Some of the factors that may need to be considered while looking into the Centralised (CCSSD) plan:
1) LOCATION – How far away is the CCSSD from my hospital? The further the distance, and greater the traffic uncertainty, greater the chances of chaos.
2) What is the expected turn-around time?
3) Instruments need to be cleaned as soon as possible after surgery. This is not always possible, even in present circumstances? If we move to CCSSD process, how long will it be before we start cleaning the instruments? Will this increase the chances of our instruments being corroded? Does this mean that we will have to spray the instruments with PRECLEANERS / MOISTURISERS? How much will this cost?
4) What is the cleaning chemistry used by the CCSSD? Will they comply with the requirements of the MANUFACTURER’S INSTRUCTIONS of my instruments?
5) At present, we have a certain amount of inventory. If & when we move to CCSSD, we will need a much larger inventory. How do we plan to finance this increase in inventory? Increased inventory means a larger storage space is required. Do we have a larger storage space? Space costs money. Have we calculated the costs?
6) What happens when my instruments are lost? Who pays for the loss?
7) What happens when my instruments are damaged? Who pays for the damage?
8) What happens when my instruments are all mixed up? How will this be sorted?
9) What is my present cost of processing? What is the cost of CCSSD processing? Is it worth the hassle?
10) Sterile instruments are always stored in a controlled environment (Temp – 18C to 22C, and RH – 35% to 68%). Is this possible during transportation? Please note that one of the factors that determines the shelf life of a sterile pack is environment control. Also, environment control is one of the factors of Event Related Sterility.
11) For those sets/trays that are wrapped in non-woven wraps …………. Will transportation lead to increase in ‘Tears/Holes’?
12) Does the CCSSD have a TRACKING SYSTEM? Is that tracking system compatible with the tracking system of my tracking system? Does the tracking system of the CCSSD meet all my requirements?
13) What standards does the CCSSD follow? Do they satisfy the needs of my hospital?
14) Theft, corruption & sabotage are at very low levels in certain parts of the world. And, these are more prevalent in other parts of the world. With unethical corporate competition and with unethical practices, the CCSSD plan may be an accident waiting to happen. How does this affect me and my part of the world?
15) What are my top 5 problems today? How will these be sorted by the CCSSD scenario?
We have to first ask the question, “On which side are we? Are we looking at being a part of the CCSSD provider? Or, are we a hospital which is looking to be served by a CCSSD”. Whichever side we are, some of the above mentioned points will be worth looking into.
In the eventuality of us moving to a CCSSD scenario, it would be prudent to have a very small processing department with our hospital —– just to cover emergencies. A very small department with a couple of washers and a couple of sterilisers would be a good start.
I am unsure whether this is what you were looking for Rangarajan & I hope I was helpful.
Wish you all the very best