TURNAROUND Frustrated OR customers are a sign that all is not well with your sterile reprocessing department.

Tacked to my office bulletin board is a printout of a frustrated surgeon's email, his scathing words highlighted in neon green. "I don't say anything because it is expected sloppiness from sterile processing."

Expected sloppiness. Words I never want to forget.

That was the perspective of this surgeon concerning the team of technicians laboring to decontaminate, clean, inspect, test, package, sterilize and transport his surgical instruments.

This was a customer who had lost faith in the product, who'd been failed one too many times and who'd written off any hope of improvement. Kind of like that one fast food restaurant that you swear you'll never go back to because they don't understand the definition of "fast," they constantly get your order wrong and they always forget to give you napkins. And who could blame you? Poor quality and service should never become the norm. You should never expect sloppiness — let alone stand for it.

Not-so-great expectations
Many sterile processing departments have failures in their past that loom large in the memories of their customers. You got 999 trays right, but the instrument missing from last week's case was the one that caused the blip on the OR's radar and created the Monday morning hub-bub.

You have customers who have lost faith in your ability to ever "get it right." And yet they remain your customers. Unlike in the real world, your perioperative team can't just walk across the street and get the kind of quality and service they want. In a sense, your surgeons and staff are a captive audience to your reprocessors' process improvement journey — and when that process fails, they add it to the list of reasons why "nothing will ever change."

But your reprocessors don't have to be defined by their failures. Even though the frustrations might be from past mistakes, there is still an opportunity for your reprocessors to chip away at the culture of failure and set a new course for the future. Here are 3 ways they can get started.

1Own the failures up front. It can be scary to own the failures confronting your department — especially if you don't control all the variables (low staffing, insufficient equipment, knowledge silos) or if the problems are rooted before your time in the department. Either way, your CS/SPD leader should let customers know the buck stops with him and his team. He doesn't have to make unrealistic promises or throw himself under the bus for no reason, but the first step to service recovery is demonstrating he takes responsibility for failures. This is key to rebuilding the bridge between the OR and SPD.

2Shield your frontline technicians. There's a reason that surgeon's angry email is tacked up in my office and not the department break room. Some feedback isn't well suited for public consumption or encouragement. The SPD leader should be willing to "take the heat" for the department's process failures up front, and then repackage those process lessons to engage his frontline staff for solution-oriented conversations. Nothing kills a CS culture quicker than a fear-induced follow-up to process failures. Instead, commit to protecting your techs, cast a vision for continual improvement, recognize the wins and then highlight the victories.

3Celebrate your improvements — great and small. Because you're trying to change the culture, it's critically important to highlight each improvement as it happens on your team. Publicize that "something is going on" in the CS basement. Are your technicians getting certified? Send a recognition email to your surgeons. Are you adding labels to your storage racks? Give a 5-minute update at the weekly OR meeting. Find ways to drown out the naysaying and recover the interest of those who may have tuned out of your department news. Surgeons and the OR team need to see and hear that the CS department is, metaphorically speaking, "Under new management!"

Your true colors
In the world of Sterile Processing, you rarely get the opportunity to build your reputation or the reputation of your departments from scratch. And even if you could, because mistakes are part of human nature, your CS/SPD techs will have to overcome a process failure at some point in their professional experience. But those failures should be seen as the exception, not the rule — in the eyes of your teams and your customers. They are opportunities from which to learn.

So, if you feel like your department is locked in a culture of failure, don't lose hope. Don't believe that you cannot change and improve. You may have surgeon-customers who expect sloppiness from your team, but that is your opportunity to surprise them with excellence. Own the failures, engage your team and advertise your improvements. OSM