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Customized By Design: Exploring the Intersection of Safety and Efficiency in Sterile Storage

, / By Ian LoperMay 2, 2022
Customized By Design

Host: The AMI guidelines tell me I cannot stack my Blue wraps because stacking causes tears. It forces air inside the wraps compromising the sterility and the sets need to be handled in a manner that avoids dragging and sliding from one location to the next.

Rising above the buzz of ultrasonic cleaners and the clanking of stainless steel are the ideas and voices that are changing in industry. You're listening to the Beyond clean podcast, the central nexus for the people, processes and products that are improving our sterile processing world. Each week, we speak with frontline technicians, CEOs, engineers, and entrepreneurs with a common goal to help you fight dirty every instrument every time. Whether you're tuning in for education or inspiration. We're glad you did. Now turn on those washers and turn up the volume, it's time to go beyond clean.

On this vendor spotlight, we speak with Ian Loper vice president at DSI. And as you've been hearing a whole lot this season on beyond clean, we're going to be talking about storage and transportation. And specifically Ian is going to introduce us to a line of products that really prevent any stacking and we're going to do a review of the AMI St. 79 guidelines and talk about why this is so important. And so today you'll be learning more about an integrated storage system. But the one thing I really want to highlight that I think is so unique, and we're going to be talking about this throughout the interview, but Ian and his team at DSI have always focused on people processes, products, and then also profit which aligns very well with the beyond clean mission. As we are also focused on people's processes and products that are driving the sterile processing industry forward. So don't go anywhere, we're gonna be right back with Ian Loper.

From 17 Studios, you're listening to beyond clean the global voice of sterile processing.

Joining us now is Ian Loper vice president at DSI. And we are going to be talking about instrument storage and in particular in your instrument storage solutions today. And I want to thank you for coming on the show. But also, the way that we prepared for this discussion today is very much in alignment with beyond clean and its mission, we're going to be talking about the people, we're going to be talking about the processes, we're going to be talking about the products. And then you've added a fourth P which is the profit or the business case. And so I think the way that we're going to be doing this vendor spotlight and and having this conversation is going to be new for how we've done it before, but it's a nice flow to the conversation. So welcome to the show. I know it's your first time, but hopefully not your last time. We're really happy to have you today.

Ian: Yes, sure Justin, glad to be here.

Host: So why don't you talk a little bit, just about your background, and maybe tell us, you know, how you find yourself, you know, providing these solutions to the industry today?

Ian: Well, DSI has been around for 30 years. And you know, our focus is high density storage systems. And that's one part instrument sets in SPD. And then the other side, high density basket storage. And so we really separate ourselves through, you know, as you mentioned, our go to market strategy with the people the process, the products and the profit. And we feel like that's the blueprint, and really the roadmap for success at DSI. And we try to overlay that strategy with our approach to providing value to SPDs.

Host: Well, I'll tell you, it's like one of those things these days where you got to keep expanding, and there isn't necessarily enough space to expand into. And so making use of the space you have or preparing for growth later and renovations, this whole conversation and it's really the reason that we dedicated an entire season to this conversation. You know, that's the reason we're talking today is because I think many managers and Frontline technicians out there are living the challenges in regards to space and storage, and really just the constant expansion that has been going on. So why don't we talk in that whole flow and start with the people because I think one misconception is, a lot of times people think people means just the patients right? But people also means the employees. And when you and I talked to prepare for this interview, you really made a strong point of that is, you know, when we talk about people, we're talking about employees, and the patients who are receiving the care.

Ian: Absolutely. So it starts with the people, it's always got to start with the people. And you've got to provide them with the necessary tools to get the job done. And within that toolbox is going to be the process and the products. And so we really overlay that strategy. As we mentioned earlier, the people the process the products, we overlay that strategy with our team, and we try to implement it as we go about our day spending time with the the folks in the SPD, in the OR. And ultimately, we want to create a safer work environment for the employees by implementing a system designed specifically for SPDs to optimise the department's floor space, eliminate trip hazards and bottlenecks within the workflow, utilise better signage throughout, and having a storage system in place that is engineered to focus on employee safety. 

