OLD RELIABLE? Are your washers keeping up with increased throughput demands?

Instrument washers are workhorses, churning out load after load for years. Resources are always tight, so as long as your washers are doing the job, chances are you’re in no hurry to upgrade or replace them. But are your washers really meeting your needs? Would an upgrade help you do more for less, spur efficiency and ultimately pay for itself fairly quickly? Or maybe that workhorse is on its last legs and you expect to be in the market soon.

For help sorting through the sales pitches and promises, we talked to 2 experts from ECRI Institute, an independent, nonprofit healthcare research organization in Plymouth Meeting, Pa., about what factors they think are true game-changers when it comes to washers, and about some traps to avoid. If you’re thinking about an upgrade, here are 5 factors to consider.

Energy efficiency
All manufacturers are trying to be more environmentally savvy, developing more and more ways to save water and electricity. “Resource conservation is No. 1, right now,” says Debra Ann Maleski, MBA, a senior healthcare consultant at ECRI.

“You’ll see if you go to vendor websites, everybody’s going green,” says Christopher Schabowsky, PhD, ECRI’s program manager for group purchasing organizations. “The LEED (Leadership in Energy & Environmental Design) Initiative is out front, encouraging facilities to think green. It’s a big, step-by-step process, so a lot of manufacturers are trying to tailor their offerings to fit with the initiative.”

For example, some washers offer shorter cycles based on the kinds of instruments or the number of instruments being cleaned. Newer machines can adjust resource allocation accordingly and “save substantial money on operating costs,” says Ms. Maleski. Instead of running a full cycle when you don’t need to, just set the washer for a quarter load or a half load and start saving. Some automatically adjust, based on the size of the load.

LEAN AND GREEN Some newer washers can tailor water and electricity usage to the size of the load.

“Vendors should be able to document their different cycles,” says Ms. Maleski. “They should be able to tell you how much time each takes and what the volume of instruments is with each, whether it can handle 1 tray, 2 trays or more — it all comes down to efficiency.”

And keep in mind, says Dr. Schabowsky, that faster doesn’t necessarily mean better or more economical. “You might have a vendor say his machine can do a load in 20 minutes while another takes 60,” he cautions. “But the question then becomes, how big is your load compared to the other vendor. If the 60-minute load is 4 times as large, then the 60-minute cycle has better throughput.”

Another warning: Be alert when vendors say their machines use “30% less” water or “40% less” electricity. “I’d be cautious about where they’re getting those percentages from,” says Ms. Maleski. “Are they comparing new machines to much older, much less efficient machines? People like to play with numbers that way, but it all comes down to gallons of water and units of electricity. They should be able to document those.”

Instrument tracking and documentation
Newer washers, with the ability to recognize barcodes, can enhance personal accountability and ensure that instruments are actually washed and sterilized.

“If you ever identify an issue with an instrument, where something didn’t get cleaned properly, hopefully you can sequester the instrument before it’s ever used,” says Dr. Schabowsky. “And if, unfortunately, it has been used, you can identify patients and contact them to let know what happened.”

For now, barcodes are typically the key to traceability, but radio-frequency identification (RFID), which uses electromagnetic fields to track tags attached to objects, will be the next big thing, says Dr. Schabowsky. “It’s a line-of-sight issue. Scanners need to be able to read barcodes, but barcodes can wear down over time, or peel off. RFID is a more robust system.”

“RFID is going to be the big buzzword throughout the industry for tracking anything,” Ms. Maleski agrees. “Patients, beds, instruments — it’s going to be really big and very efficient.”

Throughput and footprint
Throughput is a function of how many washers you have and how fast they are. Since demand is almost always going to be increasing, and sterile processing has a finite area to operate in, consider the floor space you have. Some washers can deliver high capacity and high throughput with a relatively small footprint. If you’re using multiple washers, it’s a big advantage to be able to stack them together.

Ultimately, the faster you can get from the dirty side to the clean side, the better. “Especially in a large, high-demand facility, if you can do a load in 30 minutes instead of 60, all other things being equal, you’re going to want to go with the one that can do it in 30 minutes,” says Dr. Schabowsky. “You’re not compromising or hampering disinfection, you’re just turning things around faster.”

Open or closed architecture?
A closed, proprietary system won’t let you interface with other systems and is likely to be more expensive in the long run. Those with open architecture can accommodate other vendors’ tracking and data systems, among other considerations.

“It’s definitely an advantage not to get locked into one system,” says Ms. Maleski. “If you have the ability to interface with several manufacturers, you’ll have the ability to better match your needs.”

Keep in mind also that all washers need detergents and solutions to do the job. A vendor can’t force you to use its detergents and solutions, but the small print might require you to do so to keep the warranty intact, cautions Ms. Maleski, adding that “there’s definitely an advantage from a cost standpoint to have the ability to use non-proprietary detergents and solutions.”

Employee and patient safety
“The unsung heroes in healthcare are the men and women grinding it out in the basement and some washers have designs that are more conducive to employee safety,” says Dr. Schabowsky. “These healthcare workers know they need to be on at all times, but nobody can do that, so you want to minimize possible mistakes and the chance that they’ll be exposed to biohazards when they think an instrument is clean, but it isn’t. You never want to see employees being splashed.”

The pass-through, double-door design lets you feed instruments in on one side, and, once they’re clean, they come out through another door that opens up on the other side, improving both safety and efficiency.

“Having that tunnel for instruments to pass through eliminates splashing while going from one side to the other, which can spread organisms that might be on those instruments,” says Ms. Maleski. “It’s a way to ensure that dirty and clean instruments are always separated and it’s critically important in preventing hospital-acquired infections.”