Updates to Peace Arch Hospital’s medical-device reprocessing unit didn’t quite make headlines in the recent celebration of multi-million-dollar renovations to the White Rock health facility.
But officials who helm the unit say the bottom line is, even before the upgrades – which also moved the unit closer to the operating rooms – the hospital simply couldn’t function without it.
“It all comes to us,” Janet Macaulay, medical device reprocessing manager for Peace Arch and Delta hospitals, said.
“If we stopped existing, you would have a period of time where you may or may not see impact… and then after that, it would come to a dead stop.”
And now, said Macaulay – admitting bias – the department is the ultimate in behind-the-scenes patient care.
“I really think it is one of the finest (in Fraser Health),” she said. “There’s a lot of redevelopment going on in the region and they are looking at what we’ve done at Peace Arch.”
The unit, located in the facility’s basement, is where every device used in hospital procedures and surgeries – ranging from eye operations and C-sections to endoscopies and emergency-room treatments – is sent for sterilization or high-level disinfection.
In any given week, it processes roughly 5,000 pieces of equipment.
Changes included in the renovations include new technology that is both more efficient at its task due to embedded artificial intelligence, as well as more ergonomic for the staff who use it; dedicated elevators for transporting clean and soiled equipment between the reprocessing unit and the operating rooms; improved layout to ensure the clean and dirty sides of the reprocessing process are kept separate; and improved lighting.
Asked to highlight one aspect of the new space above others, Macaulay was hard-pressed.
“Staff would say it’s the amount of space that they have,” she said.
Before, the unit was “so compact that a lot of our workflows and work processes had to be combined into one area.”
Now that the space has more than tripled in size – to 1,400m2 from 390m2– “I think they went from something like 1,200 steps to 18,000 steps in a day,” Macaulay said.
“They didn’t have to move very much in the old department. (It was) not as compact as a little house, but the space provided for those different functions were right on top of each other.
“It was very efficient. (But) they had to work well together because sometimes you were shoulder-to-shoulder.”
The revamped unit became fully operational on Jan. 8, and was imperative to the openings of the hospital’s new surgical suite and expanded emergency department.
Featured within its expanded capacity are high- and low-temperature steam sterilizers; height-adjustable work stations and sinks; large washers for carts and instruments; and more.
Metivators that ensure a one-way flow of the equipment are also new to the Peace Arch unit, and are an example of the critical role artificial intelligence has in the new unit’s processes.
Macaulay described the equipment that the metivator replaced as much like “the old-style washing machines,” in which clean items were removed from the same location as where the dirty ones entered. One-way flow was maintained – and worked well, she emphasized – however, the upgrade has essentially eliminated the possibility of human error. It has a ‘clean’ and ‘dirty’ side, and will only open on the ‘clean’ side if the cleaning process has successfully completed, making cross-contamination between clean and dirty devices impossible.
Likewise, staff handling the equipment “cannot cross over” without going through a thorough sequence that ensures they, too, are maintaining the sterile integrity of the devices.
The operation as a whole has been compared to a large kitchen: everything is washed, sorted and labelled, after which it is locked up for sterilization. Heat-sensitive items go in low-temperature sterilizers, however, most items get the 132 C treatment – where they spend a full four minutes to ensure biological kill.
After about an hour cooling off, infrared guns check the temperature before items are released for quality testing.
When a “shopping list” comes from an operating room, reprocessing staff gather the items on a cart and deliver it via the “clean” elevator, bypassing public hallways.
While it is very much a behind-the-scenes operation – with a team Macaulay lauds as “incredible individuals… experts in their field” – it would be fair to say the department is the heart of the hospital.
But, “it all depends on your perspective,” said Macaulay, who has worked with Fraser Health for about 25 years.
“What we do is not seen as as-important,” however, if the unit ceases to function, “that hospital is at risk for delivering care to the patient.”
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