Host: Yeah, that safer work environment, I mean, being a health care provider, in the past myself before coming over to beyond clean, and also my experience, you know, as a vendor, but I remember working as a nurse, that we always kind of felt like our safety was sort of secondary to the patient. And it really shouldn't be a secondary consideration. And I think that's part of the employee buy in, is to say that, you know, your, your safety is just as important. Am I right about that?

Ian: Without employee care without employee safety, the patient isn't going to get the best service. So when you think about the four walls within an SPD, you think about ergonomics, you think about pinch points, trip hazards, you think about, you know, some of the other sharp edges when it comes to storage, or some of the rigid containers, do you think about the lighting, you think about compliance. And so, you know, employee safety has got to be at the forefront of any big project of any planning. And again, the downstream impact is, you know, employee morale, employee retention, process improvement, improved workflow. And again, downstream patient care, that's always got to be at the forefront when it comes to making some of these bigger decisions.

Host: Yeah, engaging the staff is such a big part of that buy in feeling like you have some skin in the game, so to speak, you know, whenever a change is being made, and understanding the why behind it. So you mentioned process improvement, enhance workflow. But then also, on the patient side, you kind of said something about, you know, sterility and being able to improve that. So what are some of the ways that you really improve sterility with your solution?

Ian: Yeah, so sterility, when it comes down to within the OR within the suite, during a procedure, one of the first tasks that takes place is to unwrap that present that blue wrap. And if there's holes in that blue wrap, what happens you have to reprocess that set. Why because there's a good chance that it could be unsterile. And so if we can create a process a system in which it delivers that package that is sterile, that will help with patient care that will help with overall sterility throughout the process within the SPD, through the elevator into the OR suite, like I said.

Host: You know, everybody is kind of keenly aware that case delays or cancellations cost the organization money, right? but at the same time that can impact patient care as well because you don't necessarily know where they're at in the process. So what about just the consideration around preventing or reducing, you know, case delays and cancellations? 

Ian: Yeah, so that's the goal is to again focus on patient care during that process. If there are delays with a procedure with a hole or puncture or tear. In a blue wrap, we have a storage system that enables that wrap to be cultivated in a very, very safe manner, again, from prep and pack to transport to storage. And that system is our MODU-Max CTS system. We call it our no tear system and it's one part case card one part workstation, one part transport cart. And the last part, more importantly, is the storage element. It's really through not stacking that blue wrapped instrument and it enables the employee within the SPD to not drag that larger heavier set that is usually stacked within a wire shelf, to enable them to better handle that system transported and not touch the blue wrap ever again from prep and pack all the way up to the OR. So it's really a no tear system.

Host: Yeah, I love that no tear. And nothing can be more frustrating, again, than finding that out. Once you've already picked the case cart, and it's up there in the room, and people are getting ready to set up and they're looking and they're finding these holes in the blue wraps. And we have a lot of you know, as we talk about process, we have guidelines in the industry to help us through that. And I think that whenever you're making a case, for looking at ways to improve your processes, it's got to be based in guidelines, recommended practices, best practices, that really has to anchor how we make, you know, sort of an argument for either bringing on a new product or changing our our policies or our procedures about how we continue to deliver safe patient care. So let's talk about some of those guidelines. Can you give us a review of AAMI ST79 11.1. As it relates to our conversation today?

Ian: This is where our process comes in. And whether it's OSHA or JCAHO or AAMI, you know, there's there's guidelines out there and it's up to the hospital to either comply or not. And I'm not a black belt within AAMI, but I do know and can comprehend exactly what these specifications are stating and I'm going to read a few to you here 11.1.1 stacking can result in damage to the rap caused by undue pressure from the weight compression of packages can force air and micro organisms into the package contents which lead to contamination. Sterile items should be handled in a manner that avoids dragging, sliding, crushing, bending, compressing, or puncturing the packaging. 

