1.1 Patient's and surgery information are entered in the digital patient planning system by the surgeon.

1.2 The procedure is planned by the orthopaedic scheduler.

1.3 Weekly, the orthopaedic team discusses patients for the next 2 weeks and completes missing information in the planning system.

1.4 The needed instrument trays for the non-standard procedures are digitally selected by an OR nurse.

1.5 The planning is finalised 2 days in advance and is checked for missing information by the OR scheduler.

1.6 The patient is informed about the time of the surgery 1 day in advance.

1.7 An automatic final check is performed by the planning system to ensure that the availability of instrument trays is in accordance with the OR schedule for the next day.

2.1 A list with required instrument trays for the OR schedule of the next day is printed at 4 PM.

2.2 The instruments trays are collected in carts by a CSSD employee.

2.3 The instrument trays sorted for each procedure are scanned and prepared for transport in carts before 5 AM.

3.1 The carts are transported to the central storage of the hospital at 5.30 AM.

3.2 The carts are transported to the OR department.

3.3 The carts are scanned and handed over to OR personnel.

4.1 The carts are brought to the preparation area or to the emergency storage.

4.2 The carts are completed with additional instrument trays from the emergency storage if needed.

4.3 The carts are completed with additional materials such as disposable and sterile sheets.

4.4 The completeness of the carts is checked by an OR nurse.

4.5 The instrument trays are taken from the cart and arranged on an instrument table ready for the start of the procedure.

4.6 The sterile packagings are checked for eventual damage.

4.7 The instrument trays are scanned and linked to the digital patient planning system.

4.8 Sub-steps 4.5 to 4.7 are repeated for each procedure of the day.

5.1 The instrument tables are brought to the OR.

5.2 The procedure is performed.

5.3 The instruments are placed back in trays, checked for completeness, packed and placed back in a cart.

5.4 The soiled carts are brought to the soiled area in the OR department.

5.5 The carts are scanned and made ready to be transported

6.1 The carts are transported to the central storage of the hospital.

6.2 Empty carts are brought to the OR department to be filled with soiled instrument trays.

6.3 The carts are loaded in the trucks.

6.4 The carts are transported to the CSSD.

7.1 The instrument trays are scanned at arrival at the CSSD and specific cleaning and sterilisation requirements are identified.

7.2 The instrument trays are cleaned and disinfected.

7.3 The instruments are reorganised in the trays, checked for completeness and packed.

7.4 The instrument trays are sterilised.

7.5 The instrument trays are scanned and linked to the sterilisation process.

7.6 The instrument trays are brought to the storage area of the CSSD.