national benchmark to measure CS Tech productivity

[biomed1]

My facility is trying to compile data to request another full time employee for our Central Service Department and although it is obvious to people who come in contact with our department that there is a need, administration needs hard core data. I have been asked if there is a national "bench mark" to measure productivity/staffing in a CSD; Tech to OR ratio, etc. Is there anything that anyone knows about that I can use a definitive guide for staffing? Thanks

[jrc]

We use hours worked per 100 items processed to measure our productivity. We compare it against a peer group determined bya a benchmarking agency we contract with.

[biomed1]

Thanks jrc. Can you give me more information about the peer group and the benchmarking agency? Thanks.

[zjpinay1]

I need your help.

I am Zeny and I work for Community Medical Center in Fresno. We are doing a Lean Six Sigma project and one of the action plans is to develop a scorecard metrix for productivity. I am looking for what should be measured. I read from the feedback above that hours worked per 100 items processed is one of those.

If anybody is using a scorecard, performance indicators, will you please advise what works?

[biomed1]

Thanks for the feedback, Zeny. I am not sure I would base a measurement on a "per Item" variable. How do you determine "an item"? We know that peel packing something and assemblying a vascualr tray are two completely different "items". 100 items per hour is hard for me to get my hands around.

[zjpinay1]

Thanks for the feedback Biomed1. Do you a list of performance indicators or scorecard or metrix you can share with me? I would really appreciate it if you can edu'ma'cate :) me on this.

zeny

[jrc]

The benchmarking agency we use is Solucient/Action O-I. They ask a series of questions to determine which of the 300+ hospitals they survey have a department similar in size and function to ours. They get our labor usage straight from our hospital's labor management software. Then, they ask for our production. They define an "item processed" as one tray, one peel pack, one cart, etc. Since everyone you are being compared to uses the same definitions, the comparisons are reasonably valid. The reports they provide give a lot of information. YOu can choose many different things to measure. Our hospital uses hours worked per 100 items processed to determine our productivity.

To give you an idea of how this works, we are a 250 bed urban hospital. We have about 7000 surgeries a year, 4600 live births, and 82,000 ER visits. Our SPD cleans and sterilizes instruments for the whole hospital, we clean portable medical equipment, and we issue some supplies to the floors. Our items processed is about 190,000 per year. Our metric comes in about 19 hours worked per 100 items processed, which puts us at about the 20th percentile in our peer group. In other words, we use less labor to put out our work than 80% of our peer group. That keeps administration happy, but it makes my job difficult. Oh well, if it was easy, everyone would do it.

[Harvey Johnson]

If I may jump in, Central Sterile duties differ from department to department so do the standards. It's difficult to rely on a common figure for all applications.
For example our hospital has 8 OR's (two in a sky bridge connected ASC) a birth center and a heart room, case loads include general procedures, cardio, ortho, neuro, phaco etc.
We process instruments, load case carts with supplies, order and stock supply shelves twice per week, process crash carts, restock OR room cells, conduct hospital rounds for equipment pick up and processing twice per day.
Because of a recent surge in neuro and the number of trays involved we have updated our daily labor standards from 2.9 to 2.75 cases per FTE.
Seems to work just fine in our setting.....

[biomed1]

You guys are great!

jrc - how (or who!) is counting your items each day? Are you just going back to your sterilizer logs?

spd soup - "we have updated our daily labor standards from 2.9 to 2.75 cases per FTE."
Can you expound upon that? Do you mean "cases" as in surgeries? Or as in instrument cases? So you get one FTE for roughly every three surgeries on your schedule? I am so confused!
Thanks for clearing the mud!

[sheper1]

JRC we also use the same company but it does not take into account any inventory processes such as case cart building, stocking shelves, delivering supplies etc. It only looks at items processed. Filling orders, case carts etc do not fall into that catagory. So for departments that mainly process instruments as a main function it works but for mine it does not. My department processes 195,000+ items per year and we come out below the 50th percentile it also states I should cut my staff in half. I do not have much faith in the solucient data. One Quarter it had me under budgetwith FTE's and the very next Quarter I was over by 12. You can submit all that data which we do but it only uses items processed does not combine all the data submitted.

