Sterilization changes in wake of BAMC surgical slowdown

Staffing increase, extra shift after backlog cut open surgery suites in half

By Garrett Brnger - Reporter

SAN ANTONIO - The instruments that come into Brooke Army Medical Center's Sterile Processing and Distribution Division are used and dirty.

"They're bloody. They're gunky," said LTC Patricia O'Neal-Mellen, the Chief of SPD.

To get the surgical tools turned around and ready for use again takes a process that is meticulous, multi-staged and important.

"If we go down, nobody can do anything," O'Neal-Mellen said. 

So when staffing shortages helped cause a backlog in the SPD this spring, BAMC went from using 24 to 25 of its 28 operating rooms down to 12. But with changes that include pumping up staffing, adding a new shift and increasing quality checks, the hospital is back up to its normal surgical load.

"That also gave us time to implement a lot the things we were working on here," said O'Neal-Mellen, who took over the division in May.

A report by the San Antonio Express News in April said the surgical slowdown followed 73 cases of improperly sterilized instruments in the previous month, including some where organic material, such as blood or bone, were left on surgical tools.

"I don't know where their source is, but it wasn't from any data on here," O'Neal-Mellen said. "Nothing was sent up that wasn't sterilized."

Her boss, Chief of Operative Services COL Eugene Christen, told KSAT he couldn't confirm or validate that information in the Express News report.

Christen said the surgical slowdown was due to concerns that instruments wouldn't be ready when they were needed because of the backlog.

A news release from BAMC mentions operating room personnel raising “instrument sterilization concerns.”

"With the backlog, we determined that — no, we're finding out people are complaining more about finding out ‘Oh, this doesn't look right or that doesn't look right,’ or they had the wrong instrument in the set," O'Neal-Mellen said. "When that occurred we sort of stopped everything, said 'alright. We're not going to speed up what we're doing here. We're now going to concentrate strictly On quality."

In any case, BAMC has since bumped up its staffing levels by 24 people to a total of 96 and added a fourth shift during the busiest surgical times, according to the news release.

The hospital also increased quality checks, added and updated equipment and uses a "closely monitored tracking system."

According to the news release, BAMC again averages 65 to 70 surgical cases each day.

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