The Next Generation of SPD Leadership: From the Basement to the Boardroom

The Department Everyone Notices Too Late

A hospital decides to grow surgery. It recruits new surgeons, buys another robot, expands service lines, or adds operating rooms. These are visible investments, often announced as signs of growth and better access for patients.

The effect on sterile processing is less visible. Every added case brings more instruments to purchase, move, clean, inspect, assemble, sterilize, store, and return. A new procedure may also require different equipment, unfamiliar trays, staff training, or space the department doesn’t have.

Too often, sterile processing departments (SPDs) are brought in after the decision has been made. The warning signs appear later: trays are not ready, turnaround times tighten, equipment runs at capacity, staffing falls short, or the department simply runs out of room. At that point, the team is not helping design the growth plan. It is trying to make the plan work.

This is why surgical growth cannot be discussed only in terms of market demand, surgeon recruitment, or OR capacity. Someone also has to ask what the additional behind-the-scenes work will require. Does SPD have enough people, equipment, inventory, space, and time to support the plan safely? If those questions come late, the options are usually fewer and more expensive.

Running a strong department still matters. So do workforce development, sound technology decisions, and the ability to lead people through change. But those skills can only go so far if they’re absent when the organization decides what to build, buy, expand, or staff. Sterile processing leaders need to bring their expertise to the planning conversations that shape surgical growth, capital investment, and patient safety.

Seven emerging sterile processing leaders from health systems across the US considered what it takes for SPD expertise to influence organizational planning and decision-making. The leaders are (Figure 1): Brandy Bowser, CRCST with Kaiser Permanente; Mamadou Cissé, CST, HSR, with Hospital for Special Surgery; Bobbie Gaskins with the Cleveland Clinic; MK Parrott with Ascension; Felicia Sheriff, CHL, CIS, CSPDT, with Harris Health; Eduardo Velazquez. CHL, CRCST, CFER, CSPDT, with UCHealth; and Michele Webb, CRCST, CHL, CER, CIS, with Cooper University Hospital.

They work in different organizations and followed different paths into leadership, but they agree on this point: SPD cannot remain the department expected to adjust after everyone else has decided what comes next. Its leaders need to enter the conversation early enough to explain what a plan will take and where it may create risk.

The next step in SPD leadership is not just running the department well. It is helping the organization make better decisions.

Every Strategic Decision Has an SPD Consequence

Decisions made far from sterile processing can change the department’s workload overnight. A new surgeon arrives with unfamiliar instruments. A service line adds procedures. A capital purchase changes the trays required for a case. A construction project adds operating rooms without adding processing space. By the time the effect reaches SPD, the original decision may already be difficult to change.

Bobbie Gaskin sees the same pattern across surgical expansion, instrumentation, technology, construction, and quality initiatives. Each may begin as a clinical, financial, or operational decision, but each eventually creates a processing requirement. SPD must determine what the change means for trays, equipment, staffing, training, workflow, storage, and turnaround time.

The point is not that SPD needs to be included in every organizational discussion. It needs to be included when a plan depends on instruments being available, processed correctly, and ready when the clinical team needs them. Early involvement gives the organization a chance to test whether the plan is workable before commitments are made.

Without that input, an expansion that looks feasible on paper may depend on tray inventory that has not been purchased, equipment that is already near capacity, staff who have not been trained, or turnaround times the department cannot sustain. The gap usually becomes visible only after cases have been scheduled, and expectations have been set.

What happens in the operating room does not stay there. Every change in surgical demand eventually becomes a question of SPD capacity.

Every operating room (OR) decision creates a corresponding SPD decision.

Surgical Growth Is an SPD Capacity Question

One of the clearest observations came from Gaskins.

“You cannot build the OR of the future without building the sterile processing infrastructure behind it.” —Bobbie Gaskins

Gaskin’s point goes beyond adding more sterilizers or finding more square footage. SPD capacity is a connected system. It depends on having enough instrument inventory, decontamination and assembly throughput, sterilization capacity, utilities, storage, transportation, trained staff, and room to recover when equipment goes down or demand spikes. A constraint in any one of those areas can limit the whole operation.

That is why averages can be misleading. A department may appear able to support more cases over the course of a month and still struggle during peak hours, high-volume days, or shifts with fewer experienced employees. Procedure mix matters too. Ten additional cases do not create the same demand if they require more complex trays, longer processing cycles, specialized equipment, or faster turnaround.

Useful planning begins with specific questions. Which procedures are being added? What trays and equipment will they require? When will the work reach the department? Can SPD manage the peak, not just the average? What happens if a washer, sterilizer, tracking system, or transport route is unavailable?

Capacity is not simply the maximum amount of work a department can push through. It is the amount it can support safely and reliably under real operating conditions.

