Stringer Things: The 1980's Called & They Want Their Count Sheets Back

The Demogorgon, Mind-Flayer, and Hopper.

Specialty neuro instruments for Dr. Johnson's accessory tray, right?

Well, not quite. But how would you know? If you saw those names listed on one of your paper count sheets out of that ugly gray filing cabinet in the corner of your Sterile Processing department, how would you figure out whether it's is a joke or the custom name a nurse from 30 years ago gave to their favorite set of aneurysm instruments? In this case, your addiction to Netflix and pop culture would save you. But what about everyone else? And honestly, what's the real harm of paper count sheet management and rusty filing cabinets?

The Upside Down World of Paper Count Sheet Updates

If you live in the world of paper count sheets, you know this process all too well. Some eager staff member makes fifty copies of the Minor Procedure Tray count sheet and dutifully files them away in the second draw from the top. Over time those fifty copies end up landing inside various sub folders, cubby holes on assembly tables, and stacked inside someone's locker in the basement. No big deal...yet. Then one day you get a call from Dr. Agarwal's surgical tech, asking for you to add another set of forceps to this tray because the surgeon wants more atraumatic options during his procedures.

Easy enough, right? You catch the five sets of Minor Procedure instruments, add the forceps, print off a new updated count sheet, and all is well. Or so you think. One week later, while you're enjoying your day off with your friends at the Starcourt mall, you get a call from the hospital. Dr. Agarwal is livid. "One forcep!" he screams. "You can't get one forcep added to my tray?!" After you talk him back off the cliff, you assure him that when you get back to work tomorrow, you will find out where the breakdown in the process occurred.

What went on with the Russian Forceps?

As soon as you hang up the phone however, you have a sneaking suspicion about why his trays were missing the newly required Russian forceps. Somehow, one of those original fifty copies of the paper count sheet must have made their way back into circulation. So when one of your team members grabbed the tray, it was assembled under the old count sheet -- without any Russian forceps. Now you're confronting one of the overarching challenges with paper count sheet management in general: an inability to easily, and consistently, update all versions of instrument data at the same time.

But broken update procedures for count sheets is only one implication of this manual process. Misspelled instrument names, unorganized and non-standardized stringer orders, hand written notes, scratch-outs and rewrites, and the inability to link to manufacturer instructions for use (IFUs), are just a few of the everyday challenges that technicians face with a paper count sheet assembly process. Once a single copy makes it way out of the filing cabinet, it can roam around for weeks, months, or even years, just waiting to cause havoc with a particular tray – frustrating surgical teams, and even putting patients in harm’s way.

Suzie, do you copy?...Please, stop!

Ultimately, this is not just a story about the Hawkins Community Hospital and its unique struggles with surgical inventory management, Sterile Processing workflow, surgeon satisfaction, and patient safety. This is the experience of large numbers of ambulatory surgery centers, rural hospitals, and even larger healthcare facilities who have not made technology investments in SPD since the Cold War. Instead, we ask Suzie, our frontline Sterile Processing technician, to attempt to hold the complexities of the entire surgical instrument world together for us by making copies of paper count sheets -- the same way she has for the last 30 years.

There is a better way to keep the Russians in their place and hold the Demogorgons at bay. With simple investments in instrument management technologies, you can leave the 1980's behind. Giving your Sterile Processing team the tools they need to save the world and better protect your patients.

And that's one ending we can all agree with.

Greer Chambers