Success Story: Allegiance Health and Midbrook Medical
Taking instrument washing by storm
As the Central Sterile Processing Manager for Allegiance Health of Jackson, Mich., Phil Tilford is responsible for cleaning and decontaminating surgical instruments for the OR.
We process around 6,200 surgical trays a month, Tilford says, and that doesn’t include single devices.
Tilford also estimates that his staff probably cleans anywhere from two to three million instruments by hand for approximately 10,00012,000 surgical cases annually.
We sterilize; we do our decontamination; we do the assembly, he says. We do the storage. We set up the case carts for the OR. We order their supplies. We want to have everything there, sterile, and ready to go.
Their job is to do the surgery, and our job is to do everything else up to that.
It’s a dirty job, and it isn’t getting any easier. As surgical instruments become smaller and more complex to perform minimally invasive procedures, they also climb in priceÑ approaching a quarter of a million dollars for neurosurgical gearÑand they’re a bear to clean.
Blood, saline – people think stainless steel, nothing’s going to bother it, Tilford says. Anything that stays on there for any length of time will tarnish and pit it, and then you’re looking at buying a new instrument. If we can’t clean that equipment to the point where it’s safe to use, we have to throw that away and get a new one.
It’s critical for us in our department to have the technology everything we need to maintain those instruments, he said. Those instruments are an extension of the surgeon’s hand, and those dollars that we’ve thrown away go into health care costs, just on down the line.
The investment is so significant, Tilford says, that CSP is invited to sit in on meetings with sales representatives to discuss how the technology can be cleaned and maintained before investing in it.
If they don’t have that [information], we don’t let those instruments come into our organization, he says. If they can’t tell us how to sterilize them, we can’t use them.
When you can get your instruments cleaned thoroughly, properly, with a proper dilution of detergent and water, it increases the life of your instrument, Tilford says.
Making it even more challenging, he says, is the fact that the industry has had a hard time keeping up with the technology to clean them.
So about four or five years ago, Midbrook Medical, a company right in Allegiance’s backyard, thought they could build a better mousetrap.
They were just in their infancy [of this product line] and were looking at how our instrument washers work, Tilford said. It just started out a as a phone call and a cup of coffee.
Back in 2007, Midbrook was looking to diversify its automated industrial cleaning and decontamination systems business by entering the field of medical instruments. Tilford told them about the ultrasonic washers and the needs his department would have. The result of this collaboration was a device called The Tempest.
It’s a very good machine, Tilford says. It cleans our cannulated instruments, and it does a very good job. Personally, I think it’s the best one on the market, and we use it all the time.
The Tempest saves Tilford’s crew a lot of time that used to be spent hand-washing, Its thermal disinfection option makes the equipment safe to touch when the cycle completes because everything we run through the tempest comes through our instrument washers, he says.
Its usefulness is a direct result of being able to work closely with the representatives from Midbrook Medical in the development of The Tempest, Tilford says. By sitting down with the developersÑwhich are right up the road from the facilityÑthe team at Allegiance was able to contribute to every phase of the project. Tilford said they needed the machine to be aggressive enough to clean the instruments, but not to damage them.
With them being only a mile down the road with us, it’s been so easy to work with them, Tilford says. We could actually show them the instruments. They’d look at the instruments and figure out how to make their PSI high enough to clean them without damaging them. It was very exciting.
Tilford was able to tour the Midbrook plant and sit down with its owner, Nick Crowley. They talked about how to incorporate the variety of technologies needed in CSP into The Tempest. In short, they got an opportunity that few companies do.
In working with the smaller companies that you have more of a face-to-face, where you express the needs you have, Tilford says. With the bigger guys, you don’t get that.
They’re right there in our community. Most of the large companies that do the washers, the sterilizers, they’re large companies, they’re worldwide; a lot of them are from overseas. They have their own labs, and they really don’t talk to the end userÑwhich would be us in the CSP department.
The responsiveness of the development team was one of the critical factors in making The Tempest what it is, he says.
You can tell me everything, but show me. A company like Midbrook is in tune; they talk to you and find out what your processes are. You don’t get that from the bigger companies.
In addition to helping support the local economy, Tilford says, working with Midbrook also allowed staff from Allegiance to demonstrate to members of its local community the ways in which the health care infrastructure is there to support them. It’s an important give-back, and one not lost on either party.
Their employees use our hospital for their health care, Tilford says. You know how it is in the economy with people not having insurance, people not working.
We don’t turn anybody away.