Part 2: State of the Union for Sterile Processing and Technology

Welcome to consensus, a podcast from census technologies. All right, everyone, welcome into episode two in our conversation about census squared productivity. It's a pleasure to have you all along with us. For those of you who maybe didn't listen to the first episode, make sure to go back and check that out for the beginning of this conversation where we discussed a little bit more about measuring productivity in speed departments and also staffing challenges that hospitals and health care organizations are facing these days. But this in part two of this conversation, we're going to dive in and talk a little bit more about the challenges of visibility in operational processes. For speed is also going to talk some best practices for utilizing census squared and sense of track. And then finally at the end of this episode, we're going to talk about how census squared dashboards really help speed managers be a little bit more proactive as opposed to being reactive, get off the back foot, get on to the front foot. So that's all included in this episode coming up here in just a moment. Again, this is part 2 of a three part series, so let's hit it. So, Jeff, Cody, let's move on and talk a little bit about visibility and the challenges that you're running into when it comes to limited visibility into operational processes in your departments. So Cody, this is something that you mentioned a little bit earlier and I want to come back to it, is that you had suspicions about what was going on in your department, but you had difficulty validating that intuition. So a little bit about that and then yeah, that, that limited visibility aspect of what we're talking about here. Yeah so had these ideas, assumptions, suspicions about the ongoings in the Department and when they were happening. Sometimes how they were happening. And, you know, I could I had an overhead, you know, I had an eye in the sky from a standpoint, perspective. I can see what a tree moves, you know, where it's at and did exactly what type of stuff. And I can see things moving but to take. To take multiple employees, hundreds of trays and fill packs every day. Difficult to put all that data in your head just based on standpoints. I would almost argue impossible. Yeah Tony, I'm glad you asked the question real quick. You know, we can see, you know, they're building trays or we can see that are scanning at dinnertime. But there's always that gray area where there's no scans. And, you know, as leaders and decision makers, we always question those areas. It's difficult position for everyone to be in because you don't want to blame someone or accuse them of something. But, you know, you do have questions. And it's a difficult topic to address sometimes. And, you know, by having the correct scans or an S correct process points for scanning, you know, that helps a lot, too. And that's a good thing about do you have the age square, is then you can have a conversation and open conversation more easily. Yeah and you were talking about scan points and I think that's really facility specific. I've been at some facilities where it's felt like the more standpoints we have, the better. And then 70 I'm at now, that's maybe not the case. You know, maybe we don't need to scan to the drawing room every time or we don't need to scan every time somebody opens a car wash or because the work's getting done and the team seems to really. For the most part. Spread the load. And so, you know, do we want to. Do we want to be stand happy? Right and so you got to capture day. You got to capture those points. You got to have accountability. But at the same time, I want my team inspecting and assembling, not scanning. So there's. You know, there's that right number of points. And I think that changes depending on the culture and size and throughput of the Department that it's in, because I've seen both sides of that. But with when we plugged in the census r squared and we started seeing some of the, some of the imagery that come through the way that the data was presented. Just looking at that tolerance. Your question. It allowed us to make. Tweets and I think that you could use it as like a mass cleanup tool, depending on where your department's at. What your department history is, what your location at that facility is. I think you could use it to do a mass cleanup. I think you could learn if you were walking in on the job they want. And you had the tool. You can learn an enormous amount about your technicians. Your department or multiple departments. Like, just. Just literally from studying a handful of tabs. Yeah, I. If I could jump in here for a second. I just want to add on to what you were saying before I lose my sight. You know, Seamus and I were sharing a census square with one of our c-suite senior business strategists. And one of the things that he focused on right away was in the I think there's estimated time or something like that of working, you know, where it said other. And, you know, he was like an Eagle Eye and he focused right in on that other. And so, you know, my facility here we were focusing on deacons, ham scan, sterilization prep and pack. And then we're probably not scanning process points enough. So we had one site that had of under 10% other. We had another site that was around 40% other. And that right there, you know, as an experienced director or manager, you know, you focus right in on those types of things. So, you know, you good point about the scans. So you have to have the correct scans and the right information. You have to be collecting the right data. Yeah, yeah, Yeah. It's not enough just to measure it. You got to measure the right stuff. Yeah I'm sorry you had a thought. I cut you off. I'm sorry that we used it. We used it here because I've had a couple of years here, and we did a lot of clean up, a lot of improvement. In the couple of years that I've been here. We used it to fine tune what we were already doing. And there were certain. There are certain, like our saying, suspicions that I had. I thought ways that we could improve, but I didn't. The changes that I wanted to make were going to disrupt some of my employees' lives. Right and at the end of the day, you know, they're the reason I'm here, right? It's all about. It's all about. It's all about the patient, but it's also all about the employee. We're doing life together. And