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By Julie E. Williamson

Perhaps nowhere else in a health care organization are two departments more closely intertwined as sterile processing (SP) and the operating room (OR). Despite obvious differences in their core responsibilities, the two teams cannot function without the other, and they share the same primary goal: promoting patient safety and positive outcomes through the delivery of high-quality, effective service.

Although SP professionals rarely meet the patients on the receiving end of their instrumentation, safe surgical procedures simply cannot take place without their delivery of clean, well-functioning and sterile devices. At the same time, SP professionals cannot do their job safely and effectively, or efficiently provide for the OR, if the surgical team doesn’t do its part to manage instrumentation properly at the point of use and ensure that surgery scheduling stays in line with the facility’s resource capabilities (e.g., taking into consideration existing instrument/set inventories, reprocessing equipment availability, staffing levels, etc.). Without taking into consideration all factors that impact the availability of safe, functional devices – and without working together to mitigate instrument-related challenges – service quality can suffer, interdepartmental relationships and trust can erode and negative patient outcomes can occur.

“It’s absolutely critical that sterile processing and operating room professionals commit to a strong partnership, recognize each other’s challenges and work together to overcome them to ensure that patient safety remains the top priority,” said Natalie Lind, CRCST, CHL, FCS, IAHCSMM’s education director.

Put it in writing

Creating effective partnerships between the two disciplines requires each to have a better understanding of the other’s responsibilities and requirements – neither of which may be fully understood without defining them and then developing protocols and procedures to help establish expectations and offer guidance for standards-based best practices. An effective, ongoing partnership hinges on this mutual understanding and both sides’ commitment to meeting individual and shared goals, and ensuring processes are adopted and implemented by all who are involved.

Collaboratively developing a written partnership agreement can clearly identify responsibilities and expectations, all while helping ensure that instrumentation is turned around as efficiently, effectively and safely as possible.

What follows is an example of an SP and OR responsibility agreement for turnaround instruments. Note: This agreement serves as a general template that should apply to most facilities; however, it can be easily customized to meet facilities’/departments’ own unique needs and responsibilities (the facility’s policy for loaned instruments/sets should be included on this agreement, for example). To ensure the agreement becomes standardized and accepted across all shifts, all SP and OR employees should sign it, and each department should revisit the document periodically to ensure all employees are still adhering to it.

Sterile Processing Responsibilities

  1. Sterile processing personnel will clean and sterilize turnaround instruments utilizing the written instructions provided by the manufacturers of these reusable devices, in accordance with ANSI/AAMI ST79, Section 2.2.2.
  2. Items requiring immediate turnover (e.g., back-to-back surgical cases) must be processed using established cleaning/disinfecting and sterilizing protocols. Note: Multiple trays may extend the process time required for cleaning/disinfection. Whenever possible. OR staff will reduce the need for immediate turnover by considering processing requirements when surgical schedules are developed.
  3. Sterile processing professionals and OR team leaders will communicate throughout the day to resolve instrument preparation issues for the next day’s surgical cases.
  4. Sterile processing staff are responsible for using appropriate telephone etiquette skills that are consistent with established customer service policies.

Operating Room Responsibilities

  1. Upon completion of each surgical case, OR staff will remove gross debris and place used instruments in transport containers. The used instruments will then be sprayed with an enzymatic spray (or kept moist by draping a towel wet with sterile water over them) before being transported to the SP department’s (SPD’s) decontamination area. Unused instruments will be placed in their original tray and returned with the used instruments for processing.
  2. OR staff must telephone the SPD for all requests for set/instrument turnover (call extension xx).
  3. OR personnel will notify SP staff about all schedule changes as soon as possible.
  4. OR staff are responsible for using appropriate telephone etiquette skills that are consistent with established customer service policies.

SP and OR Team Leader Responsibilities

Team leaders from the OR and SPD will review turnaround instrument logs annually. The instruments and instrument trays with the highest turnaround requests will be identified and recommendations will be made to increase quantities of these items.

Summary of Understanding

SP and OR personnel will work cooperatively at all times. This collaboration will protect the patient and support the hospital’s mission, vision and values.


Successful surgical outcomes rely heavily of effective partnerships between SP and the OR. A written partnership agreement can help clearly outline each department’s responsibilities and expectations, which can promote safer, more consistently delivered practices across all shifts.

Julie E. Williamson, BA, is the IAHCSMM communications director and editor.

1. International Association of Healthcare Central Service Materiel Management. Central Service Leadership Manual, Chapter 16, p. 292. 2010. Chicago, Ill.



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