation. So technology doesn't replace discipline. It actually makes discipline visible. That visibility builds on our confidence and it reduces regulatory risk and it shifts SPD from that reactive to reliable and ready. So that's where I feel for technology. Yeah, and I can build on that from the example Sabrina gave. At the big picture, we said at the end of the day, data is key, right? But the data only works if it's serving your process and serving your outcomes, right? And I think that's where Census and Censatrack come in. You heard us talk about the workflow and actually, frankly, for different institutions and Joint Commission expects this, your workflow is tailored to your type of operative cases, your type of processes, your type of equipment. You don't just take one process from one other hospital and drop it in. And that's where I think the key is, for example, with SensiTrack, that it's built to actually integrate with the workflow that you need for your institution and at all levels. So if you're the leader and you're trying to look at the analytics and you're trying to look back, it's key. But honestly, even at the operator level, right? Which is, Oh, if I didn't check this biological indicator, but I'm supposed to check this biological indicator, it not let you go to the next step, right? If you set it up that way. And so I think, so you can see it multiple different levels vertically, but also horizontally. Can really graft it in so that it's part of your workflow of what we were talking about. It's just part of your daily case by case instruments by instrument, tray by tray workflow. All right, team. I think with that, we're going to go ahead and wrap up today's episode. We've covered a lot of ground here today. We've covered the high levels of the new three sixty standards, what they mean for SPD teams, how we're seeing these standards play out in real operational improvements, technology deployments, right, already out in the field. So I think with our last question, we'll wrap with just a high level takeaway here. For both of y'all, what's one thing that you would say SPD leaders really should prioritize after listening to this episode? Now that they're under these new Joint Commission three sixty standards, knowing the technologies that are at their disposal, knowing the workflows that we're seeing work in practice and the updates to, you know, logging, survey preparedness. Again, what are y'all's thoughts on now under these new three sixty standards, something that SPD leaders should prioritize moving forward? I would say as an SPD leader, I believe we must move from that reactive compliance to operational discipline, which means knowing our numbers, understanding our gaps, aligning our daily practices with our standards, not when someone walks in, but because that's who we are. So this is where I believe that SPD evolves from supporting department and strategic clinical partnership. Yeah, and my big takeaway is there's actually a really good hidden gem here and it's a hidden gem that goes all the way up to the top management of the hospital. The hidden gem is when you institute these lean principles, what people find is that not only does your quality improve, your defects and your waste gets reduced, but here's the secret. The secret is your productivity goes up. And so people are like, they're trying to wind their head around that, but by doing the gap analysis and kind of understanding what's slowing you down, you can actually fix it. So I would say that the North Star here is not only are you making it safer for patients, which is the most important goal, but you can actually help productivity, which is the hospital goal. And so you have these two parallel, stars that you can navigate towards the same direction. So I think the hidden gem here is these things not only help you with Accreditation three sixty, but they can help you with productivity as well. And with that folks, we'll go ahead and wrap up today's episode. So thank you to the two of you for y'all's insights today. This was great. Again, we've been chatting today with Doctor. Ivan Salgo. He is again chief medical officer and vice president at Census and ASP. We've also been hearing from Sabrina Ford, Nevada market manager of central sterilization at CommonSpirit. Sabrina, folks wanna learn more about your work, what you're doing at CommonSpirit, or maybe pick your brain some more on best practices under the new Joint Commission three sixty standards, how can they get in touch? How can they learn more? Yeah. They can reach me by email, and my email address is Sabrina forwardcommon spirit dot org. Fantastic. And Doctor. Salgo, same question your way. If folks want to pick your brain a little bit more on some of the changes that are now live under these new three sixty standards, or they just want to get in touch, how can they do so? Yeah, actually, they can get in touch through actually the census clinical group. And if you funnel your questions to the census clinical group, I work really closely with them. I'm also happy to help and work with them. All right. Thank you, Sabrina. Thank you, Doctor. Salgo. This has been great. I appreciate y'all giving us the lowdown here on the new three sixty standards and how we operate on them moving forward. So looking forward to picking y'all's brain on future episodes here, but thank you again for the time. Thank you. Thank you. And thank you everyone for tuning in to today's episode of the consensus podcast, a census podcast. If you like what you heard and saw today and you wanna tap into previous episodes, make sure you're heading to our website census dot com. Also, make sure you're subscribing on Apple Podcasts and Spotify so you don't miss out on any of those future thought leadership convos as we continue to drill down on the most important topics shaping sterile processing today. I'm your host, Daniel Litwin, the voice of b two b, and we'll catch you on the next episode of the consensus podcast.
