Instrument management systems move beyond tracking level - Products & Services

Healthcare Purchasing News, Jan, 2004 by Julie E. Williamson

A central service department returns a loaner orthopedic instrument set to the manufacturer only to have the company claim the set was never received--a mishap that cost the facility $60,000 in replacement expenses. A sterile processing team hunts for a tray that appears to have never made it back from the operating room, and the department still has yet to locate a hemostat that has long been sent out for repairs.

Think these are just unfortunate scenarios of some negligent, disorganized central service department? Think again. Such occurrences take place every day in facilities across the country, and for many, the age old challenges of instrument tracking have yet to be overcome.

"Instrument accountability affects virtually every hospital," says John Basch, vice president of Cini-Little Schachinger LLC, Rockville, MD, a consulting firm specializing in materials management, central service and waste management for healthcare. "Without effective asset management [practices], instruments can easily become lost or misplaced. It's a common--and very costly--problem."

Indeed. It's estimated that only 10-20 percent of facilities have automated systems in place to effectively identify and track instrument inventory, despite the high cost associated with loss and inappropriate inventory levels, which Call account for as much as 30 percent of a facility's total instrument budget.

The good news is healthcare facilities have more options than ever when it comes to instrument management. Today, numerous software vendors offer cost-effective solutions that can precisely track instrument, equipment and case cart location, integrate with materials management and perioperative automation systems to monitor repairs and identify appropriate inventory levels, and even track instrument sets throughout the decontamination and sterilization cycle.

"With this technology, sterile processing departments now have the power to know their inventory and see what they actually have invested," said Peter Huck, general manager of Key Surgical Inc., Eden Prairie, MN.

"When you have a clear picture of inventory and can follow instruments and equipment throughout a facility and across different processes and cycles, you can reduce the likelihood for instrument loss and damage, and maximize efficiency and resources."

Scanning the options

At a more basic level, sterile processing departments call use instrument management systems to track the location of instrument trays throughout the facility and eliminate tedious paper-based systems through electronically managing count sheets. The value of such a task becomes clear when one considers a typical 300 bed hospital has between 500 and 750 different tray configurations and can easily carry up to $3 million in instrument inventory.

To facilitate the process and enhance efficiencies, many vendors are implementing barcode technology that allows departments to scan trays, containers and case carts at various points of receipt and use, as well as check on the status of specific instruments with just a few simple key strokes, Instrument manufacturers are also offering sophisticated tracking systems. Pilling Surgical, Horsham, PA, has designed software for a cordless handheld scanner to track instrument sets and equipment from storage to the OR and back through sterile processing. Aesculap Inc., Center Valley, PA, offers three instrument management system components that can track assets, streamline sterilization work flow and monitor and optimize instrument set utilization.

Fort Sanders Regional Medical Center in Nashville discovered the value of automated instrument tracking firsthand after implementing a system in 1999. Since then, the 400-bed facility has learned to maximize the solution's value by tracking loaner trays from vendors, standardizing trays and identifying lost or unused equipment.

"We wanted to do more than just use the system for count sheets. We began running reports to see where items were in the system and what we actually had available. Thai was very helpful because we are part of a five hospital system and have to process a lot of instruments," said Fort Sanders' sterile processing manager Donna McLaughlin.

Last year alone, Fort Sanders' 21 full-time CS technicians processed more than 126,000 sets and nearly 16,000 pieces of equipment. The department handles processing and equipment needs for the entire facility, including 16 operating rooms.

"As a result of a neuro standardization project, we were able to put 126 pieces of instrumentation back into the system, which totaled approximately $8,800," she continued. "And we know there are many more opportunities for improvement."

A boost from barcoding

New barcode technology is now making it possible to track down to the individual instrument level in real time--a feature that can prove particularly useful for tracking loaner items.

By providing labels that are laser-engraved with a two-dimensional bar code that can be applied directly to an instrument, Key Surgical has made detailed tracking a reality. The company's product, called InfoDot, works like a license plate, linking a specific device to its own unique data file. Each time the instrument is scanned, a date and time stamp tracks the item at each point in the cycle. The "lift and stick" labels have been designed to last one to two years, depending on usage, and work in conjunction with a facility's software application, providing a cost-effective way to track at the detail level.