WFHSS Conference 2011 - Lectures and Presentations - Opening Session
by Wim Renders
Good morning ladies and gentlemen,
It is my honour to welcome you to the 12th congress of the WFHSS. After the previous, successful conference, organized by SOBECC in Sao Paolo, we remain in the same language area. Beforehand I would like to thank ANES, and Luisa Nogueira and her team in specific, for the invitation, the perfect choice of location, the fluent cooperation, the exemplary organization, but most of all for the warm, Portuguese hospitality.
As I already wrote in my welcome message: In choosing for Estoril we make a date with history because the Portuguese explorers were the first to cross the oceans and thus they started the process of interaction between the continents. From the 15th century onwards, they determined to a large extent not only our view on the world, but also the other way round. In its domain the WFHSS is following in their footsteps by bringing together sterilization associations and members of staff working in sterilization departments all over the world. In this way we try to enhance the harmonization of decontamination practices and of the sterilization departments. Our aim is, by making the world of sterilization "smaller", to bring the basic right of every patient, to be treated with a medical device of a good quality, closer by. However, in contrast to the conquistadores, we do not intend to impose our philosophy and views. What we do want is to exchange information, present insights and ideas, and test these against other people’s opinion. We want to engage in a dialogue in which all parties involved are equal partners. Thus, it is a reactive model which can only work and hold out if it is reciprocal. In this case, sterilization can make quick and "real" progress.
Also on national level a similar kind of interaction between the departments should be achieved. To realize this is a task that belongs to the associations. They are in the best position to act intermediary because they are the most important carriers of information to the departments. It is mainly thanks to the associations that, during the previous decades, sterilization dramatically improved. In light of the growing knowledge and insights, the increasing quality claims which are in connection, amongst others, with the appearance of new forms of disease, the instrumentation which becomes more and more complex, the increasing amount of surgeries, the rapidly evolving hospital context, this was and is no unnecessary luxury. Everyone who is a member of an association will undoubtedly agree with this and will confirm its importance for the progress of daily practice.
Therefore, I would like to direct myself to those people in the audience who originate from those countries where no associations exist at the moment. I would like to ask them to do everything they can to found a national sterilization association. A collective approach is the best condition for individual progress. An old Chinese proverb that suits perfectly in this context, says: "If you want to go fast, go alone. If you want to go far, go together". The "higher" aim of an association has to be that each of her departments delivers at least a basic service and guarantees at least a basic quality.
Peter Hooper recently told me that he was surprised that "although he already visited a great deal of sterilization departments, he had never seen a department that is identical to another. They are all different". Despite the fact that we draw on the same sources, namely directives, norms, guidelines, recommendations and more or less standardized trainings, it seems that the texts are divergently interpreted and thus differently put to practice. Sometimes sterilization seems to be "A most individual expression of a most individual emotion". Of course local factors such as access roads, space available and resources play an important role. Nevertheless the question remains if we should not be searching for a consensus about what an ideal department can be and evolve in that direction? Because for the moment the "state of art" in sterilization has various ends. Even if the roads are not the same, they should, eventually, converge in the same goal: the delivery of a reproducible, qualitative medical device, at the best price.
Taking the first step is maybe the hardest one, but at the same time it is also the most important phase of the process. Progress must be made on the basis of evidence, knowledge and experience or on a fundamental attitude like Immanuel Kant, an 18th century German philosopher, described of: "Sapere aude" or "dare to know". In other words progress must be made on the courage to listen to your own mind. I would like to add another dimension here: we also must have the courage to consequently implement our expertise. Sterilization has need of this, because sterilization has problems with letting go of traditions and habitual routines, with making the final step to a contemporary department. Two examples and questions at the same time: During my visits to departments I often record that not all of the instruments are treated in the central department. The belief and confidence in one’s own knowledge and skills must surely by now be big enough to adequately treat, for example, also the delicate ophthalmological instruments in the CSSD. And is it really necessary to build in a control of the control of the control? Once again, we must be prepared to take up our responsibilities. Choosing for security should suffice. To maximize security is not what is required. It becomes time to rediscover the essence in sterilization.
In order to be able to do so, it is necessary that the department does not only have enough employees, but most of all has the appropriate employees. Because the human factor still is the factor with the greatest impact on the course of the process and thus on the final result. The latter is the result of teamwork. It is important that every employee can rely on his colleagues and vice versa. Thus, we have to hire employees which - apart of competence, as this speaks for itself - have the right skills and attitude and are enthusiastic to work in sterilization. This is even more the case for the person in charge of the department. He or she has a big responsibility. Because the level, the perception, the appreciation of the department depend largely on the charisma and the dynamism of the manager! Besides selection, education remains, as already mentioned before, a basic element. The three level programme of the WFHSS still is the model for this.
A good selection procedure undoubtedly has the side effect that "brain drain" can be prevented. The last is a phenomenon which recently struck me in several countries, especially with regard to the responsibles of sterilization departments. It is essential that sterilization keeps attracting also academics to preserve the scientific level and to build up credibility in the hospital. Having background information at one’s disposal, having the opportunity to increase knowledge and developing his/her own personality, is necessary to keep this job fascinating and interesting. Also, the further integration of a department in a hospital can contribute to this. For quite a while sterilization is no longer an island. Making an important contribution to the success of the whole can work stimulating and contain new, attractive challenges. In this way the department can, for example, play a bigger role in efficient hospital logistics. Preparing "case carts" is an excellent and functional example of this. Furthermore, the CSSD as expert in the field of cleaning and disinfecting can not only play an important advising, but also active role with this kind of procedures on the nursing departments and outpatient clinics.
Following the example of Diaz, Magalhaes and Vasco da Gama we too should have the courage of exploring new territories and push back our frontiers. Mental barriers have to be dismantled and replaced by an openness of mind, which should make innovation and progress possible. An inquisitive stance should stimulate us to look over the walls of the CSSD and lead to a better integration of the sterilization department into the caring processes and into the hospital.
A congress is not only a forum where the present and the future world, industry and working field, science and sterilization practice come together but it is first and foremost a place where people can meet face to face. This provides an additional value, which cannot be realized by reading a scientific article.
Therefore I trust that this congress can once again become the meeting place of the sterilization world. Together we can determine the road ahead and navigate the state-of-the-art. We hope our 12th congress will become an inspiring, scientific happening.
Thanks for being here, for your support. Enjoy the conference,