[jrc]

If I may jump in, Central Sterile duties differ from department to department so do the standards. It's difficult to rely on a common figure for all applications.
JRC we also use the same company but it does not take into account any inventory processes such as case cart building, stocking shelves, delivering supplies etc. It only looks at items processed. Filling orders, case carts etc do not fall into that catagory. So for departments that mainly process instruments as a main function it works but for mine it does not.I agree that it is difficult to compare all departments. We all have different structures and different responsibilities. However, the benchmarking needs to be kept in context. It is not meant to be the "end-all, be-all" determinant of staffing requirements. It can point out some helpful information that can be used to improve efficiencies in our departments. Looking at the figures prompted me to come to administration with a plan to reduce the functions we performed. We were duplicating some of the things our warehouse does, so I got us away from being the "second warehouse" in the hospital. That helped us concentrate on our primary functions.

Sheper, the survey asks questions about all your duties, so your peer group is composed of departments doing roughly the same things. That means the comparisons should be pretty valid. The report from Action O-I also has many other things to look at. You could say you want to determine your productivity based on cases pulled, items issued, etc. For your facility, that may be a better indicator of your work.

Productivity benchmarking is a useful tool in helping figure out how to accomplish your goals, but the key is not to let the statistics determine how you run things.

[Harvey Johnson]

Yes, we count each surgery as a case in the FTE formula.

[jrc]

biomed1, we use our sterilization logs, along with records from equipment rounds collection and statistics on caseload to come up with our items processed. I classify any item we take from a dirty state to a clean state to be an item processed. That means every isolation cart, every code cart, every case cart, every pump we disinfect, every item sterilized, every tourniquet we wash. Processing is not just sterilizing. My staff fills out the logs of what they sterilize or disinfect, and I compile those into the monthly production reports.

[sheper1]

JRC in our compare group of 30+ hospitals only 5 process case carts or have any dealings with inventory. Also none of them handle the OR core inventory supplies. The solucient data does not look for specific departments that are similar it looks at hospital size and services offered. Also when contancting solucient group they only use man hopurs per items processed to calculate the rankings. They do not take into consideration any of the other data supplied. Of the hospitals that are in my compare group I contacted all of the hospitals in the 25th percentile which is the top teir and only 2 had inventory responsibilities, and none of them had any responsibilities in the operating room core. I still have not be able to convince Administration to let me back out all the hours spent dealing with inventory case cart building and data entry. All my FTE's are based off of items processed which is only 50% of my departments function.

[jrc]

sheper 1, it is really odd that your reports only rank based on hours/items processed. My reports show a host of different measures, with the percentile ranks for all of them. Maybe your administration will only look at that metric. I know the solucient folks feel it is the best measure of your productivity.

I feel your pain about having responsibilities that do not get reported. I have to work at the only hospital in the world where sterile processing handles ordering and charging of rental beds even though we never see the beds. Somewhere back in the mists of time we got saddled with that job, and nobody else wants to take it.

Does your facility not allow for normalization of hours? At our facility, if we have a department that does a funciton normally performed by another, we can move the hours over to that other department. Of course, you have to get the other department to agree, which is not so easy.

I am fortunate that I work for a vice president who is not married to the figures on the productivity reports. He understands that the statistics do not tell the whole story. Hopefully, you can convince your boss of the same.

[Tim Brooks]

We have also used Solucient/Action O-I for which they have never given us a number worth supporting a staffing level. In more cases then not they want to add us to MM staff for which we are separate. Pay close attention as to when the last reports for other institutions were updated. In some cases it may be old data from a region of the country that does not have the same seasonal issues that you may have or total operating hours.

If you are decontaminating equipment for the hospital and sterilizing instruments then you have two units to count. A number of benchmark companies only count one, items sterilized. Delivery and stocking of supplies is also a unit. We have found that no one unit can justify staff and support total worked hours per unit along with total operating department hours for which ours is 24-7.

I tend to use overtime and temp staff hours along with increased total units of service to justify staff.

Good luck

[teresaw]

I have been reading and trying to learn this methodology, but can't seem to grasp it. Have you been able to find benchmarking numbers for your facility and how did you start? I need help desperately.