so before I'm going to ask somebody, hey, can you come in an hour later from now on or an hour earlier from now on? Or how do you feel if I just completely flip your schedule over, you know what I mean? Because you shameless by asking to change your schedule by two hours. Well, how is that going to affect your kids soccer games, your wife's, you know, dinner or, you know, it's going to change everything. It's a domino effect. And so I didn't want to go to my staff and just start changing schedules based on a hunch or suspense, suspicion or an assumption. And so when this data. Presented itself. And it did it in a visual manner. I'm like. Yes yes, I can. I can. I can usually see what it would look like if I moved this on to be three. I know what's going to happen. And so I took the information to the staff that I wanted to change, took the information to them, and they were all supportive. It fell in line. The people that requested the change and presented them with why they were willing to make the change on, and it yielded positive results from productivity. It raised our quality. Um, and I think we're going to talk a little bit later more about that. But it raised productivity and quality and it changed some of them. I don't want to go so far as to say it changed their feelings about work or the feelings about here. But I feel like some of them had a little bit more job satisfaction because. You know, they were. They were. They were. Less inconsistencies and they were more productive. And so when you show up to work and you do your job, and you have a good day and more productive, you feel better about doing your job. You know what I mean? I still gave you 8 hours, but I got I got two more done. And the only thing I did was, you know, I came in an hour later. I come in two hours late, but I gave you. More was basically the same amount of effort. Right if I could jump in on that. Two years ago, I had learned that, you know, you should never, ever use your instrument tracking system as a disciplinary tool unless you absolutely have to, of course. You know, there is a time and a place for that. But the main purpose of it is not for disciplinary actions, that type of thing. It's for improvement. It's for tracking those types of things. But what I had learned over a period, over a long period of time is, you know, with a tracking system, I forgot where I was going with this, but I'll work on that. Is that oh, what we did was there with our tracking system is we used it as a tool to communicate with our employees. And, you know, we showed them to the we shared in early stages, the census. I square, you know, what was being built every month. A new module was coming out and we were shown on the data and they're like, wow, we really do that much work. Well, we, you know, I can do better than that, you know. I didn't realize that person was really working that hard. You know, I thought she was kind of a slow person, you know, that kind of thing. We had folks that would work really, really, really hard for two or three hours and then just take an extra two or three hour break because they met the quota, you know, that type of thing. So, you know, one thing that we've done by sharing the data and communicating the census by square with the staff is, you know, we've actually increased our tray volumes for our assembly over 5,000 trays per month across our system with the same amount of staff. And, you know, and and we haven't really increased any resources at all. But I mean, that's huge when you really think about each employee is averaging between anywhere I guess about 23 trays on average per shift. So but just by communicating the power of having data to our staff and our leadership even has been fantastic. So and you know, when I was talking to Seamus earlier in this process, where there's nothing out there in our industry that can help us like this. So this is a pretty amazing process for us. And Jeff, you were talking about posting it for the staff to see and that absolutely gets results. Any of those even drove a little competition for some of my staff. You know, I reap the benefits of a too. But I have historically been producing my own data gathering Excel spreadsheets. And I try to, you know, do a line graft. And I'm trying to I wanted my team and my department to know what they were doing and where they were at. And so we put they were already used to seeing that they know, you know, third or fourth day of the month when the numbers are up. Let's go see where we're at. And so. When when we started working on this project. I put both. I put the work that I'd been doing, a labor intensive and I've posted the new stuff, printed it directly off, put it right inside minus and I guess new platform. Let me know what you think. Well, when you give an open invitation to staff like that, most of the time. No, no. Well, I want you to know, they almost all hurt my feelings. They don't. They like more. Instead of my bars and lines and graphs and. Well, I'm big, you know, I'm kind of a nerd. I like they're all numbers. Well, they know they like the they like the visual and even have bars and grass. But for whatever reason, they like, they like shameless version. A lot better than they did mine. So oh, yeah, that's OK, that's for sure. Because that gets all the credit for making the bars and graphs or she did that to do well. So Jeff dashboards are part of the thing that you really appreciate about census squared productivity. So talk to us a little bit about that, that dashboard aspect and also just how this program helped kind of transform you from being reactive to maybe being a little bit more proactive on the speed side. So when I got here about 14 months ago, a couple of months into it, I was added to invited to be a part of an OR optimization study. And some of the feedback that we had gotten and we commonly hear this, our industry is that speed is like, you know, it's a mess. Things just aren't happening. Well, everything was reporting and data was largely retroactive about key, you know, no notifications or alerts, patient safety reports, everything was retroactive or, you know, we weren't proactive at all. And so one thing that we had done, know, we had gone through the information and we said we need to be more proactive. You know, from my scrub tech days, you know, one of the key words was being to anticipate anticipate what the surgeon needs when