The AAMI guidelines tell me I cannot stack my blue wraps, because stacking causes tears, it forces air inside the raps, compromising the sterility. And the sets need to be handled in a manner that avoids dragging and sliding from one location to the next.

Host: Yeah, it's so critical what you just said a couple of these things. But I'm not sure everybody's always aware of the compression of packages, forcing air and micro organisms into the package contents. I know that's word for word. But I don't think everybody always thinks about that. In terms of stacking. What comes to mind more often than not, is the dragging or the sliding when you're pulling that top set off the another one that's really an event, if you're doing event related sterilisation, that's an event not just to the rep set that you're pulling, but the rep set that it was sitting on top of that you're dragging along, as well. And so that absolutely does represent challenges for sterility for the patient, and it can result in case delays, and as a huge issue. So thank you for bringing that up.

Ian: Yeah, absolutely. So just think about the journey of that blue wrap, right from prep and pack, it gets transported, it's handled, it gets shoved into a shelf on top or in the middle of a few other blue wraps. It sits there for a day or two or three or five, then it gets pulled, and then it gets pushed back onto a transport cart, then it gets pulled again, then it gets put back into a case card, then it gets pulled again, up at the OR suite and placed on a mayo stand. And so you're thinking about thinking about the handling of this blue wrap. It's a precious Faberge egg, it's handled just way too much. And so if you put a process in place that minimises the amount of touch points, if you put a product in place, that forces the operation to become more efficient and reduce the amount of times this blue wrap is handled, then you're going to be miles and miles ahead of everybody else when it comes to sterility within the process of delivering this blue wrap to the OR suite.

Host: You know, and sometimes just organisation is such a challenge, right? Especially when you know you're picking and then you're putting back and like you said think about the lifecycle of that wrapped set and the back and forth, just because it goes up to the OR doesn't mean that it always comes right back down, goes into decon and just follows the normal process. 

Sometimes they get put away when they're unused as well. So that you know sometimes can really be a challenge to organisation Don't you think? 

Ian: So the organisation it's just like a kitchen if you have your utensil drawer and you don't have an organiser for separating the knives from the forks, forks to the spoons. That's a problem, you're not organised. It's not just one open drawer, and you just throw everything in there. And that's basically what a traditional wire shelf is, you cannot separate the inventory in an organised manner, such that to become more efficient to maximise the space, it's really a kind of a Tetris effect, you want to be able to control that location or that inventory within a small space. That small blue wrap in a small space in a small storage unit, basically designed specifically for that size and shape, a traditional wire shelf does not allow you to do that whatsoever. So if you want to maximise the cube, if you want to enhance the workflow, if you want to reduce the tears with the blue wraps, if you want to have access to the rigid containers, and the handle and the front and the back for those larger ortho sets that are sometimes, you know, beyond compliance and 30 40 50 pounds, you have to ergonomically have a storage system that is designed specifically for this department and to handle this inventory. And that's what DSI has.

Host: And it's not just for wrap sets to right like we're talking about anything with an expiration in sterile supply storage too. And, you know, that's kind of different than event related, which we obviously just talked about a second ago.

Ian: Yeah, so we have a system for blue wraps, we have a system for the variety of different rigid containers. And we have a system for peel packs along with that it's a high density basket system and ISO system that was adopted out of Europe for the last 20, 30 years. And we brought this system over about 15, 20 years ago, and have introduced this system and to the market for the last few decades. And so that's where the system approach comes into play. It's sterile supplies, it's blue wraps, its peel packs, its rigid containers, and then at some of the other bulk packs as well. So it's a wide range of product offering that is tailor made for SPD storage.

Host: So I think this leads us right into the third P which is products. And you've alluded to it a little bit. But I really want to paint the picture for the audience to really think about what this would look like in their department. And I think one of the most important points you were making there was that it's truly integrated, that it does all these different things. And then it brings it into one system conceptually, that is flexible and can meet all the needs. Am I right about that too.

