Surgical Instrument Tracking for the Royal Adelaide Hospital

The Challenge

Hospital sterilisation departments need to comply with strict standards when reprocessing surgical instruments, requiring specific workflows, operational parameters, and record keeping.

Previously, the Royal Adelaide Hospital (RAH) used a paper-based system to manage their workflows and compliance obligations which had limitations:

  • Significant physical space was required to store documents.
  • Reviewing historical data for investigations was time consuming.
  • Processes for collating and summarising data for reporting were onerous.
  • Ability to attribute specific events to individuals was very limited.
  • Instruments were tracked in sets, not as individual instruments.
  • Unable to track instruments once dispatched to theatres.
  • Difficult to capture and attribute reprocessing costs.

 

The new RAH, a paper-light, technology-centric hospital with increased patient capacity, required a better approach to managing their surgical instruments and compliance obligations.

Surgical instruments

The Solution

Our team worked closely with SA Health and the RAH Central Sterile Services Department (CSSD) to understand their requirements, map workflows, review dependencies between areas of the organisation, and implement an electronic asset management system that both met their requirements and significantly improved performance.

Adopting an iterative approach beginning with minimum viable product and progressively adding functionality, the team worked with the RAH CSSD and Getinge Australia to implement an asset management system built on Getinge’s T-DOC solution, designed to operate 24x7x365 and manage more than 100,000 unique items. This system was integrated into the SA Health environment and transitioned to become business-as-usual in the new RAH.

During this project, our team:

  • Built a database of all items managed by the CSSD and developed a classification and naming scheme to identify all items in a clear and consistent manner.
  • Specified methods for marking barcodes on items, supporting a variety of materials including stainless steel, wood, and plastics.
  • Implemented electronic workflows for managing assets including onboarding new items, retiring items, and item-specific handling requirements.
  • Tested and configured handheld scanners to optimise their ability to read barcodes on different types of materials.
  • Developed a Business Continuity Plan to manually record and re-enter data when the system becomes unavailable.
  • Developed a test regime for evaluating software updates, specifically covering functionality used by the RAH, and trained staff to undertake testing and assess software updates.
  • Delivered training to ensure the CSSD became self-sufficient, including basic training for all staff, advanced training for power users, and administrator training.
  • Embedded our team within the CSSD and Technical Suites to provide support during hospital opening.
  • Integrated T-DOC with external systems including the RAH’s Patient Administration System to provide electronic linking of instruments and implants to patient records.
  • Worked closely with the product vendor, Getinge, to resolve issues and develop enhancements based on prioritised needs of the RAH.
  • Worked closely with network and hosting teams to establish, debug, and optimise IT infrastructure to support the 24x7x365 operation of the CSSD and Technical Suites.
  • Developed user interfaces to support non-technical and English-as-second-language users by minimising text and using consistent layouts, symbols, patterns, and colours.
  • Worked with cyber security specialists to support penetration testing and harden the system against cyber threats.
  • Chaired a working group between CSSD, theatre staff and SA Health’s IT department to ensure healthy and proactive collaboration.
  • Developed reports to track performance, non-compliances, and specific issues.
  • Implemented a web-based ordering system with customisable templates to streamline the ordering process.
Packing desk at RAH

“That the team successfully delivered such a complex implementation in such a short time is testament to how effective their frank, pragmatic and collaborative approach to problem solving is.”

Todd Mikkelson

IT Solutions Product Manager, Getinge Australia

Capabilities we provided

Project management

Business and systems analysis

System design, implementation, and integration

Testing

Service management

Training

Support

Transition to operation

The Outcome

The system went live with the hospital opening and was hailed by Getinge Australia as one of the most advanced day-one activations of their solution ever achieved, inviting the team to present a case study to the T-DOC users’ group.

The team received letters of commendation from both the RAH’s Nursing Director and Getinge Australia, and the system remains core to the daily operation of the RAH CSSD today, a testament to the robust and enduring nature of the deployment.

“The system allows you to engineer out a great deal of risk.”

Andrew Ellis

Sterilising and RMD Reprocessing State Coordinator, SA Health