Over the last few decades, the rate of health-care-associated infections (HAIs) has caused great concern and placed infection prevention at the forefront of healthcare initiatives to improve safety and quality of care. But, despite changes in infection prevention protocols and the introduction of new equipment and products to prevent infection, problems with HAIs continue to plague the healthcare industry. Healthcare organizations also face increasing pressure to reduce costs. Healthcare providers – especially those in hospital owned practices – are making a rapid switch to sterile, single-use instrumentation to reduce HAIs and cross-contamination, as well as the costs associated with cleaning and sterilizing – or reprocessing – reusable instruments, which have been directly linked to HAIs.
Surgical Site Infections (SSIs) are the most common HAIs. In a 2015 Report, the Centers for Disease Control and Prevention (CDC) reported that SSIs account for 31 percent of all HAIs, or approximately 157,000 patients. Three percent of these patients (approximately 4,700) die, and 75 percent (approximately 3,700) of these deaths are directly attributed to the SSI. The cost of SSIs ranges between $10,433 and $25,546 for each event – a total cost of more than $4 billion annually.[1] According to the Center for Public Integrity (CPI), it is difficult to accurately assess how often dirty instruments cause infections, since bacteria can hide anywhere, but experts say it happens far more often than is generally understood. “The cases we hear about,” says Dr. Melissa Schaefer, a CDC medical officer, “are only the tip of the iceberg.”[2]
Until the early 1990s, surgical instruments were simpler, much larger, easy to clean and required minimal time and effort to sterilize effectively in order to prevent infection. With the healthcare industry moving toward better technologies, the use of micro-instrumentation to perform less invasive procedures on patients is growing rapidly. These instruments are harder to clean and reuse, and, as a result, instrument reprocessing has become a very complex process.
Healthcare providers know how critical it is to clean, disinfect and sterilize reusable surgical instruments, yet the thoroughness of cleaning and sterilizing surgical instruments is not standardized. The U.S. Food and Drug Administration (FDA), CDC and The Joint Commission have issued warnings, guidance and new reprocessing requirements. The Association for the Advancement of Medical Instrumentation (AAMI) and other standards-developing organizations have established or updated industry-recognized standards for reprocessing. Manufacturers and service providers have created new products and tools, and professional organizations have published guidance and recommended practices for healthcare staff on the various aspects of reprocessing. Yet, reprocessing remains a significant and persistent problem.[3]
Sterile, single-use instruments are the only way to guarantee 100 percent sterility for each patient
Many surgeons are moving to single-use solutions, indicating that safety and convenience are their primary motivations. U.S demand for single-use medical supplies will expand 4.1 percent annually to $49.3 billion in 2018.[4] This widespread change and market growth is the result of vast improvements in the quality of single-use instruments – quality that is now comparable to that of many reusable instruments. Sterile, single-use instruments are the only way to guarantee 100 percent sterility for each patient. The benefits of sterile, single-use instruments are driving demand and increased use in hospitals and outpatient procedures.
The broad benefits of sterile single-use instrumentation are evaluated in the following areas:
- Risk management. Managing the risk of infection and cross-contamination is a top priority for every healthcare professional. Using sterile, single-use instruments reduces the risk of HAIs and cross-contamination, providing peace of mind for both surgeons and healthcare managers.
- Decontamination and sterilization. Using sterile, single-use instruments removes all of the costs and headaches associated with reusable instruments and operating an autoclave, including adherence to compliance regulations and expenditures, such as the dead time spent running decontamination cycles.
- Instrument traceability. Single-use instruments are all individually traceable. The lot number that appears on the packaging is all the information that is required to trace the instrument back to its production batch and date.
- Logistics and supplies. Minor surgical procedures in the non-acute space are growing at a rapid rate. Retaining stocks of expensive, reusable, surgical instruments is not cost effective. Reprocessing reusable instruments is also a very significant cost in terms of both finances and manpower. It is essential that healthcare providers have sufficient quantities of sterile, single-use instruments. Purchasing sterile, single-use surgical instruments allows providers to manage their own supplies in line with their demand, at low cost and with order fulfillment in 48 hours or less.
