CSSD Making the Business and Professional Case Cynthia Spry, RN, MA, MSN, CNOR, CSIT September 16, 2010
Objectives Discuss contributions of CSSD to healthcare facility Describe how to make the business case for CSSD Describe CSSD Professionalism Explore opportunities to promote CSSD 2
CSSD Within the Healthcare Facility • Located away from mainstream • Out of sight, out of mind, until there is a problem or a need • Minimal understanding of CSSD work Pay and recognition less than ideal • Considered a cost center only • Poor or absent partnerships • CSSD staff not engaged in professional aspects 3 • Adjacent to OR – lots of back and forth • Represented on significant committees • Input and Output valued and recognized - not just a cost center • CSSD staff professional and current • True partnerships with OR, ICP, etc.
Contributions Contribution to Patient Safety and Healthcare facility bottom line Patient safety Infection prevention Inability to quantify – makes for less visibility Means doing what is right even when no feedback Prevention of injury due to equipment malfunction 4
CMS “Never Events” “Patient death or serious disability associated with the use or function of a device in patient care in which the device is used or functions other than as intended” Approximately 20 states with similar pending legislation 5
Contributions Contribution to the bottom line Not always about how much you make but how much you keep § Smooth operation encourages business/surgeons/patients/staff retention (think orientation costs) § Patients now able to compare hospitals www. hospitalcompare. com § Fewer repairs, fewer expenses 6
Christmas Time and Santa Typical process Someone decides what is needed List of wants created and prioritized Cost identified Justification included The case is pleaded Decision is made Your stocking may contain coal or what you asked for 7
A well written business plan can help determine what will be in your stocking Business plan requires time, research and excellent documentation “CSSD managers need a good basic education in business and finance to effectively develop business plans and make a business case to justify a greater investment in their CSSD” R. Schule HPN May 2010 8
The Business Case – Why? Because you want something and you must justify it if you can hope to get it A business case is the key to getting what you need/want A business case should be part of your 3 -5 year strategic plan 9
Business Case A report that: Identifies a problem § Equipment need or staff development need Describes a solution States the cost to implement the solution Identifies the ROI or the cost avoidance (CA) that will be realized if the solution is implemented WIFM, WIFM 10
What Does Not Work It is obvious we need… I have been saying for years we need… If only I had been given…we wouldn’t be in this mess Anyone who spends time in this department could see we need… You do not need to be a rocket scientist to know what you need, but you must be able to articulate it appropriately – the business case 11
Profit Center VS Cost Center Profit center generates more revenue than it costs to operate Cost center generates less revenue (or no revenue) than it takes to operate Which type of center are you? Making a business case is possible for both 12
Current Situation State the problem e. g. not enough staff to meet demands on SPD e. g. Not enough sterilization capacity to meet instrument demands – extended cycles Describe why this is a problem and is an important issue for the healthcare facility – not why it is a problem for you – (SO WHAT!) Never personalize the problem 13
Current Situation Include the intangibles as well Happy customers Employee satisfaction Efficiencies Happy surgeons Health care facility reputation, etc. 14
Data – The Critical Component Support your problem description with data, data especially financial Work with OR/SPD/ICP/RM to obtain data 15 Number of cases – increase in cases Changes in specialty e. g. bariatric surgery program, increase in orthopedic surgery, changing patient population Increased number of devices requiring extended cycle VS number of surgeries Support with cost of downtime Number of hours and cost of overtime Use of instruments – repair costs
Data Sources OR Director or business manager SPD Director Infection Control Risk Management Hospital Finance What do you know about finances in your department Payroll, inventory, productivity Materials Management Literature 16 Google Scholar
Financial Data Describe data source Describe how you calculated and arrived at the numbers You may use data from similar facilities to support your case Compare repair costs, turnover times, etc – why the difference, why similar? 17
Your Proposal State what you propose e. g. a new sterilizer e. g. additional staff member e. g. new instrumentation or tracking system e. g. contract with a repair company Describe how it addresses the problem State the cost Describe the ROI or the CA - WIFM How will it impact your data? 18
Your Proposal Identify the risks and the opportunities Before you present your case anticipate objections and be prepared to either preempt them up front or as they arise Justify why you need something when things are working fairly well now Keep it simple – don’t mix apples and oranges – choose something that will quickly demonstrate value 19
The Business Case for Infection Prevention Products to facilitate infection reporting A new disinfectant system An endoscope reprocessor A sterilizer ? 20
Impact of SSI Patient Health Care Facility ICU 60% greater risk Higher costs Readmission 5 X more likely to be readmitted within 30 days Reduced reimbursement Reputation Mortality – 2 x more likely* The Institute for Healthcare Improvement estimates that 60 % are preventable 21 *Hall MC. SCIP module 1 – www. medscape. com/viewprogram/7214
The Cost Range of cost of SSI* $1783 - $135, 602 Mean cost $25, 546 Your facility may have this data What about cost of a lawsuit *AJIC 2005 22
Infection Prevention Cost Avoidance (CA) May be difficult to quantify how your new product/system will prevent infection unless can quantify how current product/system supports infection HOWEVER current focus is on patient safety (infection prevention) and cost avoidance NOW IS THE TIME!!!! 23
Summary and WIFM Summarize problem and solution – Executive summary Summarize data Determine next steps Be sure to WIFM 24
Business Plan Template Executive Summary What services you provide – data Profiles of Management and Key personnel Market and Industry Analysis Trends, Innovations, Anticipated changes Strategic Plans 25 Tie it into the facility mission and
Getting what you want/need – supported with The Business Case The consummate professional staff 26
The Professional Case CSSD week next month - October 10 -16 Put your best foot forward Promote professionalism Professionalism will increase the odds for success 27
What is a profession? Characteristics of a profession Very specific or specialized, body of knowledge Specific skill set Identity and group mission Standards and guidelines of practice and behavior e. g. AAMI, CDC, IAHCSMM 28 State and federal laws, institutional policies
Characteristics of a professional Overview Lifelong learner – dedicated to ongoing learning Competent Conscientious Timely Effective communicator and collaborator Integrity 29
Implications Showing up on time FLEXIBILITY “Not my job” not part of one’s vocabulary Respect for colleagues Diplomatic Seeking help as needed and requesting feedback 30
Demonstrating Professionalism Certification – not just because it is required Becoming a fellow - only 30 so far (see www. iahcsmm. org) Engaging in professional organization – IAHCSMM, AORN. APIC Staying current – reading journal and other material, webinars, etc 31
Demonstrating Professionalism Status – 2010 – HPN July 2010 47% high school - $44, 605 26% AD - $57, 568 18% Bachelors $67, 000 15% are members of AAMI (3% in 2009) 68% are members of IAHCSMM 70% certified, 15% in process 32
Demonstrating Professionalism Demonstrating willingness and flexibility Maintaining high standards of practice Speaking up …(diplomatically but with confidence) 33
CSSD professionals are privileged to serve Patients and the healthcare facility are privileged to have a staff of CSSD professionals Let the world know who you are Promote yourself to the healthcare facility and to each other – CSSD week is the golden 34 opportunity
Promoting CSSD Open house Visual displays Newsletter Reach out – don’t wait for a problem Get involved outside of the department Create awareness of CSSD and its services Meet your customers!! Many a deal begins 35 informally – garner support for your
Attitude changes everything! 36
Attitude – You can make the difference! The story of Johnny the Bagger as told by Ken Blanchard and Barbara Glanz 37
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