Building a Bridge Between the OR and Central Sterile Processing Improves On Time Starts at New York Presbyterian

With the 2026 conference season underway, Infection Control Today^® (ICT^®) is posting interviews from last year. Attending conferences can significantly enhance your leadership and career trajectory, and here is an interview from AORN25 that hints at what you’ll miss if you don’t go.

At AORN25 (Association of periOperative Registered Nurses) held in Boston, Massachusetts, April 5 to 8, 2025, and beyond, infection prevention often focuses on pathogens, policies, and protocols. But sometimes the biggest gains in patient safety and efficiency come from something more fundamental: communication.

At New York Presbyterian Allen Och Spine Hospital, a collaborative project between the operating room and central sterile processing transformed strained workflows into measurable success. Jihan Asante, MPA, RN, NEA-BC, patient care director for the perioperative department, and Marie San Pedro-Pierce, MSN, RN, CNOR, CSSM, CNL, perioperative patient safety coordinator, presented their poster titled “Building a Bridge Between the OR and Central Sterile Processing.”

“We chose to work on this project because we found that there were some issues within the [operating room (OR)] in terms of meeting our metrics and as well as relationships between the central processing department and the operating room,” Santi explained.

Those issues were not minor. The teams were experiencing tray issues, including bioburden, incorrect trays being delivered, and wet trays. Extended setup times were frustrating perioperative staff and surgeons alike. “It just caused frustration from both ends,” San Pedro-Pierce said. “We included the surgeon in this as well as our central processing team and our team members.”

Rather than placing blame, the teams asked a different question: How can we improve this together?

San Pedro-Pierce described communication as the first critical step. “Improving communication, closing the loop, needing more was the first step,” she said. The team also conducted a practical exercise called walking in our shoes. OR staff spent time in central processing to observe instrument reprocessing workflows. Central processing staff visited the OR to see how trays were used during cases.

That mutual exposure shifted perspectives. It also highlighted a shared responsibility for quality. “Metrics matter,” Pierce emphasized. The team began monthly reviews of metrics with perioperative staff, including how trays were returned to central processing. “It also starts with us in the operating room,” she said. “If we send down the trays in a way that’s beneficial for the central processing team, if we’re doing our point of views and such, then it made the work easier for our central processing team.”

The impact was clear in first case on time starts. The hospital’s goal was 90% on time starts, defined as within 30 minutes for most cases and 40 to 45 minutes for large spine cases. Before the initiative, performance hovered in the 50 to 60% range.

Through improved communication, optimized surgeon preference cards, and improved tray accuracy, the numbers shifted dramatically. “We saw that there was a great decrease in tray errors,” San Pedro-Pierce said. By the end of the year, the first case on time starts had climbed to approximately 88%.

The work is ongoing. “We’re still working on this, and we’re still improving,” San Pedro-Pierce noted.

The lesson extends beyond one department or institution. Operational excellence in the OR is inseparable from sterile processing performance. When teams build bridges instead of silos, patient safety, efficiency, and morale all improve together.