OR Manager March 2022 - 17

Human Resources
BY ANGELA LEWELLYN
Acclimating to OR, sterile processing department cultures
he differences between sterile
processing (SP) and OR tasks
and department cultures are significant.
However, they share a collective
goal: both work toward the best
outcome for every patient. Still, both
departments often suffer from having
unrealistic goals for each other.
One example is that the OR may expect
instruments delivered faster than
SP can provide. Or SP may expect the
OR to be able to wait for instruments,
not understanding the OR's urgency to
fulfill immediate patient needs.
In this article, I will share some insight
into the cultural differences
between the two departments to understand
each other's approaches to
patient care, thus easing the division
caused by these expectations.
T
Understanding the value of
culture
As a cross-trained OR circulator and
surgical technician who transitioned
to sterile processing, I quickly realized
the sharp differences between the two
environments. My only experience and
communication with SP prior to my transition
were calling for the next case
cart for my team's procedure. I did not
fully grasp the labor-intensive efforts
taken by SP to complete my request
for the instrumentation needed. And
looking back, I realize that lack of understanding
was odd. Both teams work
closely toward the same goal, which is
ultimately quality and patient safety.
To that end, shouldn't we understand
the science, technical skills, approach
to patient care, and culture of either
department?
According to Steve Todd from OpenSourced
Workplace, " Culture is the
character and personality of your workplace.
It's what makes your business
unique. " Todd continues, " [Culture] is
the mix of your organization's leadership,
values, traditions, beliefs, interactions,
behaviors, and attitudes that contribute
to the emotional and relational
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environment of your workplace. "
Culture determines our approach to
teamwork and to the communication/
collaboration that leads to our commitment
to excellence. Our learned processes,
procedures, and collaborative
work ethic are all factors that affect our
approach to problem-solving.
Different perspectives: OR
versus SP
The OR's experience of serving each
surgical case has a different lens than
SP's approach to helping the same
case. Many OR managers and leaders
are well informed of processing steps
taken to produce a clean, sterile, and
complete tray of instruments. It benefits
both departments when SP's perspective
and service approach are well understood.
This aids communications
and supports real-time expectations
from each other.
The OR culture is meeting immediate
needs. When undergoing procedures,
the approach to problem-solving in a
fast-paced environment is focused on
direct patient care. The OR team often
has a " make it happen " approach. This
is understandable considering the time
constraints and accountability to the
team and the patient.
OR teams work closely together
daily, adapting to each other's personalities,
characters, and work ethics.
Working elbow to elbow, they adjust
and have immediate oversight for solving
case challenges. Each has specific
tasks-from opening the room through
the entire procedure-and their duties
vary. For example, when opening a room
and preparing for a surgical case, the
circulating nurse works hand in hand
with the surgical technologist to open
items aseptically and possibly count
instruments.
If challenges arise during this time,
such as when the instrument tray is not
present or if the tray is missing items
needed, the circulating nurse will usually
call SP to gather them. At the point
of prepping for a case, there is no time
to review the problem or determine why
the items are missing. The OR team
must work immediately to retrieve the
items needed and correct the issue.
To ensure corrective actions are
taken for a sustainable resolve, the
team is usually required to work outside
their scope. If the OR department does
not have a designated service leader, it
exposes the team to an extra layer of
energy and time spent. Although, many
times, the team is supportive when creating
solutions to ensure uniform care
moving forward, this causes additional
strains for the team.
The SP culture is process thinking.
SP uses a task-driven linear approach
and seeks to look at the bigger picture
to review the process as needed. Unlike
the OR, they are siloed when performing
duties. Technicians performing preparation
and packaging duties are dependent
on decontamination technicians to
clean and disinfect instrumentation. If
mistakes are identified later in assembly,
the manual and mechanical process
does not allow immediate remedies.
Quality checkpoints are performed
much like a manufacturer. For example,
the quality of work is evaluated by the
technician performing the second step
in the process of the tasks performed
in the first step by a separate technician.
Each part of the process usually
has an assigned team member, and in
the assembly stage, the team member
signs their name to the item. To remedy
a misstep is a longer process.
Suppose an instrument opened in
a surgical procedure is identified with
bioburden. The SP team can trace the
item/tray back to the day it was processed
using a load/lot sticker. The
department leader can track items to
personnel in the decontamination area
and even to the assembly area, where
the team member performed quality
checks for bioburden. Once followed
Continued on page 18
OR Manager | March 2022 17
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OR Manager March 2022

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