you're passing instruments. And speedy was not doing that well at all either. So what one of the biggest factors they had mentioned in this study was, you know, the lack of a view. You know, we didn't have our scheduler at the time. We didn't have, you know, the OR boards and the tells our schedule boards and digging time and prep side we do now. And so we do have our scheduler. We were scanning at different process points now, so we've incorporated a lot of their suggestions. Well, actually, they don't give you the suggestions. They tell you what the problems are. It's up to the customer to develop an action plan. And that's one thing I had done with Seamus and sensus was I brought some of those recommendations from the consulting company to senses. And I think I think, you know, what we were able to develop or create as far as what, you know, the voice of what St Luke's needs actually meets, what we needed exactly what we need it. So one thing that we had realized was our existing technology had not been optimized or even built. We had no standardization of how to use what we the information, the technology we were using. So we had a lot of work to do. And, and that's why the timing was perfect on a lot of the technology that we've incorporated since then. I think that's really well put, Jeff. And just that transition from reactivity to proactivity in creating that action plan. Once you have the data in place. I think that's really, really well put. So when it comes to productivity and efficiency, issues are bottlenecks and speedy processes. But you know, what were you experiencing and what challenges were you really experiencing in your department? It's Jeff. Let's go to you first. How did you go about improving that communication and collaboration within your departments? Well, you know, you know what? somebody who was smart and I said the source of every problem is poor communication. So what I've done, you know, my know, this is true. A lot of suggestions from, you know, the c-suite, my coaches and peers here and even my staff, you know, we set up, you know, daily calls where we I meet with all my leaders for 15 minutes every morning and they present certain data to me like what is with the work in progress number of trees down is mechanical equipment all working and if it's not what's the plan staffing and those are our three primary types of things we discuss. But you know, before I have that meeting, I normally review the census square and I look for any kind of trends. Or any kind of issues. So that way I'm prepared when I get on the phone with those folks and and I have a good view or sort of like that air traffic control type thing. And that's one thing I had to express to Seamus and Beth and the other folks at sensus where I was, was first becoming familiar with this is I told them I wanted to be an air traffic controller. I wanted to be I want to sit-in front of the computer that was set up like a true automobile dashboard. I can see how fast I'm going or if I'm not going at all, how much fuel I have left in the gas tank, those types of things. So those were so those are the types of things we worked on with bottlenecks. You know, the right staff in the right place at the right time was is always an issue. The employees would always say, we don't have enough staff, we don't have enough staff, but never any solutions on how to do that. We need more staff. And that's the last thing that any leader wants to tell the c-suite is they need more staff unless you can actually prove it. So, you know, we discussed earlier about having metrics and data to prove that. So that's my bottlenecking. And since you say I squared productivity helped you find those bottlenecks right now because finding it, you know, identifying and then working through them is a time consuming process. Right exactly. So I'm. We realized as we were working through inefficiencies and ineffectiveness, we looked we observed the whole process. You know, we had manual processes that were still being handwritten, even though we had Ashwin tracking system. And we could tell that by the, you know, the census by square that we just didn't have the data. You know, we looked at our average whip, you know, for our larger size, we are whip every day was at 125 trays at one time. It was 400 trays before we had implemented a lot of this type of technology, medium sized. We had 60 trays an hour with a small slice. We had about 30. You know, one thing that we did do is we any kind of updates with the census square is we got the employees involved and they were actually able to help, you know, to decipher the data, interpret the data and come up, come forward with a lot of ideas on how to make improvements. So, you know, now what we're seeing is our whip, you know, at large sites is about 10 and small sites sometimes where 0. And, you know, am I consulting days as a speedy consultant? You know, we had and even in my lean background, you know, we had realized that, you know, if you zero out every day, which some facilities like you to zero out, it's really not cost effective because now you have site you have staff with no work to do, you know, that type of thing. And we know that the work will be coming through. So so one of the biggest advantages of having data was figuring out where we had, you know, traditional staffing. You have day shift, you have second shift and you have the third shift. What we realized, you know, is what most of us noticed just through the experience is that decontamination becomes more busy around 10 a.m., 11:00 AM in the morning, and sometimes you need split shifts and that type of thing. But just as that's happening, you have now you have your day shift going to lunch. And so that creates problems as well. So when I can see the data on a line chart where we're busiest in which area, then we can shuffle individuals around. We, we learned that some sites are busy Monday, Tuesday, Wednesday, nothing on Thursday and Friday. And Thank you, everyone, for tuning in to part 2 of our three part series on census squared productivity. We appreciate it very much. Of course, make sure to go back and check out part one if you missed that. And stay tuned for part three coming your way very shortly, you can subscribe on Apple podcasts, Spotify or wherever you get your podcasts these days. Make sure you subscribe to. Stay up to date with the latest and we'll see you on episode three.