As a consultant and key opinion leader in #SterileProcessing, I get asked often "what the industry benchmarks are for surgical tray errors" such as:
👉 retained bioburden,
👉 broken instruments,
👉 missing instruments,
👉 incorrect instruments,
👉 missing indicators,
👉 holes in packaging, filters, etc.
My standard answer, as many of you already know, is
"There isn't one."
And there's a lot of reasons there isn't one.
And I'll transparently say, our all-star clinical members of the Beyond Clean Advisory Group have it on their radar to address this benchmark gap, along with developing many other reasonable KPIs that are MIA in our industry. More on that another time.
But for tray errors in particular, I've long advocated for "internal benchmarking" over and against the traditional external benchmarking many of us are used to.
Why internal vs. external?
Well, for starters, I'm reminded of the perennial parental quip, "Well, if all your friends jumped off a cliff would you do that too?" And in the case of surgical instrument tray errors, we've got a whole lot of departments and facilities across the country today who, if they were tracking these error rates thoroughly, would be falling off the proverbial cliff.
To say it another way, we've got a whole lot of problems folks. We've got a whole lot of existing errors out there, and we've got a whole lot of errors that aren't even being tracked or reported at all.
Because of this, if you are a facility who is already wanting to take errors seriously enough that you're asking about a benchmark -- I can promise you that you're probably ahead of the quality curve. HOWEVER, the fact that you're asking also tells me that you already know that your own internal error rates are unacceptably high.
Which brings us to the beauty and deep(er) value of internal benchmarking.
With internal benchmarking, you control all the variables:
👉 What kinds of errors are you measuring?
👉 When are you measuring them (proactively in SPD - before they reach the OR? And/or reactively in the OR - once they have impacted the case?)
👉 What are you doing to streamline and capture errors at a high percentage of actual errors experienced vs. error reported?
👉 Are you distinguishing between "process errors" (that wouldn't necessarily impact the patient) vs. "patient safety errors" (which would impact the quality of care)?
👉 Are you striving for continuous improvement overtime or simply seeking to be as good (or as bad) as everyone else?
You get the idea.
Sterile Processing is a human process. There WILL always be errors.
But the errors don't all need to be as dangerous as they may be today.
They don't necessarily need to be repeated again and again for the same reasons.
They never have to be accepted as the status quo, simply because everyone else is making the same amount.
That's a little taste of why I'm a huge fan of internal #benchmarking.
What say you?
Hank Balch
Hank Balch is the Founder & President of Beyond Clean. He began his career in instrument reprocessing as a frontline technician in 2009, and has served as an Instrument Database Specialist, Department Manager, and System Director for various SPD departments across the country. Hank is an award winning Sterile Processing leader (2016 Healthcare Purchasing News "CS/SPD Department of the Year", 2023 Super Star in Sterile Packaging, 2024 GiG Award), twice nominated for IAHCSMM President (now HSPA), founder of two state-wide IAHCSMM chapters, conference speaker, and well-known industry writer, blogger, and social media connoisseur. He has written over 200 Sterile Processing articles, with his work being published in Becker's Hospital Review, Infection Control Today, Healthcare Purchasing News, Communique, Outpatient Surgery Magazine, AAMI BI&T Journal, SteriWorld, NewSplash and other publications across the globe. His passion is seeing frontline Sterile Processing professionals equipped to #FightDirty, every instrument, every time.
Additional AI-generated resources on this topic:
Why internal benchmarking of surgical tray errors is a more effective model than relying on external benchmarking:
1. Tailored to Unique Operations
Every Sterile Processing Department (SPD) operates under unique circumstances, including differences in:
- Case volume and complexity: High-volume, high-acuity facilities will naturally face different challenges than smaller centers.
- Instrument inventory and technology: Facilities with cutting-edge tracking systems or automated reprocessing will differ from those using manual processes.
- Staffing levels and expertise: Turnover, training programs, and certifications vary greatly across institutions.
Internal benchmarking allows a facility to evaluate its specific challenges and priorities, ensuring goals and improvements are tailored to its operational realities, rather than striving for metrics that may not be relevant or achievable.
2. Drives a Culture of Continuous Improvement
External benchmarks often create a sense of comparison with peers that can be demotivating or misleading. Internal benchmarking, on the other hand, emphasizes:
- Personalized improvement: Encouraging staff to outperform their past performance rather than competing against an arbitrary standard.
- Ownership and accountability: Teams are more likely to take pride in surpassing their own goals rather than aiming for metrics set by outsiders.
This approach fosters a culture of accountability, collaboration, and pride in continuous growth.
3. Overcomes Limitations of External Data
The lack of standardized, national benchmarks for surgical tray errors presents inherent challenges:
- Inconsistent definitions and reporting: Facilities may classify or track errors differently (e.g., one facility may log a torn wrap as an error, while another may not).
- Incomplete or inaccurate data: External benchmarks may rely on self-reported data, which can be prone to underreporting or errors.
- Lack of context: External benchmarks don’t account for factors like patient acuity, tray complexity, or operational constraints, making comparisons less meaningful.
Internal benchmarking ensures accuracy and consistency by using your facility's own data, tracked using standardized methods.
4. Enables Rapid, Targeted Interventions
By focusing on internal data, SPDs can identify trends and act quickly:
- Real-time feedback loops: Regular reviews of errors enable rapid responses to process breakdowns, staff retraining, or equipment maintenance.
- Customized improvement plans: Errors such as retained bioburden or missing indicators can be addressed with interventions tailored specifically to your facility’s root causes.
This agility isn’t possible when waiting for national data or external comparisons, which may be delayed or irrelevant.
5. Encourages Sustainable Improvements
Internal benchmarking supports long-term success by:
- Tracking progress over time: Facilities can measure trends in error reduction, focusing on gradual and sustained improvements.
- Fostering a growth mindset: Staff are empowered to see errors as opportunities to learn and improve rather than as failures compared to others.
This approach aligns with the broader goal of creating a resilient SPD with a proactive focus on quality and safety.
6. Promotes Cross-Departmental Collaboration
Internal benchmarking often highlights systemic issues, encouraging collaboration between the SPD, Operating Room (OR), and other stakeholders:
- Shared goals: Teams can collectively work to reduce tray errors, improve communication, and streamline processes.
- Mutual accountability: Rather than focusing on how the facility compares to others, internal benchmarking fosters a “we’re in this together” mindset across departments.
Conclusion: A Better Path Forward
While external benchmarks can provide a high-level perspective or serve as aspirational goals, they often lack the specificity and relevance needed for meaningful improvement in SPDs. Internal benchmarking allows departments to set realistic goals, measure their own progress, and cultivate a culture of continuous improvement tailored to their unique environment.
By focusing on internal data, SPDs can transform surgical tray errors from a point of frustration into an opportunity for growth, innovation, and excellence.
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