CSSD
Making the Business and Professional Case
Cynthia Spry, RN, MA, MSN, CNOR, CSIT
September 16, 2010
Objectives
Discuss contributions of CSSD to healthcare facility
Describe how to make the business case for CSSD
Describe CSSD Professionalism
Explore opportunities to promote CSSD
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CSSD Within the Healthcare Facility
• Located away from mainstream
• Adjacent to OR – lots of back and forth
• Out of sight, out of mind, until there is a
problem or a need
• Represented on significant committees
• Minimal understanding of CSSD work
Pay and recognition less than ideal
• Considered a cost center only
• Poor or absent partnerships
• CSSD staff not engaged in professional
aspects
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• Input and Output valued and recognized
- not just a cost center
• CSSD staff professional and current
• True partnerships with OR, ICP, etc.
Contributions
Contribution to Patient Safety and Healthcare facility
bottom line
Patient safety
Infection prevention
Inability to quantify – makes for less visibility
Means doing what is right even when no feedback
Prevention of injury due to equipment malfunction
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CMS “Never Events”
“Patient death or serious disability associated with the
use or function of a device in patient care in which the
device is used or functions other than as intended”
Approximately 20 states with similar pending legislation
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Contributions
Contribution to the bottom line
Not always about how much you make but how much
you keep
 Smooth operation encourages
business/surgeons/patients/staff retention (think
orientation costs)
 Patients now able to compare hospitals
www.hospitalcompare.com
 Fewer repairs, fewer expenses
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Christmas Time and Santa
Typical process
Someone decides what is needed
List of wants created and prioritized
Cost identified
Justification included
The case is pleaded
Decision is made
Your stocking may contain coal or what you asked for
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A well written business plan can help determine what
will be in your stocking
Business plan requires time, research and excellent
documentation
“CSSD managers need a good basic education in business and
finance to effectively develop business plans and make a
business case to justify a greater investment in their CSSD”
R.Schule HPN May 2010
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The Business Case – Why?
Because you want something and you must justify it if
you can hope to get it
A business case is the key to getting what you
need/want
A business case should be part of your 3 -5 year
strategic plan
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Business Case
A report that:
Identifies a problem
 Equipment need or staff development need
Describes a solution
States the cost to implement the solution
Identifies the ROI or the cost avoidance (CA) that will be
realized if the solution is implemented
WIFM, WIFM, WIFM
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What Does Not Work
It is obvious we need…
I have been saying for years we need…
If only I had been given…we wouldn’t be in this mess
Anyone who spends time in this department could see
we need…
You do not need to be a rocket scientist to know what
you need, but you must be able to articulate it
appropriately – the business case
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Profit Center VS Cost Center
Profit center generates more revenue than it costs to
operate
Cost center generates less revenue (or no revenue)
than it takes to operate
Which type of center are you?
Making a business case is possible for both
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Current Situation
State the problem
e.g. not enough staff to meet demands on SPD
e.g. Not enough sterilization capacity to meet instrument
demands – extended cycles
Describe why this is a problem and is an important
issue for the healthcare facility – not why it is a problem
for you – (SO WHAT!)
Never personalize the problem
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Current Situation
Include the intangibles as well
Happy customers
Employee satisfaction
Efficiencies
Happy surgeons
Health care facility reputation, etc.
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Data – The Critical Component
Support your problem description with data, data, data
especially financial
Work with OR/SPD/ICP/RM to obtain data
Number of cases – increase in cases
Changes in specialty e.g. bariatric surgery program, increase
in orthopedic surgery, changing patient population
Increased number of devices requiring extended cycle VS
number of surgeries
Support with cost of downtime
Number of hours and cost of overtime
Use of instruments – repair costs
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Data Sources
OR Director or business manager
SPD Director
Infection Control
Risk Management
Hospital Finance
What do you know about finances in your department
Payroll, inventory, productivity
Materials Management
Literature
Google Scholar
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Other?
Financial Data
Describe data source
Describe how you calculated and arrived at the
numbers
You may use data from similar facilities to support your
case
Compare repair costs, turnover times, etc – why
the difference, why similar?