Ian: Yes, sir. And it's a system as as you alluded to, they could also stand alone. And it starts with a storage element. So it's the storage system for handling the blue wraps, the rigid containers, the peel packs, that's part one, it's a high density system. It's engineered designed specifically around this type of inventory. The second part is our our newer product, which is the Triton case card. And this really rolls everything together, which makes it an integrated system. And it's a very unconventional design within a conventional design. So it looks like a case cart. It is a case cart. But the internal workings are a little bit different. Standard case carts out there in the field for the last 40 years have basically been fairly boilerplate with bells and whistles added over the years. But what we've done is designed our modular shelving system within the box and it's basically a divider system that divides the cabinet and a variety of different ways to handle smaller wire shelves that were used to store blue wraps. And so you basically take this wire shelf with a blue wrap on it not touching the blue wrap, you pull it out of the storage system, and you slide it right into the case cart and it's dedicated location and it's dedicated home in increments of three inches. So you're able to adjust this smaller shelf in increments of three inches to maximise the cube have a dedicated location and not stack the blue wraps. So it's it's much different than the standard market with the the flat wire shelf that you could potentially pull out if you'd like to we do have that product. But this is more of an integrated system where you've got the storage element, you've got the transport cart element and you've got the case cart element all working together making it a complete standardised system.

Host: What I really loved about like just looking at the past pictures with the wire shells and the customization opportunity. It's not so customised that they can all be used together, it's customised in the way that you get just what you need. With still the ability to, for everything to work together nice and easy. So there's some standardisation, but the standardisation is built around customization, which I just thought was, was really cool. And looking at that case cart piece, the whole not having to drag or pull the wrap set off, but just taking that wire basket or that wire shelf out, it really stabilises that blue wrap and protects it. And then no matter what your configuration is, you know, the case cart can adapt, you know, to that configuration. And so, you know, a lot of that just has to do with kind of understanding your inventory, and making sure that you have the right sized baskets and shelves for what your inventory is.

Ian: Yeah, and that's, that's why we have boots on the ground. That's why we have our own employees, we don't use manufacturing reps, we have our own employees, we've got reach from coast to coast, across the country, we go out, we're project planners, we measure the space, we measure the inventory, we basically do an audit of the space of the inventory. And custom configure a product a storage system around your inventory, we sit down at the table, we bring the different heads together, we we bring people down from the C suite, we bring people the text to the group, we understand what the customer's needs are, what the constraints are within the department, we take out the tape measure and make sure everything's going to fit, we try to get a good feel for what the future expansion looks like. And go back to the drawing board and figure out room flow and and really design a system around the department around the four walls around what the operation wants to achieve, which is to optimise the floor space, get compliant, increase the department's efficiencies, and make the appropriate equipment changes to address employee safety and maximise productivity, 

Host: what you're really describing as this consultative approach with an eye towards the future, so that you don't get pigeonholed and have to do this all over again, from soup to nuts. And I think, really, there's two scenarios, right, you're either moving into a new building, or you're renovating, or you're trying to take advantage of the space that you have today. So you know, you were just talking about sort of that process. But I want to move us into the business case discussion, because this is really where I think the industry often needs so much help, right? When when you start talking about making an investment, a lot of times it's a capital investment, but not always. But many times it is a capital investment. So you've got to show ROI, or you've got to show cost avoidance, but somebody who holds the purse strings needs to say, Yes, I approve this, we can see the benefits as an organisation. But I'm not sure that, you know, managers are always empowered with the right information to make that business case. And I think this is where, you know, really our discussion today. And your approach to supporting the industry is really helpful is how do you make that business case? I think maybe we approach each one of those situations differently. How do you start to make the business case when you're moving to a new site or renovating your existing space? And you're going to have more space as a result of that?

