The market for healthcare services is rapidly changing; consumers are savvier, competition is fierce, and laws and policies governing the market are in a near-constant state of flux. Such pressures have forced healthcare leaders to think differently about the organizations they lead and identify creative solutions for increasing efficiency, improving quality, and cutting cost. Most recently, one such solution gaining momentum in healthcare systems throughout the country is relocating ancillary operations, specifically sterile processing, to offsite facilities.
Relocating sterile processing operations to a centralized offsite facility, whether owned internally or operated by a third party, is a rapidly emerging trend. While some systems have already successfully implemented offsite processing, many others are actively considering a move, citing benefits such as increased efficiency and equipment utilization, improved regulatory compliance, enhanced quality, decreased processing cost, and opportunities for new revenue generation in the recovered facility space. However, the move to an offsite facility also comes with risk. From a clinical perspective, one must be concerned about infection prevention, quality assurance, and availability of instruments and supplies at a moment’s notice. From an administrative perspective, there are issues related to transportation, compliance, inventory management, operations planning, and other crucial supply chain functions.
Unfortunately, there is no easy answer; the case for offsite sterile processing is unique for each hospital and healthcare system. The best offsite sterile processing operations are engineered solutions—facilities sized and designed to meet the dynamic needs of the healthcare systems they serve. Too often, leaders simply view offsite facilities as a “silver bullet” for space constraints within the four walls of a hospital. If footprint reduction is the key motivator for creating an offsite facility, then proceed with caution. The reduction alone will likely not be enough to justify a move off site. Instead, consider the following eight factors to determine if an offsite sterile processing facility is right for your organization.
Offsite Sterile Processing Readiness
1. Demand for processing
In general, offsite operations make the best business case when demand from multiple facilities can be combined for processing (e.g., a hub and spoke model). However, that is not to say that offsite operations are limited to large healthcare systems. Partnerships between multiple hospitals, surgery centers, etc. are not unheard of when considering offsite operations, although they can introduce their own unique complexities.
2. Geography and transportation requirements
Systems with a compact geographic footprint are often better suited for offsite operations than those spread over a large area. Time is of the essence when collecting soiled instruments and delivering sterile material to clinical staff. As such, transportation systems must meet the required service criteria and be well managed. The expense and expertise associated with operating a successful transportation system must not be overlooked.
3. Data integrity and process standardization
Visibility to accurate, near real-time data is a must. Reliable item masters, preference cards, tracking data, etc., should be available prior to moving operations off site. Without access to reliable data, successfully managing an offsite facility is nearly impossible. Furthermore, standard processes and systems are required to ensure the offsite facility can effectively interface with its onsite counterparts.
4. Inventory management and service level
Balancing the quantity and location of inventory within the system is a crucial aspect of offsite planning, and one that must not be overlooked. Offsite operations may require a net increase in inventory to accommodate longer processing times, as well as transportation time. Availability of instrumentation and supply when needed, often referred to in the industry as the fill rate, must be nearly perfect to ensure success. A robust inventory management system is vital.
5. Clinical environment
Any offsite operation must be designed to complement clinical operations and improve outcomes. Systems with a significant volume of predictable, elective procedures planned far in advance are typically the best candidates for offsite processing. On the other hand, hospitals such as academic medical centers that see frequent emergent cases or highly complex procedures are not as ideal because they must often retain a significant processing and storage capability on site, thereby diluting the business case for an offsite facility.
6. Supply chain expertise
Running an offsite sterile processing operation means not only managing the processing engine itself, but also managing transportation, inventory, etc. While some health systems have individuals with these skills in house, many do not. Experience indicates that the most successful offsite projects have strong leadership who have, or are willing to obtain, supply chain talent. Running a successful offsite facility is a full-time job and should be treated as such.
7. Integration with a strategic vision
The rise of consolidated service centers (CSCs) has had an important impact on offsite sterile processing operations. The business case for offsite processing, coupled with that for other ancillary operations like supply chain, equipment storage, pharmacy, clinical lab, etc., is often more compelling than that of sterile processing alone. It is important that leaders consider a broader strategic vision to include future centralization of shared services, acquisitions and mergers, etc.
8. Buy-in from leadership
Buy-in from all levels of leadership is crucial. If key players are not on board, moving off site is not likely the best course of action. However, it takes more than executives and senior management to make the offsite operations run efficiently and effectively. It is prudent to identify a project champion and involve key leaders from the OR and sterile processing department early in the process. If buy-in from end-users (e.g., nurses, surgeons, technicians, etc.) is lacking, experience suggests the outlook is dim.
If effectively analyzed, the eight factors presented above should lead to more questions than answers—and that is a good thing! Offsite operations are complex, multifaceted systems that require thorough analysis and planning. It is crucial that healthcare leaders consider each facet carefully. Offsite operations have unique challenges that make the planning and design process fundamentally different from designing an onsite operation. Not only does scale necessitate a more detailed approach to facility layout and equipment planning, but it also requires prudent consideration of advanced technology, transportation, inventory management, and long-term strategic plans with regards to growth, real estate, and finance. That said, complexity need not be scary. The potential benefits of offsite processing can be realized when facilities and processes are engineered to meet the needs of the hospitals and healthcare systems they serve.