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Your Proposal
State what you propose
e.g. a new sterilizer
e.g. additional staff member
e.g. new instrumentation or tracking system
e.g. contract with a repair company
Describe how it addresses the problem
State the cost
Describe the ROI or the CA - WIFM
How will it impact your data?
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Your Proposal
Identify the risks and the opportunities
Before you present your case anticipate objections and
be prepared to either preempt them up front or as they
arise
Justify why you need something when things are
working fairly well now
Keep it simple – don’t mix apples and oranges –
choose something that will quickly demonstrate value
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Start with something small enough to win but big
enough to make a difference
The Business Case for Infection
Prevention
Products to facilitate infection reporting
A new disinfectant system
An endoscope reprocessor
A sterilizer
?
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Impact of SSI
Patient
Health Care Facility
ICU 60% greater risk
Higher costs
Readmission 5X more likely to
be readmitted within 30 days
Reduced reimbursement
Reputation
Mortality – 2x more likely*
The Institute for Healthcare
Improvement estimates that
60 % are preventable
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*Hall MC. SCIP module 1 – www.medscape.com/viewprogram/7214
The Cost
Range of cost of SSI*
$1783- $135,602
Mean cost
$25, 546
Your facility may have this data
What about cost of a lawsuit
*AJIC 2005
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Infection Prevention
Cost Avoidance (CA)
May be difficult to quantify how your new
product/system will prevent infection unless can
quantify how current product/system supports infection
HOWEVER current focus is on patient safety (infection
prevention) and cost avoidance
NOW IS THE TIME!!!!
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Summary and WIFM
Summarize problem and solution – Executive summary
Summarize data
Determine next steps
Be sure to WIFM
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Business Plan Template
Executive Summary
Summary
What services you provide – data
Profiles of Management and Key personnel
Market and Industry Analysis
Trends, Innovations, Anticipated changes
Strategic Plans
Tie it into the facility mission and strategic plan
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Financial Forecast
Getting what you want/need – supported with
The Business Case
The consummate professional staff
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The Professional Case
CSSD week next month - October 10-16
Put your best foot forward
Promote professionalism
Professionalism will increase the odds for
success
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What is a profession?
Characteristics of a profession
Very specific or specialized, body of knowledge
Specific skill set
Identity and group mission
Standards and guidelines of practice and
behavior
e.g. AAMI, CDC, IAHCSMM
State and federal laws, institutional policies
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Characteristics of a professional - Overview
Lifelong learner – dedicated to ongoing learning
Competent
Conscientious
Timely
Effective communicator and collaborator
Integrity
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Implications
Showing up
Showing up on time
FLEXIBILITY
“Not my job” not part of one’s vocabulary
Respect for colleagues
Diplomatic
Seeking help as needed and requesting feedback
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Demonstrating Professionalism
Certification – not just because it is required
Becoming a fellow - only 30 so far
(see www.iahcsmm.org)
Engaging in professional organization – IAHCSMM,
AORN. APIC
Staying current – reading journal and other material,
webinars, etc
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Demonstrating Professionalism
Status – 2010 – HPN July 2010
47% high school - $44,605
26% AD - $57,568
18% Bachelors $67,000
15% are members of AAMI (3% in 2009)
68% are members of IAHCSMM
70% certified, 15% in process
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Demonstrating Professionalism
Demonstrating willingness and flexibility
Maintaining high standards of practice
Speaking up …(diplomatically but with confidence)
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CSSD professionals are privileged to serve
Patients and the healthcare facility are privileged to
have a staff of CSSD professionals
Let the world know who you are
Promote yourself to the healthcare facility and
to each other – CSSD week is the golden
opportunity
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Promoting CSSD
Open house
Visual displays
Newsletter
Reach out – don’t wait for a problem
Get involved outside of the department
Create awareness of CSSD and its services
Meet your customers!! Many a deal begins
informally – garner support for your business
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case
Attitude
Attitude
changes
everything!
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Attitude – You can make the difference!
The story of Johnny the Bagger as told by Ken
Blanchard and Barbara Glanz
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