Ian: That's a great question, Justin. And we see ourselves as a partner within the hospital system. Hospitals can't necessarily operate without vendor support. And we are literally we see ourselves as as a unit. And you know, we understand hospitals are in business to provide patient care within the region. But on the other hand, hospitals are in business to make a profit and we understand that within the OR that's viewed as the profit centre. We understand SPD with all the inventory and equipment in the SPD within the four walls that's really viewed as a cost centre and we've structured our business to focus solely on those departments as well as supply chain and materials management but really hone our focus in on OR and SPD those are the profit centres and those are the cost centres so that's where the profit and Cost Management come into play. And where DSI is value proposition is the strongest in terms of customer facing benefits and their return on their investment. As we see it hospitals have two options if they're busting at the seams. They were structured and planned for you know 15, 20 years ago with 10 OR suites and now all of a sudden they have 20 OR suites and their inventory has gone up. customer has two options, they either invest in more spacey efficient storage equipment, like DSI, has high density product range, or they blow walls out with a renovation project or move to a new building in order to generate new space, which comes at a much deeper cost to the business. And those two options are pretty compelling and and extreme in both cases. One is extreme cost and disruption to the operation. And the other is less costly, less invasive, and easily implemented in a timely manner.

Host: So doing a new construction, does that always mean that the issues that you've had in the past are just going to be solved for the future, like just building a new department or moving to a new space, solve all the problems that may have plagued you previously? 

Ian: Yeah, I mean, it's crazy, these new buildings, and then the new space, what happens is, some of these hospitals drop major capital on on the new space, and they just put the same storage equipment inside the space. So they're gonna have the exact same problem, they're gonna have tears and blue wraps, they're gonna have workflow issues, they're gonna have, you know, space constraints, maybe not this year, maybe not next year, but maybe three, four or five years from now, as they continue to grow. And so hospitals need to really start to think about efficiencies about more longer term plans, not necessarily a band aid approach, but more efficient equipment within an SPD or even in or for that matter. 

Host: So Ian, I really like how you connected the cost centre and the profit centre right, because they really are hand in hand they cannot make profit, if the cost centre is not working properly. Can you just kind of summarise for us, you know, when it comes to making the business case, on the cost avoidance or the cost centres impact and the profit centre impact, like, what are some key bottom line takeaways for why you should invest in using your current space doing it better, and doing it in a better way, so that the packaging the sterile packaging is not damaged. Because that hits both it hits the cost centre, and it hits the profit centre.

Ian: So let's just look at option one, which is very standard to either move to a new building or renovate push walls out and generate new space. And you know, rob Peter to pay Paul, according to the construction cost index, which is a nationally known construction index, they state the average construction cost per square foot is over $300, within the hospital industry across the US. So if a customer chooses to renovate, and they want to add 1000 square feet, 2000 square feet, it would cost them nearly $300,000. 300 to $600,000, not including new storage equipment versus the equivalent of a single one time investment, and let's say $100,000 in our equipment. So that cost variable is three to six times the cost in terms of your options if you want to grow your space. And so for us that is potential profit down the line. It's a huge cost. But there's a profit tag to that around there as well. So,

Host: okay, but what about some of the other things like employee retention, right, because at the very beginning of this conversation, we talked about how oftentimes care providers put themselves second. But when we talk about people, we weren't just talking about the patients and a large part of this conversation has been around maintaining the integrity of the sterile packaging, but you know, it costs a lot of money to replace employees in the department. And it's not always that they're leaving, you know, because they're unhappy. Sometimes they're leaving because the ergonomics of the job that they're doing, they wind up on workers comp, and so I got to think that there's some savings and some efficiencies to be had in that regard to

Ian: The sterile processing department. Some of them are immaculate, some are brilliant, you've got windows, they're very clean, you can look outside, they're very efficient. It's a good employee morale. There's a lot of SPDs out there that are underserved, under loved under invested, not designed very well and not up to code and are out of compliance and a very challenging work environment. So even simple things like the lighting, simple things such as labelling simple things such as having safe equipment to work with, those are no brainers. And, you know, some of these decisions are made by people who have never stepped foot in that SPD. So if you want to retain your employees, and increase your productivity, and have your resources perform at their best, you have to provide them with the necessary tools. And that comes down to the proper washing machines, the proper workstations, the proper scopes, the proper magnifying glasses, the proper storage systems, in a safe working environment to get up to code to get up to compliance, that will retain your employees, you'll keep them around, and you won't have to spend so much money replacing employees every couple of months, you're going to be able to retain some of your best assets, and that's your people.

