MDR: What You Don't See In The OR...
Floor zero is integral to the structure to St. Joe's hospital, as is the Medical Device Reprocessing team (MDR), which calls floor zero home.
We met up with Ray Van Allen and Zeljka Radujkovic, both Medical Device Reprocessing Technicians (MDRT), to understand what MDR is, how it works and the vital services they provide to ensure our patients receive the best care.
What is MDR?
Ray: Medical Device Reprocessing receives all the soiled instruments from the O.R. as well as all the code carts from each unit. We disassemble, clean, inspect, sanitize, and sterilize. Everything that comes through our department must be sterile, which means that nothing can leave with any bacteria or micro-organisms.
How big is the MDR team and how is the team organized?
Zeljka: Within MDR we have 63 staff all together. Though all of us have experience throughout the department, we work at different stations. The first station is the soiled station, which receives all soiled instruments though an elevator exclusively reserved for instruments that are contaminated. This station processes and organizes everything for the industrial washing machines. The second step is the inspection and prep station where every tool is inspected one by one in order to ensure the machines did not miss any source of contamination. Each tool is organized and put back into its respective tray for final packaging and sterilization. Finally, the third step is the dispatch station. Once the tools have come out of the autoclaves they are carefully organized into our storage facility. We process roughly 50 sets a day which need to go back onto surgical carts.
How different is each surgical kit you assemble?
Zeljka & Ray: Every set is unique, and the number of instruments and type of instruments varies greatly. For example, a Cardio Vascular Thoracic set has 63 instruments, whereas a knee sets can have as many as 232 instruments.
When is it most stressful in MDR?
Ray & Zeljka: We have a very high turn around of sets and we often get rushes put on certain instruments, which means we have to clean and sterilize them pretty quickly. Last year we processed 1,376,586 instruments throughout the entire year, which roughly averages to 5,275 instruments a day from Monday through Friday.
How do you see MDR changing over the next five years?
Ray: I think the technology is only going to get better. When I first started here 25 years ago we had a piece of paper that followed an instrument to each station, now every item is scanned digitally as soon as it comes into the department.
Zeljka: Now when the items arrive they are scanned and a picture immediately shows up on the screen which tells us what type of cleaning it requires, how long it needs to go into the washer, how it should be packaged, and so on. We can track where each item is and how long it takes at a station, which allows us to know what tools should go in what order. It's really interesting how far things have come.
What is the most rewarding aspect of your job?
Zeljka: It's rewarding to know our job plays a valuable role in keeping a critical part of the hospital running. Amazing things happen in the OR and I love being a part of that.
Ray: On a personal level I like it because I am highly detail oriented about certain things, and what I love about this job is how precise everything has to be as well as the continuity of it, we move at a fast pace.
What is something you have worked on in the past that you are most proud of, and how has it helped you today?
Zeljka: A couple years ago the MDR department flooded very badly, and when that happened we were caught completely off-guard. We walked into the prep room and it was raining from the ceilings. Our department has to be kept at a certain temperature to regulate humidity, so everything had to be completely re-done from scratch to create a sterile environment. It was incredible to see the team come together and to minimize the damage and down time to our department. When it happened none of the scheduled surgeries could happen until we had completely fixed the mess and re-sterilized everything.
When you aren't at St. Joe's, what do you like to do in your spare time?
Zeljka: I have two little daughters, eight and six years old. We love to run and in general just spend time together. I also like to go out to spend time with my friends.
Ray: I really enjoy fishing and spending time with my grandson, as well as spending time with my wife!
What is your go to coffee or tea order?
Ray: A Tim Hortons double-double!
Zeljka: Just one milk for me.
Top Picture Descriptions (From Left to Right/Top to Bottom):
Ray with an emergency cart.
Ray and Zeljka in the prep room suited up.
Zeljka showing a code cart.
Dirty sets awaiting sterilization.
Sorted sets going into industrial washer.
MDR Technician processing equipment.
MDR Technician checking a surgical cart.
Ray checking a set for before it is wrapped.
Surgical set on loan.