Good evening ladies and gentlemen,
It is a pleasure to welcome you in the name of the WFHSS to our 9th combined congress. This time the statuesque city of Milan functions as a backdrop and the Italian sterilization society AIOS as our hostess. She will not only guide us around the local sterilization world and grant us a broad perspective on the current situation of "decontamination" in the world but she will also lift a tip of the veil of the future.
It is one of the objectives of the WF to bring together societies and people to exchange information and ideas. In this way we want to make a contribution to ensuring that the quality of reprocessing is of the highest possible level across the globe. Because critical analysis and a comparison of the functioning of your own department with other departments should stimulate progress and innovation and thus not only lead to better sterilization practice but also to better patient care. This is not a superfluous luxury as it is a fact that in a large number of our departments there is still plenty of room for improvement. To attain a state-of-the-art level, is for quite a lot of us still a dream. But in order to reach the goal, the journey has to be undertaken. We are convinced that this congress will allow us to take a new step in the right direction.
The CSSD has a key role in the hospital as a supplier of sterile medical devices. And despite the fact that the CSSD provides a facilitating service, its contribution may not be minimized. Because it does not mean that our department is not important, on the contrary. But we should not forget that we decide ourselves whether we are taken seriously because we can only be as important as the service we provide and as the commitment we show. Therefore our product should be of the highest possible quality. We can and have to be big in something small; we should be committed for 100 % to this task. The higher our conviction to do this, the more important the CSSD will be in the hospital. At the same time this will help us to shed the negative image which all too often still clings to our department.
This requires permanent alertness and a lot of empathy for the patient. The latter is not always easy as we never get the stimulating emotional feedback which results from direct patient contact. Our motivation, the dedication of the members of staff in our departments has to arise from the realisation of the importance of our service within the framework of the total care provided in the hospital and the recognition of it by management. To the extent that the members of staff of sterilization departments feel valued, they will also perform better and their identification with a high quality end product will be higher. This is crucial for the quality of the output because the members of staff are the most important determining factors and actors in the provision of sterile medical devices. Their sense of self-esteem and self-respect reflects on the end product and the department and vice versa. It is a vicious circle because the extent to which the CSSD is given the recognition it deserves is in direct proportion to the quality of the end product.
We trust that during this congress the crucial role of the CSSD is once again highlighted. This can only contribute to the correct estimation of its value in the hospital.
This is not only crucial internally, with regard to our members of staff, as I have just now indicated, but it is also crucial for external reasons. Let me explain: it is also very important that both the local and the national authorities realize the importance of the sterilization department. Only then will they be prepared to make necessary investments in people and means, to give our departments financial oxygen. People and means are complementary, are symbiotic and a prerequisite to be able to produce a good end product. These are two of the pillars which support any department.
Unfortunately the recognition and thus the willingness of the management of both the hospital and the Health Department, all over the World, to provide the necessary financial means is not always big. That this is not in the interest of the patient is evident. Actually it is not acceptable at a time when patient safety is becoming more and more important in our health culture. More attention should be paid and value attached to the preventative and cost saving role of an end product of high quality provided by the CSSD, also by the authorities. E.g. it is not acceptable that the management of a hospital allows things to slip out of control in the CSSD and afterwards uses the bad quality as an argument in favour of a takeover by a third party. Nevertheless this is what is happening in certain countries.
The department too should be aware of the fact that the provision of medical devices which do not meet minimal quality standards negatively impacts on the future of the CSSD. It should do its utmost to prevent this from happening. Here lies a very important task for the manzger of the sterilization department who should insist with direction of the hospital on corrective measures if necessary. And the national sterilization society too should at a higher, mostly national level, be prepared to fight for the interests of the departments.
Please do not misunderstand me! Although I am not a supporter of out- or insourcing or external centralization, it could be an acceptable alternative when this happens for the right reasons. But a department should always be given a fair chance to prove itself and to be successful. However, this is only possible when all parties involved are prepared to collaborate to achieve this aim.
Investments in people and means are not the only critical success factors. It is also crucial that the departments dispose of the necessary know how. This is the third pillar on which a good CSSD is founded.
That is why first and foremost a minimal educational qualification depending on the level at which one is functioning and specific training are essential requirements for all our members of staff. This in order to understand the how and why of the department. Especially by our national societies a lot of effort is devoted to the organisation of training programmes. Indeed to transfer information into knowledge and to disseminate this knowledge is the core business of a society.
But in spite of the fact that the basics of the science of "decontamination" are the same all over the world, not only are the training programmes very heterogeneous but the same goes for the value of the diplomas which are awarded. An initiative should be taken urgently to bring about more homogeneity in training programmes and in the diplomas awarded. The three tier training model for the organisation of training proposed by the WFHSS could be used as an excellent guide in this regard. This is already the case in a number of countries.
Moreover it should be extremely useful to have at one's disposal a training manual which could be used everywhere. I am of the opinion that the writing of such a manual is a top priority. In this way the diverse efforts which are made at present can be grouped and thus a waste of time and energy can be avoided. In this way not only the harmonisation between the departments can be brought a little bit closer but in the future also the upward mobility of the members of staff can be guaranteed.
Maybe this will become necessary as a result of a growing shortage of manpower which is being predicted by some. Already now a number of positions cannot be filled anymore or not by qualified members of staff with the unavoidable consequences for the quality and the department.
The linking of a better remuneration to the taking and passing of specific training programmes has in a number of hospitals contributed to a better selection of the members of staff. In this way attrition can be countered.
Undoubtedly the latest has a lot to do with the image and the attitude of the department. The CSSD has to have the courage to leave its historic position as an underdog and has to project dynamism and self-confidence. The CSSD should provide opportunities and challenges to its members of staff. In this way burn out and monotony can be fought, attrition avoided and an attractive working environment offered.
The multidisciplinary nature of the CSSD and of decontamination which combines aspects of engineering, microbiology, hospital hygiene, physics and chemistry makes it into a very fascinating area in which to work. But in order to gain full respect, both internally and externally, it is of the utmost importance that the scientific underpinning of our discipline is emphasized. Science should show us the way to an evidence based practice and to an independent, respected position. Research should make a substantial contribution to a rational, future oriented approach and innovation in our departments. This is, according to me, the way forward.
Besides basic training, continuous education should ensure that knowledge remains up to date. This is all the more necessary for the CSSD which is active in an environment which is evolving very quickly. We trust that this congress will make a contribution to this objective.
A pleiad of national and international speakers guarantees absorbing papers. Hopefully they succeed in transfering to the world congress their enthusiasm for what should be a basic right for every patient the right to an adequately sterilized device. To guarantee this is the simple essence of our work in the hospital.
Finally I would like to thank the Italian society for being prepared to organize this congress.
I wish you all a successful conference and the necessary commitment and confidence to realize our key task namely to provide a good medical device to the provider of care and the patient.
Lot's of success!
Milan, 04 June 2008