What are the common problems and challenges faced by CSSDS today?
1. The Challenges
Central Sterile Service Divisions (CSSDs) – also sometimes called the sterile processing department (SPD), sterile processing, central supply department (CSD), or central supply – are a vital part of the surgical workflow. Here, surgical instruments are sterilized, or processed, before being packed into trays and sent to operating theatres.

CSSDs are incredibly important: they ensure that instruments are safe to use, and that the correct instruments are where they should be, when they are needed. However, these complex environments have their own inefficiencies and challenges, which can have economic and patient safety implications. Common problems can range from packing errors, malfunctioning instruments, training new staff members, identifying new instruments and, ultimately, how to process more trays with fewer technicians.

So, is it possible to run a high-functioning CSSD, while reducing costs and building a competitive advantage?

There is a tendency here for surgeons to over-order "just in case" – increasing processing costs and potentially leading to the over-filling of surgical trays, which itself often increases the risk of broken equipment.
Missing instruments cause delays in the operating room

Missing or malfunctioning surgical instruments make up 58% of surgical delays. Each lost instrument accounts for seven minutes of lost surgery time, costing an average of $259 for each delay. These delays and costs add up. In surgery, every second counts.

If an instrument is not where it needs to be during an operation – maybe it's missing, broken, or not sterilized – there are a few possible outcomes:

  • Someone might be sent to replace the missing or malfunctioning instrument

  • The operation might be cancelled if the instrument can't be retrieved quickly enough

  • Even worse, if the particular step of the surgery is vital, a patient might have to be moved mid-surgery to a different hospital

Poor inventory management

The lack of standardized processes to manage inventory, and the fact that instruments are often stored in multiple locations, makes it difficult to keep track of surgical equipment. Poor inventory management can result in lost equipment, or simply not spotting broken instruments, increasing costs and cancellations of operations. Additionally, high reliance on manual processes by CSSD technicians can introduce human errors and inefficiencies in the management of surgical equipment.

In the operating theatre, the management of surgical inventory is highly reliant on the surgeon's 'preference card', where a surgeon specifies how many of each instrument they would like for a procedure. There is a tendency here for surgeons to over-order "just in case" – increasing processing costs and potentially leading to the over-filling of surgical trays, which itself often increases the risk of broken equipment.

Track and trace technology can reduce errors in inventory management, helping to increase the efficiency of tray packing, reduce the number of incomplete trays going to surgery, and limit any associated financial penalties.

A lack of trained technicians

As technology moves on, so too do surgical instruments, with new instruments making their way into the operating room every day. Accurate identification of instruments is critical in processing to ensure that tray contents are correct and are not overpacked – however, keeping pace with this progress is not easy.

A lack of skilled staff is a real challenge for CSSDs. Training a new technician costs £7000-10000, and can take anywhere from three to six months. Retaining staff is an additional challenge, with a churn rate of 10-15%. For existing staff, against a backdrop of an overstretched and busy operating theatres regular training updates on new instruments can fall through the cracks and be deprioritized. This absence of training causes a knowledge gap and reduces staff confidence, causing mistakes, missing instruments and delays.

There is an answer…

Despite the challenges faced by CSSD and surgical teams, there are solutions powered by technology that can make CSSDs safer and more efficient. Click to read our second installment as we take a deep dive into how we can help solve some of the inefficiencies in sterile processing.

May 4, 2022