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Manager Monthly
CSSD Transforms from ‘The Problem’ to ‘Problem Solvers’
Not unlike many other Central Sterile Supply Departments, the one at William Beaumont Army Medical Center had been faced with some unique challenges related to staffing, morale, leadership, and quality customer service.
Fortunately, for the El Paso, TX-based Department of Defense facility, WBAMC wasn’t interested in camouflaging its CSSD-related shortcomings. Instead, real, positive change was the order of the day – with a change in command ranking near the top of the department’s list of improvements.
Prior to F. David Salazar’s arrival as Department Supervisor of WBAMC’s Central Materiel Service/Sterile Processing in December 2007, CMS lacked a dedicated department supervisor, which contributed to procedural inconsistencies and subsequent customer complaints, and low employee morale. Although senior Enlisted and Officer military staff members had been responsible for overseeing the department, it was difficult having long-term, active and consistent leadership in CMS due to military staff being deployed, transferred to another base or leaving the military altogether. Further adding to the department’s challenges was the fact that it served a level three trauma hospital with a residency program, which meant regular physician turnover, was the norm. Without a strong CMS/Sterile Processing leader, that revolving door of physicians sometimes made it difficult for technicians to meet the evolving needs of the OR.
“We had three different chiefs of surgery in one year, due to an increased tempo of deployments,” noted Salazar. Fortunately, it was the new chief, Lieutenant Colonel Rebecca Lisi, who created the department supervisor position and placed Navy-trained Salazar, a technician, at the helm.
“I’m here all the time. I won’t be deployed, so there is constant leadership,” explained Salazar. “We are a very strong department now and things no longer fall through the cracks.”
Back Row: Dianitza Nieto, Paul Byers, James Lee, Johnny Dixon, Harold Johnston
Front Row: Thelma Ramos, Ceci Musni, Juanita Loya, PFC Witt, SPC Moua, PFC Fortunus, SGT Pluko
A blended team
While Salazar’s supervisory role has undoubtedly been a significant boon for the department, and for WBAMC as a whole, he insists that the lion’s share of the credit belongs to his hardworking, dedicated — and uniquely blended -- team. “They see themselves doing a good job, but I see them doing a really great job,” he raved.
Including Salazar, the CMS/Sterile Processing department is comprised of 26 professionals from three very different backgrounds: active duty military, Department of Defense civilians and Veteran Affairs civilians. Aside from serving the level two trauma hospital, the CMS also processes for both the Army and VA institutions (the VA facility is located next to WBAMC). Since assuming the responsibility for both institutions in 2008, the CMS has seen its individual processing of sets and peel backs increase from 2,000 per month to roughly 10,000 per month, on average.
“Within two years, we have increased our productivity by 80%, but increased our staffing by roughly only 25%,” Salazar said. Despite the surge in the number of items processed, the CMS has experienced a decrease in injuries and errors – and, along with that, a notable reduction in customer complaints (CMS’ ultimate goal is to reduce its percentage of errors and injuries to zero).
The reduction in injuries and errors may be somewhat of a statistical anomaly (after all, the more items processed, the greater the opportunity for mistakes), but Salazar and his team credit the improvements to stringent adherence to standards and consistent compliance with regulatory requirements and policies and procedures. “Sterile processing is an exact science. There is no guesswork,” stressed Salazar. “We follow the standards and our [customers] know that we will not bend on that. It’s about delivering consistent quality and safety.”
That commitment to quality and diligent adherence to safe processing practices has gone a long way toward improving relations between WBAMC’s CMS and OR professionals
“Before Mr. Salazar came on board, there was dissention between CMS and the OR,” said Melissa Martinez, a former Army surgical tech who now serves the CMS as a Department of Defense civilian. “When he came on, standards were consistently being met and everything just fell into place.”
LTC Lisi, who serves as Chief for the OR, CMS and Same Day Surgery, largely attributes the success of WBAMC’s CMS to Salazar’s leadership and vision, and his ability to transfer that vision to the staff.
“CMS has built a bridge between the operating room and the medical clinics, which has improved customer service. The department also made many improvements in the sterilization processes, which saved time and money, yet increased productivity,” LTC Lisi noted. While the tangible and measurable value obtained working as a team is difficult to convey in exact numbers, the department has a common vision and values, common goals and priorities, a common commitment, and open communication, she added. “The staff is a collaborative team led by a skilled and effective leader who oversees, guides, directs, assesses, and adjusts to allow for the staff to stay focused and productive.”
Dedicated, ongoing CMS/Sterile Processing education has also played a key role in the department’s success. Armed with IAHCSMM textbooks and educational materials, Paul Byers, a civilian technician, leads the department’s educational program. Even operating room nurses, surgical techs and dental students go through the training program, which provides a window into the world of sterile processing and outlines the standards and requirements that must be diligently followed to ensure quality patient care. In addition to the formal IAHCSMM training, Byers also schedules in-services at least once a month.
“Prior to Paul, there was no one person dedicated to education,” explained Martinez. “With Paul, we now have consistency with our training, which is very important and helpful.” Department-wide certification is also on the radar. “In the coming years, we want every [CMS] staff [member] to be certified,” said Byers, who is currently working toward certification himself. Salazar, who will be sitting for the Certified Registered Central Service Technician exam at the end of July, is already setting his sights on achieving Certification in Healthcare Leadership.
A healthy future
Such dedication to professional growth and knowledge advancement will undoubtedly play a key role in the CMS’ continued success, and its ability to keep up with the organization’s anticipated growth. The future growth of the base will include 70,000 additional soldiers and their families over the next five years, according to Salazar, as well as the construction of a new Army Hospital.
“We look forward to being a positive contributor to the overall mission of the Army and local area hospitals,” he said, adding that the CMS team is dedicated to ensuring that each critical step in the process is meticulously and diligently managed. “We have to get it right. First time, every time, on time – day and night, rain or shine – that is our job.”
Having Salazar at the helm, representing CMS on a wide range of interdisciplinary and high-level executive meetings, and regularly going to bat for both his team and CMS’ customers, will go a long way toward ensuring that the department will continue to thrive and succeed.
“You have to have a star manager. It’s very rare that you find a supervisor who can do it all so well,” noted CMS technician Johnny Dixon, a former military VA employee. “When you have a supervisor like Mr. Salazar who is so well-versed and keeps it all together, it’s a pleasure to be part of that team. We are so lucky to work with him.”
Still, Salazar, who was recently named WBAMC’s Employee of the Month, contends that the real shining stars are his staff. “They really deserve the awards. They make me look good and allow me to do the job that I need to do for them. Each of us plays an equally important role. That’s just the way a good team works.”
