A Successful Implementation at Regina Qu'Appelle Health

Following a consulting engagement, Sullivan Healthcare Consulting (SHC), presented Regina Qu’Appelle Health Region, (RQHR), with a comprehensive inventory of recommendations to support improvement in the provision of quality service for their two-hospital, regional, Medical Device Reprocessing Department (MDRD). Top on the list for resolution was: staff turnover, instrument and resource management, staff engagement, program sustainability, and the universal budget challenge faced by all hospitals.

The RQHR was committed to service and quality improvement and retained SHC’s Lola Hannah, an OR Nurse with a master’s degree in both education and conflict resolution, to implement the process improvement recommendations. Hannah had established success in resolving the performance and quality issues discovered in the consulting phase. She worked closely with RQHR’s Executive Director of Support Services, Terri Carlson, who embraced the opportunity and the need for change. As the project executive lead, Carlson brokered critical conversations and advocated for necessary resources. For Carlson, having an on-site consultant who was familiar with the program’s challenges, budget, OR, and conflict resolution was key to success in making the necessary changes.

This collaborative and communicative partnership between Hannah as Project Manager and Carlson as Executive Director was the most important factor in the program’s transformation. And it was the open and honest communication between the two women that led to the successful implementation. Carlson explained, “I found working with Lola to be easy and effective. If something wasn’t working, Lola was very receptive to feedback and used it very professionally and constructively.” Likewise, Hannah praised Carlson for her ongoing ability to provide great leadership for the project.

Hannah was able to distill Sullivan’s recommendations into four interdependent focus themes, and four independent focus themes. One area of independent focus was staffing and staff development, as high turnover rates in MDRD – because of simultaneous retirements and high novice-to-senior staff ratios – was affecting timely instrument processing and handling. An MDRD education coordinator role was introduced. A structured and standard process for interviewing, hiring, orienting, supporting, and assessing new staff was developed and put in place, as well as identification and introduction of an ongoing MDRD staff self-assessment and staff development planning tool for experienced, senior staff.

Another inter-dependent area of focus was instrument and resource management, concluded by the addition of a dedicated MDRD coordinator to manage the significant instrument inventory. Without it, staff members from both the MDRD and the OR had sought daily confirmation about which instruments and associated sterile supplies were on hand, and whether they were readily available. Hannah noted “When you embed daily quality improvement work with intention, people see the value of their work. Staff need to have specific, laid-out plans so that they can come to work with the confidence that they know what they have to do and how it has to be done. And staff must have support roles to ensure achievement of best practice."

Three program roles were added to the MDRD service line:

  • A Regional Educator coordinator to help manage the strategic direction of staff engagement. This ensures high product quality, improved morale, reduced turnover, and enhanced patient safety.

  • An IMPRESS Coordinator to ensure the hospital was maximizing the power of its instrument management system, resulting in a team that knows the full scope of their instrument inventory.

  • A MDRD Program Director to provide strategic support to the MDRD program and all its instrument and associated supply system, advocating for medical device reprocessing, and resulting in a proactive and efficient use of staff and resources.

Additionally, Hannah ensured the recommendations and the resulting process improvement plans were informed by all regulatory standards and requirements. This ensured the MDRD was also easily meeting all its quality and safety obligations. "A huge added benefit to this strategy was the hospital did not have to do anything special to prepare for its scheduled accreditation visit,” Carlson explained, “We went through our regulatory review this year and it required very little work other than what we had already been doing. It was painless.”

In the end, the collaboration between Sullivan and Regina was deemed a great success. Carlson said, “I’ve really appreciated Lola working with me as a partner these last 15 months. She’s been nothing but a benefit for us. I don’t know how I could have done it without her expertise, but also her personality. With as much as I have on my plate, if I had a consultant that needed a lot of supervision, it wouldn’t have worked." Now the right tools and staff are in place and Regina is positioned for continued growth. Carlson said, “Lola left us work plans crafted out for the next couple of years, including the order that we need to do them to realize the next steps. We couldn’t ask for better go-forward work.”

The department is now ready to move solidly forward with the guidance of its new program director, taking over the work Hannah and Carlson began.

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