Why Outsource CSSD

Outsource Sterilization department with comprehensive Infection Control Program is need of the hour especially for primary and secondary hospitals and clinics to resolve challenges like:

1. 1. Hospital Acquired Infection
   2. Cost
      1. 1. Equipment Cost
         2. Infrastructure Cost
         3. Manpower Cost
         4. Instrument Cost
         5. Miscellaneous Maintenance Cost
   3. Lack of understanding of Quality Validation Program
   4. Inventory Control

Hospital Acquired Infection (HAI)

HAI is one of the major worries in Indian healthcare system. The main source of HAI are instruments & equipment that are earlier used on patient & not properly sterilized before reuse. Only washing under the running water or soaking in alcohol or heating on flame does not disinfect instrument & make it ready to use for surgery. The lack of know how about the complete process of sterilization leads to HAI to the patients.

Increased HAI leads to:

• • High morbidity and mortality rate
  • Increased antibiotic load, that results in multi drug resistance in the patient’s body
  • Increased patient length of stay in ICU and wards
  • Increased patient hospitalization bill because of overstay

As per study conducted at All India Institute of Medical Sciences (AIIMS), New Delhi, a single episode of Surgical Site Infection causes an excessive expenditure of Rs. 29,000/- .

ECONOMIC BENEFITS of Outsource CSSD

At SPD India, our core aim is focused on reducing HAI rate of the empanelled hospital by effectively implement infection control program to eliminate wrong practices & sterilizing medical products at the optimum level using best of the infrastructure with strong policies & procedures & quality validation program.

If hospital experiences even 5 cases of surgical site infection per month, approximately Rs.1,50,000/- is spent on the treatment for the recovery of the patient. This amount is either claimed from the patient else hospital has to bear the charges. Either ways, hospital loses its credential of providing quality treatment to the patient & it also affects the top line margins.

The cost that are saved by Outsourcing CSSD are as follows:

Equipment Cost

• • Autoclave: Even the smallest capacity of quality equipment duly complied to European Standard EN285 costs in lakhs.
  • ETO: Especially with small hospital the load for low temperature sterilization is not much & hence it is not viable to buy the equipment.
  • RO & DM Water Plant: For autoclave & surgical instrument long life, requirement of dedicated RO & DM water plant.
  • Oil Free Compressor: For drying of washed instruments & ETO functioning we need dedicated compressed air line & the air quality should be free from oil & dew.
  • ETP Installation: Since chemical/ cleaning agent will be used for washing of instruments, ETP (Effluent Treatment Plant) needs to be installed for treating the waste water.

Infrastructure Cost

• • CSSD requires zoning as dirty zone, clean zone & soiled zone.
  • These zones need air conditioning with pressure differential.
  • Clean & Sterile area need anti-bacterial paint & seamless- jointless flooring.
  • ETO need dedicated room & dedicated exhaust line which should be at least 20 feet high above the building height.

Manpower Cost

• • To effectively run & maintain EN285 standard equipment, specifically trained & certified manpower is required.
  • To implement infection control program we need dedicated Infection Control Nurse & Microbiologist.

Instrument Cost

• • Pilferage cost of surgical instruments.
  • Repair & Maintenance cost of surgical instruments.
  • Condemnation cost of surgical instruments due to rusting or poor maintenance. With proper cleaning using right water quality i.e. DM water, cleaning agent & right sterilization equipment can increase the life of the instruments & hence the cost of purchase.

Miscellaneous Cost

• • CMC/ AMC cost of the equipment.
  • Cost of Electricity & water treatment.
  • Cost of delayed OR due to non-availability of sterile instrument sets.
  • Consumable purchase cost for quality validation protocol.

Other Benefits of Outsource CSSD

Quality Validation Documents that are required to be managed as per NABH/ JCI Guidelines

• • Printed report of Vacuum leak test performed every day before starting of fresh load.
  • Printed report of Bowie Dick Test.
  • Biological Indicator pass report with every load. This report is available online & can be viewed and printed by the hospital.
  • Chemical Indicator with every set.
  • Cycle graphs for both Autoclave & ETO will be provided.
  • Monthly water testing report for Inlet & Outlet water.
  • Printed labels with batch no. & lot no. of Bowie Dick test, Biological Indicator & Chemical Indicator along with set name will be issued to hospital for their record keeping.
  • Random swab sampling of sets for microbiology test from third party NABL accredited Lab.
  • On demand, the hospital can ask for Certificate of Acceptance from SPD India for the consumables that are used like SMS wraps, Indicators, trays, etc for their record.

Web Based Instrument Inventory software

• • At the time of empanelment, the hospital user id will be generated on the software.
  • Current hospital instrument inventory will be entered into the software along with the photographs
  • Unique ID that is generated in the system will be engraved with the help of laser printing machine on each instrument.
  • Hospital can track the status of the instrument that are lost, missing or discarded from the inventory & also the expected life of instrument on real time basis.
  • In case any instrument is missing or lost or discarded from the inventory then same will be recorded with UID. This way the hospital will exactly know the instrument inventory status

By outsourcing CSSD, hospital can save a lot on direct & indirect cost, as well as, can focus on their core competency i.e. treating patients.