Sterile Processing Leaders Call for Greater Autonomy, Education, and Recognition in Patient Safety

Sterile processing departments (SPD) sit at the center of surgical safety, yet many SPD leaders say they still lack the authority, visibility, and professional recognition necessary to fully support infection prevention efforts and perioperative care. According to new research discussed by Kevin M. Bush Jr, EdD, DHSc, MSHA, MA, FACHE, CPHRM, CPHQ, CPPS, CIC, CHES, administrative director of perioperative administration at ChristianaCare; and Brandon Gantt, DHSc, MHA, LSSGBH, manager of sterile processing quality, education, and training at ChristianaCare, reporting structures and limited professional autonomy continue to shape the effectiveness of SPD operations nationwide.

The study examined how sterile processing departments are structured across health systems and how those structures affect patient safety, protocol adherence, and professional development. Bush explained that sterile processing departments report to a wide range of leaders, including nursing, perioperative services, supply chain, and operations management.

“I was so curious about the structure of sterile processing departments across the country,” Bush said. “Sterile processing is such a major partner in patient safety, and what’s the impact of that reporting structure?”

Gantt said the study was designed to formally examine gaps in authority and visibility that SPD professionals experience within healthcare organizations.

“Sterile processing is at the root of perioperative safety, but it doesn’t always have the visibility or authority in representing decision making,” Gantt said. “I thought this study would be important to formally examine where those gaps exist.”

One of the study’s most concerning findings was that 43% of SPD professionals reported feeling pressure to bypass sterilization protocols due to operational demands, such as turnover times, case volume, or inadequate supplies.

Bush said the finding highlighted broader operational misalignment within health care systems. “SPD is such an important impact on surgical site infections, readmissions, hospital lengths of stay,” Bush said. “We really need to make sure that SPD professionals have a voice in patient safety to ensure that all the standards are met and followed.”

Gantt described the statistic as alarming because it suggests unsafe workarounds may still be normalized in some health care environments. “That 43% is kind of scary because you want to make sure that your staff feels empowered to uphold standards without there being any type of compromise,” Gantt said. “If you’re really bypassing safety and safety culture, it kind of leads to undermining infection prevention efforts, which could increase the likelihood of patient harm.”

The discussion also focused heavily on the perception of sterile processing within health care organizations. Both leaders argued that SPD is frequently viewed as an operational support service rather than a clinical safety partner directly tied to infection prevention outcomes.

Bush said SPD should have direct executive-level representation within perioperative governance structures rather than simply being nested under nursing or supply chain leadership.

“The most effective structure was one where SPD had greater autonomy while being integrated into the perioperative governance structure,” Bush said. “Looking at SPD as more of a clinical safety partner versus an operational support service.”

Gantt agreed, adding that SPD has strong ties not only to perioperative operations but also to infection prevention and quality programs.

“Patient safety is best supported where SPD is recognized as a clinical safety function,” Gantt said.

The interview also explored the growing complexity of SPD leadership roles and the need for stronger leadership development pathways and credentialing programs. Bush said there is currently no consistent national structure defining what qualifies someone to lead a sterile processing department.

“There is no baseline or structure around how we’re selecting a manager for SPD,” Bush said. “People come from backgrounds of surgical technology, nursing, business operations, or they’ve grown up in sterile processing.”

Bush believes future SPD leaders will need expertise not only in sterilization science, but also in infection prevention, patient safety, risk management, and people leadership.

Gantt added that SPD leadership requirements have evolved dramatically in recent years. “It’s 2026, and the leaders need to be equipped in knowing how to really interpret regulations, looking at risk, leading teams,” Gantt said. “You almost have to be a chameleon. You have to wear many different hats.”

Rather than pushing out experienced technicians who may not yet hold certifications, both leaders emphasized creating accessible educational pathways within health systems. ChristianaCare has invested heavily in internal SPD education and certification support programs.

“We’re not trying to walk away from you,” Gantt said, referring to longtime technicians without credentials. “But we do have to make things a little bit more formalized, that way we understand that you have a baseline knowledge.”

Bush said the organization has already helped certify more than 100 SPD professionals through structured internal education programs and mentoring efforts.

Both leaders stressed that health care organizations must begin investing more intentionally in SPD teams if they expect stronger infection prevention outcomes and operational reliability.

“You’re not going to be able to meet any of your operational metrics in the OR without a successful SPD operation,” Bush said. “Site infections, on-time starts, [and] turnaround times all depend on it.”