3 Steps to Heal Your OR/SPD Divide

The inherent complexities of instrument processing and the daily pressures for processed instruments can create an endless cycle of professional conflict. Left unchecked, such tension between the OR and SPD creates a toxic work environment that is contributing to staff shortages on both sides.

We wondered, is there a way to heal this divide?

To learn more, we watched Malinda Elammari’s, CST, CSPM, CSPDT, CFER, CSIS, CRCST, CIS, CHL, CER, CLSSGB talk from AORN Expo 2022, Bridging the Great Divide Between OR and SPD, and then called her up to see what advice she could share with readers.

“The short answer is, yes, we can heal the divide,” Elammari reassured us.

As a former surgical technologist turned sterile processing professional with Healthmark Industries, Elammari sees both sides of the conflict. She says the underlying causes for the OR/SPD divide aren’t about instruments, but about communication breakdowns and a misunderstanding of roles about the actual work being done in each space.

Leadership must create a foundation to bridge this divide, she stresses. “When leaders from the OR and SPD can model collaboration and open communication between the departments, this creates a pathway for strong lines of communication between staff.”

Once OR and SPD leaders have opened the door for collaboration, Elammari suggests these three helpful actions to help staff improve workflows and reduce conflict.

1. Get to Know Each Other

Building professional-personal relationships makes people more likely to talk about the challenges they face with instruments in their practice, whether it’s pressure to maintain the OR schedule or pressure to ensure all reprocessing safety practices are followed on the SPD side, Elammari explains. “Getting both sides talking also creates common ground—maybe it’s even a shared love for cats. Once you can connect with someone on a human level, you are more likely to pick up the phone and ask the ETA of an instrument set, rather than getting angry when it’s not there yet.”

2. Walk in Each Other’s Shoes

Once OR and SPD professionals get a chance to know each other, set up a professional learning experience that allows the SPD professionals to see first-hand what pressures OR nurses are under and how they approach point-of-use instrument treatment. Then have OR nurses follow a used instrument set from decontamination through the complete reprocessing process. “This can create so many ‘Aha’ moments for each side, especially for OR staff to see how correct point-of-use treatment prevents additional time in decontamination and potential instrument damage that could lead to lower instrument inventory.”

3. Create a Schedule for Instrument Turnaround

In this approach, the OR clearly communicates when they need instruments back, making sure to accommodate standard processing time, Elammari says. “On the flip side, SPD should establish communication methods to update the OR on the status of the instrument set, which in turn will relieve pressure on the OR side to know they will have what they need for the upcoming case.”

Sustaining these lines of communication is key, especially as staff turnover is an issue in today’s world, Elammari stresses. “Leaders must continue to foster shared understanding and collaboration between all professionals handling instruments. When they do this, it’s patients who are the ultimate winners.”