The answer will not be the same for every organization. Some may need to expand onsite space or equipment. Others may improve instrument utilization, add inventory, change staffing patterns, or use automation to relieve a specific bottleneck. Regional or offsite processing centers may create scale or address space constraints, but they also add transportation time, inventory needs, handoffs, coordination, and contingency planning. Each option solves a different problem and creates different operating requirements.

Michele brings the discussion back to timing. If SPD is involved only after a growth decision, its leaders may be left explaining why the existing operation cannot support what has already been promised. Involved earlier, they can show what the plan will require, compare options, and identify where investment is needed. To influence those decisions, however, SPD leaders must be able to translate capacity into terms the organization can act on: case growth, capital needs, cost, risk, and operational reliability.

Speaking the Language of the Organization

Being included in planning conversations is only useful if SPD leaders can explain the work in terms others can act on. Mamadou Cissé makes that point plainly: Department data carries more weight when it is connected to an outcome the organization really cares about.

A missing instrument may begin as an SPD issue, but that is not where its effect ends. It can delay a room, extend turnover time, disrupt the schedule, or require an expensive replacement. Low tray utilization may point to capital tied up in sets the organization rarely uses. A sterilizer bottleneck may limit the number or type of cases the hospital can support. The operational details matter, but leaders outside SPD also need to understand the consequences.

This does not mean reducing every concern to dollars. Patient safety, quality,andstaffworkloadremain importantintheirownright.It means showing how those issues connect. A request for additional trays is stronger when it includes utilization, case demand, turnaround pressure, and the cost of not having the right set available. A staffing request is clearer when it shows workload by shift, overtime, quality findings, and the demand expected from planned growth.

MK Parrott notes that many SPD managers are expected to analyze data, prepare presentations, justify spending, and brief executives without having been prepared for those responsibilities. These skills should not first appear when someone reaches a management role. Emerging leaders need opportunities to work with budgets, capital requests, performance measures, improvement projects, and presentations while they still have guidance and room to learn.

The goal is not to make SPD sound like finance or operations. It is to make the department’s expertise understandable across those functions. Technical knowledge gives the leaders something important to contribute. Business fluency helps that contribution travel far enough to influence a decision. When SPD leaders can do both, they are better positioned to move the conversation from what the department needs to what the organization is trying to achieve and what it risks if the processing requirements are overlooked.

SPD leaders need to become comfortable owning data, not just instruments.

Recognition Is Not a Marketing Problem

Sterile processing has spent years trying to gain visibility. Awareness matters, but visibility by itself does not change how a profession is valued or when its leaders are included. Recognition grows when other parts of the organization understand the expertise behind the work and learn that SPD can be counted on as a credible partner.

Bobbie Gaskins sees professionalism in the everyday choices that build that credibility: How people communicate, continue learning, work with clinical partners, respond when something goes wrong, and uphold standards when no one is watching. A campaign can introduce people to SPD. It cannot substitute for the reputation created through consistent performance.

Eduardo Velazquez makes a related point about professional expectations. Greater recognition and compensation should be accompanied by stronger education and a more established role for SPD in perioperative decisions. If the profession wants greater influence, it must continue to strengthen the knowledge, judgment, and accountability expected of the people who represent it.

MK Parrott adds communication to that responsibility. The value of SPD may be obvious to those who work in the department, but it is not always obvious to people whose only interaction is a delay, a capital request, or a quality report. Explaining the work clearly and connecting it to the organization’s priorities is part of professional practice, not a separate promotional task.

Felicia Sheriff shows that credibility becomes influence. By building relationships, serving on committees, and staying involved in organizational discussions, she was well positioned to advocate for SPD as leaders decided where advanced technology support could have the greatest impact. Her visibility was useful because it was backed by participation and a clear understanding of what the department could contribute.

Recognition also helps those trying to enter the profession. After earning her certification, Brandy Bowser spent 4 years seeking her first paid SPD role because employers wanted experience she had not yet gained. Her experience exposes the limits of simply telling a better story about sterile processing. Schools, externships, entry pathways, and leaders willing to recognize potential must make that story believable.

Recognition, then, is not something SPD can advertise into existence. It is built through expertise, professional standards, clear communication, relationships, results, and opportunities that bring new people into the field. Those same habits form the basis of something even more important than visibility: trust.

“Someone took a chance on me, and I believe it is our responsibility to do the same for the next generation.” —Brandy Bowser

Building Executive Trust

Executive trust is rarely built in one meeting. It develops when SPD leaders bring reliable information, explain what it means, and follow through on what they say they will do. Over time, that consistency changes the conversation. Leaders are no longer called only when something goes wrong; they are included because their perspective helps the organization plan more effectively.

