If you’re a Perioperative leader or a surgery coworker you’ve had the challenges of missing instruments. You arrive at 6:45 in the morning preparing to set up your case. You pull your pack, supplies, and instrument sets off of the case cart. There are several scenarios that can happen next:

  • The instruments are not there

  • Certain instruments are missing

  • The instruments have not been sterilized

You start on the morning hunt to find the things that you need all under a time constraint of that 7:30am start. You call down to sterile processing and they don’t really know what happened to your instruments even though they were the last department to see them.

The surgery staff has patience the first couple of times as the team attempts to communicate. The sterile processing department often experiences intimidation and are fearful of the surgery department. This type of relationship is not beneficial for either department. Each department leader knows the problems, but might not be sharing the problems with each other in a constructive manner.

How can these departments improve relationships, communication, efficiency, and service? 

It starts by working together to form a collaborative relationship, and seeking to understand each other‘s point of view.  Making assumptions that we know what the problems are without collecting the data to support the collaboration is simply speculation.  What we find when we investigate the issues are the real barriers that are present in our department’s daily work.  Our teams are just trying to do the best job they can with minimal resources and limited education opportunities.

Collaborative Team Huddle : Easy to implement and Facilitate best practice

The collaborative team huddle is an opportunity to bring the key stakeholders from various departments together for a daily conversation.  The huddle is a gathering of formal and informal leaders at a specific time each day to reflect on the prior day’s events and plan for the next day’s events. The huddle topics are patient focused, which is intended to improve patient care.  These huddles are led by the department leaders when getting established and then transferred to others frontline members of the team. The rotation of huddle leadership promotes development for the team members and gives an opportunity for mutual SPD and OR needs to be discussed in a safe, controlled environment.

To set up the daily huddles, state the mutual department goals. Common metrics in the surgery department would be things like first case on time starts, reduction of turnover time between cases, and reduction of immediate use sterilization.  Sterile processing metrics often include the reduction of bioburden, reduction of wet loads, and reducing delays related to instrument availability.  The collaborative goals should be posted for the departments to reference over time and track improvement. This type of intentional collaboration starts with understanding of expectations and grows over time into greater levels of trust, respect, and communication.

In completing your collaborative huddles, consider creating a tracking sheet, which can be used to document a summary of the conversation, follow up action items, and successes.  The tracking sheet can then be posted in a centralized location for key stakeholders to access and review, if needed.  It is best if your team focuses on one targeted issue at a time until the OR/SPD team gets into a rhythm of working together and you are able to build on small successes.  Your team might find there are issues that are considered a “just do it”.  The “just do it” are things that your team can change right away. An example of a “just do it” is collecting the count sheets with notes to organize into topics that become huddle topics.

The implementation of a collaborative huddle into daily practice can quickly become part of your department’s standard work just like morning report and can ultimately improve patient, coworker, and surgeon satisfaction. If you have ever had one of those early morning challenges related to surgical trays or late night stressors in preparing for next day cases, brining your OR and SPD teams together for regular huddles might be a great start to improving this process, and hardwiring collaboration in the name of patient safety.


Author: Emily Tchiblakian, MHA BSN RN