1 3 years’ assessment of outsourced sterilisation Valérie TALON - Aseptic Surgery Forum- March 26, 2010

2 The context The GHPSJ: –3 establishments in the process of merging –650 beds –All the surgical activities (except the neurosurgery) and a maternity – interventions / year A difficult economic environment due to a social plan being implemented

3 The context (suite) Why the outsourcing ? – A general policy of the hospital –To gain square meters Starting up: April JuneOctober 2006 Decision Audit Sterience : listing, codifications

4 Requirements : MD sterility and conformity of the product (1) Logistic aspect: – secured circuit: removal, transport, delivery Collection at 20:00 PM Devices handled at night Delivery at 6:30 AM – Management of urgencies and respect for delivery of supplies

5 Requirements : MD sterility and conformity of the product (2) Sterile MD : –Compliance of the contents of container with the listing –Packaging according to the recommendations of the users –Care for instrumentation: Protection of the fragile MD Check optics, engines, sharpening Greasing, maintenance An objective : SECURITY

6 Problems The quality of container packaging : ? –Listings / contents of boxes –Errors in assembling / dismantling Loss and breakage of instruments: –Disappearance of material without both parties being responsible –Breakage of fragile devices 20% incomplete containers

Problems Delay in deliveries Waste of time Stress of the surgical teams 7 Disorganization +++

Implemented actions : By the hospital Night audit on site Follow-up of quality indicators : –red seals –Delays in delivery Procedure “losses and breakage” A pharmacist in the surgical unit for organization 8

Implemented actions : By Sterience Training of the staff Reorganization of the zone of sorting reception Reorganization of the zone at the end of the washing phases for implementing a control of the instruments Revision of listings 9

Assessment of situation Variation in the amount of work Sterilisation at night Corrective measures : –Taking time to set up –No tangible impact Additional cost of nonconformities DISAPPOINTING RESULTS 10 Logistic and qualitative problems Tiredness of the teams

Outlook for the future Track and trace the instruments for 2010 Rationalization of the material Return to day treatment for part of the load resulting in improvements 11

Thanks for your attention Valérie TALON Hopital Saint Joseph 185 rue Raymond Losserand PARIS