Having a good throughput model in CSSD reduces bottlenecks, improves turn-around time, and ultimately creates a safer environment for your patients.
Below are vital inputs to helping draft a throughput model for your CSSD:
1. The average output model of OR cases by the hour.
2. The average number of instruments/trays per case.
3. The average time for cleaning and inspecting instrumentation ( by the single instrument).
4. The average cycle time of your reprocessing equipment and the capacity per cycle.
5. The staff's expected productivity by the instrument per hour in decontamination and prep and pack (usually a percentage of #3).
Utilizing the data inputs above will help you evaluate your equipment needs and staffing levels. Creating a mismatched in your production plan can lead to a need for instrument storage either by staffing or equipment. Since space is in low supply in CSSD, it is better to create a synchronized plan.
Using a years' worth of OR end times or more (i.e., the number of cases entering CSSD by the hour) will set the stage for developing your model. Tray production output in decontamination is limited to the number of sinks, cart washers, ultrasonics, washer-disinfectors, staff, and production. Matching the average number of trays/instruments from the OR to equipment and staff throughput capabilities will help you develop a balance in decontamination. Using peak periods of OR output is the critical focal point for designing your plan. Otherwise, bottlenecks will occur during peak periods. Also, having too little equipment or staff in your model at any time will develop a backup.
Using the OR input model trays/instruments per hour on a sliding production scale from the decontamination area will help you design your Prep & Pack, staffing model. The sliding scale includes equipment and staff throughput capabilities and equipment cycle times so you can predict when the first instrumentation will be available in the Prep & Pack area. Critical issues in prep and pack, like decontamination, are staff and equipment, and equipment, in this case, is workstations. If you have too few workstations to meet hourly volume, you again will need to create storage space for the overflow of instrumentation. This will also shift the production output over longer hours and create a need for staff at later times of the day. Lastly, it also reduces the availability of instruments for emergencies and case cart development.
Duplicating the efforts above using productivity expectations and the staff's output in prep & pack will help you forge a model for your sterilization area. Production by the hour and your sterilizer's volume capabilities (i.e., carriage volume and cycle times) should establish equipment needs and staffing. Don't forget about the need to have staff not only load sterilizers but unload and move instruments to storage areas.
Synchronicity is key to productivity.
Graphing out your model gives you a visual to help you plan your schedule staffing plan. It will also help you find out quickly where your deficiencies are.
At Evolved Sterile Processing, our consultants have a greater focus on sterile processing. With our decades of experience, we will help you develop better processes and educational resources for your staff.
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