At a time of falling budgets and ever increasing scrutiny, can the NHS and other healthcare providers afford to waste time looking for missing medical instruments?
According to a BMJ Quality Improvement Report published in 2015, “poorly organised clinical equipment can waste significant amounts of time otherwise available for direct patient care.” At a time when the NHS and other healthcare providers are under increased scrutiny and are operating on ever tighter budgets, it is evident that new efficiencies and processes are needed.
This problem is not a new one nor is it insubstantial. According to a 2009 survey by Nursing Times, “more than one-third of nurses spend at least an hour finding items of equipment during an average hospital shift.” This could mean that nurses spend up to 40 hours per month looking for equipment with which to treat patients. Why is this?
At its root, this problem stems from organisation and communication (or lack thereof), exacerbated by high demand on both services and the specific equipment required. The storage areas where much equipment is kept have also been found to be often cramped, overcrowded and not sufficient for their purpose.
The BMJ Quality Improvement Report came to six conclusions on how the problem could be tackled. The main observation was that store rooms created more confusion and delay than benefit, and the problem could be solved in part by ensuring that equipment was kept on portable, uniformly arranged trolleys in wards and theatres:
- Multidisciplinary engagement and ownership: It’s important that trolleys that hold the equipment are appropriately stocked for the wards they are on, and that people are aware of differing equipment for different specialities. Ownership of each equipment trolley needs to be taken by a specific ward or person to ensure it is properly stocked.
- Uniformity: Each equipment trolley should be laid out in the same way, so healthcare professionals such as nurses and doctors know exactly where types of equipment are stored on a trolley to speed up retrieval.
- Co-ordination and leadership: There needs to be overview of and leadership for medical equipment and medical equipment trolleys overall. This will ensure co-ordination and periodic review, to build in continual improvement.
- Importance of data: Data about time-keeping and equipment needs to be effectively and efficiently logged if improvements are to be measured and assessed. In turn, the data has to be valid if improvements are going to be achieved.
- A can-do attitude: Staff need to buy into and support the improvement process, so they can see the benefit for themselves as well as the patient in seeking to optimise medical instrument management. A positive attitude will guarantee success.
- Listening to feedback (good and bad): Effective medical equipment management is a continual process, and all stakeholders have feedback that needs to be considered and listened to. This will reinforce staff’s sense of own worth as well as providing vital insights into how medical instruments can be co-ordinated between practitioner
There are also technological solutions that could help healthcare professionals in locating equipment. Standardised barcodes as well as transmitters for large items of medical equipment are already used in hospitals, but these are only effective if staff are properly trained in the use of such technology and the approach is uniformly adopted across an institution.
Pelican Feminine Healthcare products are barcoded and labelled to comply to GS1 standards. This enables product and location synchronisation throughout the Supply Chain. Early adoption ensures we are already aligned with NHS investment initiatives such as “Scan4Safety” and “PEPPOL”, all in line with the recent ‘Carter report’ recommendations.
Whether the solution to missing medical instruments lies in process or in technology (or both), there is also scope to discuss whether such practices could be introduced across medical institutions, becoming a standardised, national healthcare discipline.
Of course, disposable, single-use medical instruments offer many benefits directly if effectively stored and distributed. Such instruments have not been used before and are designed not to be used again, so medical instrument management is streamlined. Concerns about whether a reusable instrument has been sterilised by an autoclave or other process are rendered redundant, as is ensuring instruments have been sterilised and returned after a procedure. Single-use instruments also offer an ironclad insurance against cross-contamination between patients.Pelican Feminine Healthcare offer a variety of single-use medical instruments that are focused on gynaecology, obstetrics, sexual health and women’s health in general, and we fully support any initiative that ensures that medical instruments are effectively and efficiently managed in a healthcare environment.