🧼 The Hidden Engine: Optimizing Sterile Processing for Safer Surgeries and Stronger Teams

When people think about life-saving moments in healthcare, they picture surgeons in the OR, nurses at the bedside, or the flash of an emergency response. But there's a quieter engine running beneath it all — the Sterile Processing Department (SPD).

Every scalpel, clamp, or retractor that makes it safely into an operating room is handled, cleaned, assembled, and sterilized by SPD professionals. And yet, despite their critical role, SPDs remain one of the most under-recognized, overburdened, and under-resourced units in many hospitals.

So what does it take to truly support an SPD? Three recent studies shine a spotlight on the intersection of operational excellence, workforce well-being, and systems design — and offer a roadmap for a better future.

🛠️ 1. Lean Six Sigma: Manufacturing Principles Saving Lives

A study published in The Joint Commission Journal on Quality and Patient Safety demonstrated the transformative potential of Lean Six Sigma in SPD operations. After applying a phased improvement initiative involving workflow analysis, staff training, and a $2 million investment in storage and inventory systems, the hospital achieved:

• First Pass Yield (FPY) improvements from 81.0% to 97.4%

• Defect rate reductions from 2.2% to under 0.10%

• Instrument search times reduced from 10+ minutes to under 10 seconds

These outcomes not only enhanced operational efficiency but also reduced the risk of surgical delays and improved overall patient safety (Natarus et al., 2025).

The project’s success was attributed to:

• Implementing the Lean 5S methodology in both physical and digital workflows

• Accurate count sheet updates and better communication with the OR

• Integrating barcode scanning and inventory location data into the instrument management system (IMS)

💬 2. Who Heals the Healers? Quality of Life in SPD

While process optimization matters, so does the human experience behind it. A Brazilian study published in Revista Brasileira de Enfermagem surveyed 82 SPD nursing professionals to assess their quality of life (QOL). The most impacted areas were:

• Pain

• Vitality

• General Health Status

• Social Aspects

The study concluded that the physically demanding and high-pressure environment of SPD work contributes to reduced well-being — and called for rethinking work dynamics to better support the mental and physical health of SPD teams (Rego et al., 2020).

This reinforces the need to balance systems improvement with investments in people, ensuring those who protect patients are also protected.

🔍 3. Where Do Errors Really Come From? A Systems View

A third study published in BMJ Quality & Safety used the SEIPS model (Systems Engineering Initiative for Patient Safety) to analyze instrument assembly, the phase responsible for over 55% of tray defects. The research found:

• Missing instruments were the most frequent assembly error, accounting for 17.6% of all defects

• Errors were linked to production pressure, inconsistent nomenclature, inadequate ITS design, and staff training gaps

• A variance matrix revealed how systemic issues — not individual failures — were the primary drivers of assembly defects (Alfred et al., 2021)

This study emphasized that fixing SPD reliability isn’t just about retraining staff — it’s about redesigning the system they work within.

🔄 The Common Threads

Despite their different lenses — operations, wellness, systems — all three studies lead to the same core truth:

Sustainable excellence in sterile processing requires a balanced investment in process, technology, and people.

Across all three, we see recurring themes:

• Staffing and training are foundational

• Standardization of nomenclature and workflows is essential

• Digital and physical inventory integration improves reliability

• Well-being and work environment design are critical for retention and performance

🚀 Moving Forward

At the SoCal Sterile Processing Association, we believe that every tray tells a story — not just of instruments, but of the people who prepare them and the systems that support them.

These studies offer a compelling case for change. By investing in structured improvement strategies like Lean Six Sigma, upgrading infrastructure and information systems, and addressing the well-being of SPD professionals, we create a future where safety, efficiency, and staff satisfaction can coexist.

Let’s keep the conversation going. Join us at our Summer Symposium on June 14, 2025, in Long Beach to dive deeper into these topics, hear real-world success stories, and connect with leaders driving innovation in SPD.

Together, we can strengthen the engine that keeps surgery safe.

📚 References (APA 7th Edition)

• Alfred, M., Catchpole, K., Huffer, E., Fredendall, L., & Taaffe, K. M. (2021). Work systems analysis of sterile processing: Assembly. BMJ Quality & Safety, 30(4), 271–282. https://doi.org/10.1136/bmjqs-2019-010740

• Natarus, M. E., Shaw, A., Studer, A., Williams, C., Dominguez, C., Mangual, H., Olmstead, J., Westmoreland, K., Gill, T., Wellington, W. Z., Wheeler, D. S., & Ida, J. B. (2025). Optimization of a sterile processing department using Lean Six Sigma methodology, staffing enhancement, and capital investment. The Joint Commission Journal on Quality and Patient Safety, 51(1), 33–45. https://doi.org/10.1016/j.jcjq.2024.10.006

• Rego, G. M. V., Rolim, I. L. T. P., D’Eça Jr, A., Sardinha, A. H. L., Lopes, G. S. G., & Coutinho, N. P. S. (2020). Quality of life at work in a central sterile processing department. Revista Brasileira de Enfermagem, 73(2), e20180792. https://doi.org/10.1590/0034-7167-2018-0792