By: Hank Balch with Beyond Clean
The real epidemic in many sterile processing departments across the U.S. is not measles or the flu, it’s a disease called MMOB (Mind My Own Business), and its side effects can be just as debilitating and deadly as the most virulent strain of H1N1. Let’s take a look at how this cultural bug can infect your team and why it’s imperative that you do everything in your power to fight against it.
In the cultural water One of the traits the sterile processing department culture values most is the ability of a person to mind his or her own business. People who get involved in conversations or conflict that have nothing to do with themselves are looked down upon as busybodies and gossipers. No one wants to be that guy or girl who sticks his or her nose where it does not belong, so we cultivate the innate skill of trying to keep our heads down and eyes focused on whatever task we have in front of us. We are taught from childhood that no one likes a tattletale, so we commit to never tattle and never tell.
The problem is that when we bring this general cultural concept of politeness into a specific context such as sterile processing, it can slowly pull individuals and teams down into the dangerous sea of tunnel vision where no one cares to see what anyone else is doing, even if the behaviors are leading to inefficiencies, higher costs, and potential patient harm.
Perhaps one of your team members always skips detailed visual inspection and brushing of lumen items during decontamination. You notice a particular employee isn’t verifying load parameters, but is just writing the same thing on every load card. You observe technicians assembling loaner trays without ever lifting up any of the sizing trials. What do you do?
If your department culture has been infected with the MMOB disease, you may be expected to tune that other person out, focus on doing your own job well, and hope that supervisors or managers eventually see the noncompliance themselves so that they can take action. If you did say something, you might hear a response, such as “You’re not my boss,” or “I’ve always done it this way.” There may be real cultural pressure from your department peers to keep your mouth shut. Swimming against this stream of tunnel vision is no easy feat for sure, but is it the right thing to do?
How to swallow your pride, call others to humility, and mind everyone else’s business Where do you start? First, let’s get something important out of the way. You may be afraid to speak up and correct someone else’s actions because you know that you don’t have it all figured out yourself. You have made mistakes in the department and perhaps even intentionally cut corners, and you know that if you try to wave a flag now, it might very well blow up in your face. In light of this, self-preservation kicks in and you make the decision to keep quiet. After all, no one wants to be a hypocrite. You’ve messed up, so give everyone else some space.
One of the problems with type of response is that its root often consists of an interesting combination of pride and a lack of self-confidence. Our pride tells us that we don’t want anyone to point out our mistakes, so why would we do that for others? And our lack of self-confidence keeps us from finding the courage to do the right thing in these difficult cultural situations.
Whatever the reasons, there is never a circumstance in sterile processing where real errors and actual mistakes should go on without response, and typically the initial response should be from team members who actually see it happen. This doesn’t mean that you have to swoop in with a holier-than-thou attitude to inform the peons about the obviously correct way to do things. Instead, it means that everyone on the team understands that they are their brother’s keeper, and they must be willing to swallow their own pride and receive necessary correction from their peers in the name of patient safety.
Department leaders must also encourage, model, and reward team members for looking out for each other. If you get a report that so-and-so is skipping critical processing steps, the initial response should not be to call that other person into the office for a verbal warning and stern talking to. Instead, you should find out the reasons why this team member is skipping the steps in the first place. Does he lack education? Does he have the tools he needs to complete this task? Are there distractions that are pulling his attention away? Whatever the reason happens to be, department leaders must communicate to the entire staff that their commitment to team accountability is not about tattletaling, gotcha moments, or finding excuses for discipline.
When sterile processing technicians mind each other’s business, they are fulfilling their duty to every single surgical patient that ends up underneath their scalpels, clamps, and surgical retractors. These patients don’t care about your pride or your past mistakes. They only want to go home from their surgery in better shape than they came in. For that to happen, we need departments full of team members who have each other’s backs, not in some kind of see no evil, speak no evil culture of silence, but in a healthy understanding that what matters most in our departments is not the pride of never making a mistake, but the assurance that if we do make one, our co-workers have permission to fix it before it’s too late.
After all, we are in the business of patient safety, so let’s mind it well.