- Cost allocation. Hospitals and healthcare reimbursement agencies are under increasing financial constraints, which has made it even more important that the true cost of each procedure is accurately assessed. True cost of sterilization and instrument tracking is difficult to record, with many costs hidden in resources such as utility bills and staffing costs. Single-use surgical instrument costs are simple and easy to calculate.
- Insurance reimbursement. Reimbursement for reusable and single-use supplies varies greatly. Reusable items are categorized as routine supplies in healthcare reimbursement policy. According to Moda Health, “In most cases payment for these supplies is included in the administration charge, which is reportable with a CPT or HCPCS code. In the inpatient setting, the administration service is included in the room charge or facility fee, and reimbursement for these supplies is included in the reimbursement for the eligible services. These items, if identified on a claim or itemized bill, are not eligible for separate reimbursement or for inclusion in outlier calculations for additional reimbursement.”[5] Single-use items, on the other hand, are considered ancillary – or non-routine supplies – because they are non-reusable. Non-routine supplies are directly identifiable to a specific patient and therefore are separately billable, either with or without a HCPCS code, with the appropriate revenue code.[6] Before submitting billing, please consult your billing manager for policy details.
- Cost savings. Disposing of an instrument after only one use may seem like a waste, but when you consider the amount of time and resources associated with reprocessing a reusable instrument and the documentation required to validate that it has been done properly, the cost savings greatly outweigh the negatives.
Ron Templeton, executive vice president of Sklar Instruments, states, “Single-use solutions are the way of the future for healthcare. They are the safest, most convenient and reliable choice. Not only do they provide cost savings, they can serve as an additional revenue stream for providers, because when a single-use instrument is utilized in a procedure, in some cases, it can be billed by the provider and reimbursed.”
Sklar has been following these healthcare trends and offers a wide range of sterile, single-use solutions to fit our customers’ needs. These solutions include the expansion of our sterilization facilities to provide an extended line of sterile kits, which are customizable, multiple grades and breadth-of-line for sterile single-use instruments, as well as consulting services to help customers transition seamlessly from reusable to single-use solutions. Sklar has the largest number of SKUs and patterns of high quality sterile, single-use instrumentation. To find out more about how you can take advantage of Sklar’s sterile single-use products and services, visit www.sklarcorp.com or contact us today at 1-800-221-2166 to request a sample.
About Sklar
For over 125 years, Sklar has built a legacy of offering surgical instruments that are unparalleled in quality and value to meet the ever-changing needs and standards of the healthcare industry. Since 1892, Sklar has been a leading supplier to the U.S. hospital network and a leader in both sterile, single-use and reusable solutions. Sklar has a comprehensive product line that is extremely competitive, offers over 19,000 SKUs and covers the following specialties: bariatric, cardiovascular/thoracic, colon/rectal, dental, dermatology, electrosurgery, ENT, laparoscopic/endoscopic, laser surgery, micro-surgery, neurology, OB/GYN, ophthalmic, orthopedic, pediatric, plastic surgery, podiatry and veterinary.
Notes:
[1] Centers for Disease Control and Prevention (CDC). Surgical Site Infection (SSI) Event. January 2015. http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf
[2] The Center for Public Integrity (CPI). Filthy surgical instruments: The hidden threat in America’s operating rooms. February 2012. https:// http://www.publicintegrity.org/2012/02/22/8207/filthy-surgical-instruments-hidden-threat-americas-operating-rooms
[3] The Association for the Advancement of Medical Instrumentation (AAMI). Reprocessing Summit Publication: Priority Issues from the AAMI/FDA Medical Device Reprocessing Summit. 2011. http://www.aami.org/events/eventdetail.aspx?ItemNumber=1284&navItemNumber=634#sthash.xJXzKFhE.dpuf
[4] Freedonia Industry Study (www.freedoniagroup.com), Disposable Medical Supplies, February 2014. Study #3111
[5] Moda Health. Reimbursement Policy: hospital routine supplies and services, October 2009: November 2015. https://www.modahealth.com/pdfs/reimburse/RPM043.pdf.
[6] Nave, Shelley, RHIA CPC-H. “Hospital Supplies—To Bill or Not To Bill?” Coding & Compliance Focus News, December 2011. http://medassets.com/_assets/pdf/ccfn_2011-10of10.pdf.
Infection Prevention: Sponsored by Sklar