Behind the scenes in Medical Device Reprocessing

Beth Kingsbury, operating room nurse, Keith Aisthorpe, volunteer, Kevin Radcliffe, volunteer and Becky White, Medical Device Reprocessing supervisor at the Halifax Infirmary.

Kevin Radcliffe didn’t think about the instruments used by his medical team during life-saving heart surgery more than a decade ago. But that changed when he recently had the opportunity to get a behind-the-scenes look at the Medical Device Reprocessing department. 

Kevin was one of the volunteers asked to participate and provide a patient perspective in the Medical Device Reprocessing department’s Failure Mode Effects Analysis. Failure Mode Effects Analysis is a proactive quality improvement approach that identifies what could go wrong and how, and then puts processes in place to prevent those failures from happening. 

“You could have the most talented heart surgeon, but if the knife they are using isn’t sterile, you have a big problem,” he said. 

Medical Device Reprocessing is part of Nova Scotia Health Authority’s peri-operative and surgical services program. More than 200 staff in 17 sites are responsible for reprocessing reusable medical devices used in operating rooms and clinics throughout the province. They sort, prepare, sterilize, assemble, test and distribute thousands of different types of instruments including scalpels retractors, clamps and forceps, with many checks and balances for each item.

“This isn’t loading the dishwasher at home,” said Keith Aisthorpe, another volunteer who was part of the Failure Mode Effects Analysis process. Each piece of equipment requires special care and treatment with very specific instructions about time, temperature and type of cleaning and sterilization required. “It was reassuring to see how methodical the staff are in making sure every single one met those specifications. There’s a science here.

Medical Device Reprocessing was also a bit of a mystery to Beth Kingsbury, an operating room nurse for more than 25 years. Her perspective shifted when she spent five months with her colleagues at the Halifax Infirmary site of the Queen Elizabeth II Health Sciences Centre as part of an effort to bridge the knowledge gap between the operating room and Medical Device Reprocessing. As a result, staff in the operating room have a better understanding of the complex procedures and rigorous quality control measures in place to ensure the tools they use are clean, safe and ready when they need them. 

“As long as you have the tools you need, you don’t think about where they came from or what they had to go through to get there,” said Kingsbury. “But it’s important that our teams understand what each other does and how we do it.” 

Staff in Medical Device Reprocessing now have a better appreciation for how the surgical team uses instruments during procedures ranging from hernia repairs to heart transplants. This means better communication, collaboration and problem solving between Medical Device Reprocessing and the operating room. 

“This is about us working together as a team to keep patients safe and keep things running smoothly,” added Becky White, Medical Device Reprocessing supervisor at the HI. “Taking an integrated approach to patient care and safety built on best practices, teamwork and a shared purpose is in everyone’s best interest.”

Lessons learned from Failure Mode Effects Analysis in Halifax, and at the Colchester East Hants Health Centre and the Bridging the Gap initiative are being shared across the province.