PERSONALITY PLUS Reps can be gregarious sorts who know how to capitalize on the relationships they develop with surgeons and staff

Sales reps might have the same goals as you do — great patient outcomes, pleasing surgeons and making money — but that doesn't mean they'll follow the rules when you let them behind closed doors. Here's how to ensure that they do just that.

Demand professionalism. Expect reps to understand and follow such core competencies as HIPAA requirements, bloodborne pathogen guidelines, infection control basics, fire safety and aseptic technique, to name a few. Are they adequately trained or are you making assumptions about their knowledge of surgical protocols? Do you monitor their behaviors to ensure that they act accordingly around your staff and surgeons?

Prepare folders containing your policies and procedures, and have them sign off that they've read the contents and agree to follow the rules before being allowed in the ORs. Outside credentialing agencies that provide vendor education, liability insurance, vaccine verifications, drug testing and more can do the heavy lifting for you (see "Vendor Credentialing Services"). Some reps are required by their companies to undergo such credentialing at no charge to your facility.

Get loaners on time. Preview your case schedule and plan ahead to ensure reps have enough notice and time to get all loaner equipment and implants to your facility the day before they're needed in surgery, so your staff has enough time to reprocess them properly. What about reps who continually test your 24-hour policy? Some facilities in my area have decided to fine them $100 whenever equipment's delivered on the day of surgery.

If a rep truly does all he can to get an item delivered on time, but can't get it done — and it's not another last-minute delivery that's quickly becoming a trend — do what you can to get the device ready for the case in which it's needed without shortcutting proper reprocessing. Of course, you should never run implants — which are often brought in by reps — through immediate-use sterilization cycles. And remember that handpieces need time to cool before they're used; a surgeon or patient can be burned by a handpiece that a rep tries to rush into the OR.

Ask for quiet. You want reps to stay as quiet as possible in the OR, but you also understand that other facilities might need access to them when questions arise about how their devices work — just as you'd want them immediately available to your surgeons when they're visiting elsewhere.

Reps shouldn't talk incessantly on the phone in your ORs, but they also shouldn't be in and out of the room to take calls in the hall (increased traffic increases infection risks). Consider giving reps 2 warnings for phone use before banning them from the OR. We ask ours to limit outside communication to sending and receiving texts. So far, that policy has been effective in limiting excess noise during our procedures.

Limit socializing. Reps obviously have excellent social skills and excel at building relationships with your surgeons and staff. But when reps befriend the surgical team, its members might cover for their bending of the rules and you lose some of your ability to manage their access to the OR.

Do your best to limit after-hours socializing between reps and your staff — reps shouldn't attend team-building gatherings paid for by your facility. Remember, too, that social events sponsored by reps must include some form of education, and they are limited in how much they can spend on such occasions. Alert a company's management if you feel their rep is often stepping over the line of appropriate social behavior or hosting events that violate guidelines in place to curtail undue financial influence on the products your surgeons and staff prefer to use.

Track supplies. Reps often deliver supplies you've purchased from their companies, items provided on consignment and supplies loaned for the day. They also often feel entitled to enter storage areas to check on their supplies or even take a surplus from your stock to bring to another center in need. That's all well and good when they own the supplies (those given to you on consignment from their companies), but what happens when the line gets blurred between who owns what, and they borrow your items to take to another facility with the idea of replenishing your stock later? (Never mind that sometimes you end up storing a rep's "junk" that you don't need or won't ever use.)

To avoid confusion and to keep a close watch on your supplies, establish a policy that reps cannot enter supply areas without being accompanied by a staff member. Also make sure your materials manager approves all items reps take out of the building and credit to your center.

Friendly reminder
It's important to point out that many reps respect facility leadership and will bend over backward to get last-minute supplies or equipment if you're caught shorthanded. Some just get too comfortable and, when they do, you have to remind them that they're guests in your facility — not on your payroll.

RELATIONSHIP ADVICE
Staff-Rep Rules to Work By

TEAM PLAYERS Sales reps can explain how complex instrumentation works.

You should:	Sales reps should:
Never let reps touch patients or take part in procedures in any way. Ensure reps don't bring in unapproved equipment. Clearly establish where reps are allowed to go, and where they're not. Review equipment training conducted by reps, and hold staff accountable for what they learn. Educate staff on the policy of what gifts they can accept from vendors.	Know your facility's rules and never abuse its privileges. Always follow core competencies. Understand your staff, surgeons and the procedures you host. Always be on time. Always be prepared for the cases they're involved in. Educate your staff on the ethics of their financial relationships with your center.
— Lisa Moschkau, RN, BSN, MASL