MK Parrott begins with the facts: how many surgical cases the department supports, how much work moves through each part of the process, where demand is changing, and what the performance data show. The numbers give the discussion a foundation. They also help separate a recurring operational problem from an isolated event or a request based mainly on frustration.

Data becomes more meaningful when people can see the work behind it. Inviting executives and clinical leaders into the department allows them to observe trays as they move through decontamination, assembly, sterilization, storage, and distribution. A volume report may show thousands of items processed; a visit reveals the coordination, judgment, equipment, and time required to make those instruments ready for use.

Cissé connects department measures to case flow, cost, capacity, and risk. Sheriff builds relationships before an urgent request is on the table. Gaskins stresses the importance of bringing a workable response, not simply identifying what is wrong. These approaches work best together. Evidence needs context, relationships need substance, and solutions need follow-through.

Trust grows when SPD leaders make the issue clear, recommend a practical next step, and remain engaged after the decision. It also shows when they acknowledge uncertainty, report setbacks honestly, and return with better information rather than defending a weak position. That record of steady, useful participation is what allows a department leader to become something more: a partner the organization seeks out before the plan is final.

The Future SPD Leader as an Enterprise Partner

Becoming an enterprise partner does not mean leaving department operations behind. It means using deep knowledge of those operations to inform decisions made elsewhere. The leader who understands instrument demand, workflow constraints, staffing, quality, and equipment reliability can see consequences that may not be obvious in a planning meeting.

In practice, that may mean reviewing the processing requirements for a new service line, testing assumptions behind a construction plan, helping to compare technology investments, or explaining how staffing and inventory affect surgical capacity. The contribution is not limited to identifying what SPD needs. It is helping the organization understand which options are workable and what each will require.

Brandy Bowser’s view of leadership as service fits this broader role. Removing barriers and stakeholder development remain essential inside the department,butservicealsomeanshelpingcolleaguesacrossthe organizationmakebetterdecisions. That requires listening to clinical and frontline concerns, sharing operational realities without becoming defensive, and working with others to find a path forward. Enterprise partnership is not authority over other functions. It is the ability to contribute expertise in a way that improves the shared plan.

The enterprise still needs technical depth and credibility inside the department. The difference is how far that expertise travels. These leaders must be able to work across perioperative services, infection prevention, finance, facilities, supply chain, information technology, quality, and workforce planning without losing sight of the operational details that make their contribution valuable. When SPD leaders help others understand the trade-offs, contribute workable options, and share responsibility for the outcome, sterile processing becomes part of how the organization plans rather than simply a department that reacts afterward.

The Goal Is Not a Seat at the Table

For years, sterile processing leaders have talked about earning a seat at the table. The phrase captures a real problem: decisions that affect SPD are often made without the people who understand the work. But presence alone is not the goal. A seat matters only if the leader is prepared to contribute something the organization needs.

That contribution begins before the meeting. It requires knowing the department’s performance, understanding the operational and clinical effects of a decision, and clearly explaining the trade-offs. It also requires bringing options. Leaders gain influence when they can move the conversation from “SPD cannot support this” to “Here is what it would take, where the risks are, and which choices are available.”

“Sometimes you have to earn your seat at the table, and sometimes you have to pull up the chair yourself.” —Bobbie Gaskins

That readiness has several parts: professional credibility, strong relationships, comfort with data and business language, an understanding of people and technology, and the ability to see how a choice in one area will affect another. It also requires leaders to share responsibility for the outcome rather than stop at pointing out the problem.

Influence is built when that kind of contribution becomes consistent. SPD is invited earlier because its leaders ask useful questions, make risks visible, and help the organization find a workable path forward. The chair is important. What the leader brings to it is what changes the decision.

The Future Cannot Be Planned Without SPD

Sterile processing may operate behind the scenes, but its reach extends across the surgical system. The readiness of a single tray can affect a case. The department’s capacity can affect a service line. The reliability of its people, equipment, and processes can affect whether an organization can deliver on its plans.

That is why involving SPD is not a matter of recognition for its own sake. It is a matter of planning with the full picture. New surgeons, additional operating rooms, advanced technology, staffing changes, and construction decisions all create processing requirements. Those requirements do not disappear when they are left out of the conversation. They simply become harder and more expensive to address later.

The leaders offer a practical model for changing that pattern. They develop people and protect standards inside the department, but they also carry operational knowledge beyond it. They used to explain what was happening, offer options rather than only objections, build relationships before a crisis, and remain accountable for the outcome after a decision is made.

When that contribution is present early, sterile processing becomes part of how the organization evaluates growth, investment, risk, and readiness. Its leaders can point out constraints others may miss, explain what a plan will require, and help find a workable path forward. The future of SPD depends on leaders who can make that contribution. The future of surgery depends on organizations willing to hear it.

The question should no longer be whether SPD belongs in strategic conversations. The question should be how organizations ever planned for the future without it.