ROAD WARRIOR 2021
General Johnson, SPD Director
General Johnson was introduced to sterile processing as a teen when he began working as a volunteer in a hospital. During that experience, he “fell in love with blood, muscles, and bone.” Two years later he became a scrub tech and then pursued nursing school. But he soon realized the nursing world wasn’t a good fit for him, so he went back to sterile processing where he immediately felt back at home. Quickly rising through the ranks, he just completed a contract in Dubai as a processing director over 16 hospitals. Always one to thrive under pressure, Johnson knows he doesn’t have to do everything on his own because it’s a team effort. He sees every new job as an opportunity for everyone—himself, staff, and his supervisors—to grow.
What is your priority on a new assignment?
The first thing I do is talk to the staff. I’m not there for the long haul, so the goal is to achieve a certain amount within a certain period. Within the first 30 days I have conversations, get an understanding of what the issues are, and attend every meeting I can. It’s important to gain trust because often staff has through several managers by the time I get there. At one facility, they had a different manager every year.
What metrics illustrate a well-run SPD?
A lot of times, people think they need more staff, but really, workflow is the problem. And they get into a habit of just trying to get through the day. At one assignment, I moved shifts around and had daily huddles to figure out where the hiccups were, who needs to be held responsible and accountable for what happens today, so we can make tomorrow a little easier. Then we get into a rhythm and eventually we’re not just planning for the day, but planning for the next couple of days, the next week, and then the next two weeks. I don’t plan beyond that because you need to have the flexibility for last-minute schedule changes.
How can SPD support volume growth?
Volume growth and inventory are connected. Once you identify the true needs of each surgeon and their service lines, you can make decisions about inventory. I’ll use one of my previous assignments as a real-world example. I had a surgeon that wanted to do four cases every Tuesday and Wednesday, plus a couple of small cases in between. The problem was that we only had two trays with all the instrumentation he needed. So, he would do the first and second case, but needed subsequent trays ready for the third and fourth cases, and we didn’t have enough time to turn over that first tray. Between cleaning and the procedures themselves, I had two and a half, maybe three hours to turn over that first set for the third case.
I shadowed him during his cases on a Tuesday and saw the instrumentation he was consistently using. He didn’t need some of the instruments he had or could have used something else. I had the team peel pack some of those scissors, needle holders, and some forceps that he trialed in this third and fourth case that we wound up adding to the set because we had an abundance of them.
Within three days, we were able to go from two trays to four by getting rid of a set that no one else was using but him. By that Friday, he was out of there by 3:00 p.m. when he’s usually leaving at 6:00 p.m. He told me he had been having this problem for two years and couldn’t believe it could be fixed in three days. Within a month we added a fifth set because I was able to make up the instrumentation from the other trays that we weren’t going to use anymore. This helped increase his surgical volume because he had five complete sets that allowed him to do five cases back-to-back of the same type of procedure without worrying about turnover.
A lot of facilities focus on FCOTS and that second case, but you need to be thinking about your third, fourth, and fifth cases for the day.
How do you approach relationships with surgeons?
I meet with them directly to find out what they’re concerned about. Some of those concerns are superficial, but many times things are going on that shouldn’t be happening. When I approach these issues, I don’t do shortcuts and I don’t like to assign blame. I tell them I’m here to figure out what the problem is so that I can make their jobs easier. I explain my rationale for why we can or can’t do something. It’s important for the OR team to feel they have a reliable go-to person in SPD to address issues.
Do you have any advice for SPD technicians who have been promoted to management roles?
Go to the monthly surgical meetings so you can hear directly from them what their concerns are and how you can help. Keep track of conversations through email and include the person in the C-suite. Don’t rush to achieve a bunch of things because if you miss one thing, that’s what people will fixate on. What are the concerns right now? Address those and move forward.
When you make changes to trays, be at their first case to make sure things went smoothly. See with your own eyes the progress of what is happening with every single tray. Just being there and making myself available cemented those relationships with the surgeons and helped me successfully streamline a lot of instrumentation. Rather than someone yelling and pointing fingers, it becomes a peer conversation. I’m not here to disrespect anyone, I’m here to fix the issue. When emotions get high, I just say, “I understand you’re upset, but I don’t deal with those tones inside the OR. When you’re finished with your procedure, I’ll be right outside the room, and we can discuss.”
Where can we find you in between interim jobs?
I am a workaholic at worst, but in between assignments I like to spend time with my kids, shop, work out in the gym. Maybe get a tattoo.