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Florida Hospital Overhauls Tissue ManagementProcess and Improves Patient Safety By Beth Suriano, RN Director, Surgical Services Jupiter Medical Center, Jupiter, Fla.  Identifying Tissue Management Risks Several years ago, vendors delivered tissue allografts to our hospital in the same way they brought in other inventory and supplies. Occasionally sales representatives would keep tissue inventory in their cars, and distribute the tissue directly to clinical units here at Jupiter Medical Center. This was pretty much standard operating procedure at hospitals across the country. The news media, however, began running stories about contaminated tissue — and the dangers that such tissue posed to patients. The Joint Commission took up the issue and published new regulations and management guidelines. Like other providers, we needed to change how tissue was arriving at our hospital. But we also realized we needed to change our entire tissue management process. Tissue needed to be much more tightly controlled and monitored. Cumbersome Manual Processes Under close examination, we found manual tissue management processes that didn't optimize efficiency or patient safety. For example, if tissue was recalled, staff would put in long, stressful hours trying to determine whether we had any of the contaminated tissue in our inventory or whether we had already implanted the tissue in patients. Nurses would manually page through reams of loose-leaf notebooks filled with handwritten documentation to identify any instances of the recalled tissue. Our manual tissue management also resulted in:  Wasted money and inventory. Since it was difficult to determine from manual trackingexactly what we had and what we needed, we would order tissue that we never used. Inefficient use of staff time. Staff spent many hours trying to manage tissue documentationand meet regulatory requirements. Manual safety efforts. Staff performed manual reviews to ensure expired tissue did notmake its way into the operating room. As a result, we knew we needed to move away from manual tissue management and look for a computerized method that would enable us to keep pace with emerging regulatory requirements and ultimately to keep patients out of harm's way. To better manage tissue inventory and comply with regulatory requirements, we began using McKesson's tissue tracking and inventory management software. The solution helps us efficiently manage tissue and device implants — from when we receive them through implantation in the patient or final disposal. It also enables us to better comply with the Joint Commission's requirements that hospitals use standardized procedures to acquire, receive, store, prepare, and issue tissue implants. Proactively Managing Tissue With McKesson's solution, we are now able to automate the entire tissue management process. Improvements we've seen include the ability to: Manage tissue inventory storage. Some tissues need to be refrigerated, others need to be stored "fresh frozen" and others can be maintained at room temperature. The solution identifies exactly how each tissue needs to be maintained and prompts staff on proper storage measures. Automate the tissue distribution process. If we have a surgical case that requires a tissue, the system can identify which tissue implant should be used for the particular patient. At the same time, the system monitors tissue inventory and reorders grafts as needed. To keep our inventory safe, the system automatically reviews expiration dates and proactively alerts staff to utilize tissue based on the expiration dates (older unexpired inventory is used versus wasted). The system also sends an e-mail to staff when expired tissues need to be removed from the shelf. These alerts help us protect patient safety and also save about $10,000 per year through improved tissue inventory management. Streamline the recall process. Instead of spending hours manually searching for recalled tissue, staff now can identify the location of the tissue at the click of a button. The affected tissue is then pulled out of inventory. If it already has been placed in a patient, the surgeon is immediately notified and patient communication initiated. Enhance documentation. The system guides users through the tissue management process to ensure entry of documentation required for regulatory compliance. Staff is prompted if required information is missing. As a result, our records are always complete — and ready for any audit. By leveraging technology to completely reinvent tissue management, we have been able to successfully comply with regulatory requirements, improve productivity and reduce expenses. Most importantly, we are confident in our ability to provide safe tissue implants to our patients. Beth Suriano, RN, is director of Surgical Services at Jupiter Medical Center. In this position, she is responsible for the daily operations related to surgical procedures and for all resource utilization within Surgical Services. She manages 10 operating room suites, the post-anesthesia care unit, the pre-operative clinic, the sterile processing department, pain management clinic, and the Endoscopy suites.   |
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