Host: Yeah, that is a big, underrated impact on budgets and hospitals. And whether you're spending the money in areas where you could have saved, or that cost avoidance piece, or you're actually having the case delays and the cancellations that's decreasing the profit, it all hits the organisation on the bottom line the same way. So the more efficient we work with less issues, the more financially sound the organisation is, and then that frees up capital to continue investing in other areas. And I think that's something that sometimes just as not discussed enough, and I'm glad we put that into the context of not only what we what we talked about, you know, a no tear system, but also as it relates to employees and the cost of turnover, because it's substantial. And when you have a shortage in workforce, you end up paying quite a premium for travellers. So that comes into play as well. And so I think this is an excellent way to keep people safe and working and happy and at the same time making sure that everything goes off without a hitch in the operating room. So Ian, really great job on this podcast. Appreciate your time today. Is there anything you want to add before we close?

Ian: Yeah, just we see ourselves as partners, we really do want to help. We want to serve those who serve others. And we've been doing that for the last 31 years. We do feel like we have a template to go to market to help within the SPD and the OR and supply chain to help the people help the employees help the patients help the process with a product and we couple that as our blueprint. We use that here at DSI, we want to instil that within the hospital. And ultimately, it is bottom line, people process product and profit, I would make sure my people are happy and they have the right tools to get the job done. Within that tool bag. You've got to have the right processes and you got to have the right products. Ultimately what falls out of that funnel is a profit that you can reinvest back into the hospital system. So absolutely. We're here to help. We're here to serve those who serve others.

Host: Well, we talked a lot about DSI as integrated storage system, very flexible. And I want you to go see for yourself visit the website DSIdirect.com. And then if you have questions, you can email them cs@DSIdirect.com. Ian is super active on LinkedIn. And you know, we love that Here at Beyond clean social media, being active and sharing information. And education is a big part of what we do. So you can follow Ian Loper and the rest of his team on LinkedIn. You can also find the company on Instagram, and you're gonna see before and after pictures, new product announcements, etc. So again, Ian, great job on this show today. Appreciate you coming on.

Ian: Thanks, Justin. Appreciate it.

Host: That was Ian Loper vice president at DSi and a great conversation about a no tear system for storage and it's modular. It's incredibly flexible and customizable. And some of the things I mean obviously very much in line with that people processes products, but then the addition of profit and making that business case for taking advantage of the space that you already have in your department. But putting it to better use, because space is always going to be an issue in sterile processing departments as we continue to scale up. And I think that one of the things that really stuck out to me is how much people matter to Ian and his team at DSI, specifically around getting the frontline take technicians involved in that process and putting employee safety at the forefront as well instead of always making that such a secondary consideration. Obviously, we're all here to provide patient care, and ensure that everything that we wrap that gets to the OR maintain sterility. And we don't want to lose dollars in sterile processing because of case delays and case cancellations and all of that. But so I really think this integrated storage system with specialised case carts, modular shelving options, and really preventing stacking, we had a nice review of the AAMI ST79 guidelines and our conversation with Ian today as well. I want to remind everybody, you can head on over to the website, DSIdirect.com or you can email cs@DSIdirect.com. For more information, make sure to follow Ian and the rest of his team on LinkedIn. And you can find DSI direct on Instagram. And they're going to be posting before and after pictures. Plus, there's already a bunch of content like that on there. And there'll be announcing new products as well. That's going to do it for this vendor spotlight. But as a reminder, you can help support beyond clean by subscribing on Apple, Amazon and Google podcast as well as Stitcher, iHeartRadio Spotify. Or find us on your favourite podcast application by searching for beyond clean. We also have bonus content for certain episodes. And you can get that by downloading our smartphone app for iPhone and Android. We'd certainly appreciate a rating and a review because your feedback is important to the show. And if you have any topics that you'd like us to cover on a future episode, just send an email to info@beyondclean.net Thank you for listening to this vendor spotlight on beyond clean.

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