Sterile Processing Departments (SPDs) have always been the quiet backbone of surgical services. But “quiet” is no longer sufficient. The coming years will reward hospitals that treat SPD as a strategic, data-driven function and penalize those that treat it as a back-room cost center. Two consistent themes emerge from recent industry work: water and data — both must be governed, measured and operationalized to reduce risk and increase surgical readiness.
The problem is not just equipment — it’s governance.
Too many conversations about modernizing SPD focus on devices: new washers, RFID tags, or sterilizers. Those investments matter, but they don’t produce reliable outcomes unless they sit inside a disciplined system of governance, standard operating processes, and defensible records. The AAMI ST108 standard reframes water management as a governance problem: what you test, how often you test it, how you document it, and how you act on trends. Water touches nearly every step of reprocessing; poor governance there undermines cleaning outcomes, instrument integrity and patient safety. ST108 assumes not only testing, but consistent capture, review, trending and escalation. In short, it’s operational intelligence. The data show we’re fragile where we should be resilient. The 2025 Surgical Asset Management benchmark report reveals the fragility in blunt terms. Human error tops the list of tracking challenges (76%); loss of instruments is reported by roughly half of respondents (51%); and more than half (57.7%) say inventory unreadiness causes surgical delays at least sometimes. At the same time, 72% of facilities have implemented some form of tracking, but most operate in hybrid environments that combine barcode, RFID and manual paper processes, a setup that preserves weak links rather than eliminating them. This combination — high belief in the value of tracking, poor follow-through on implementation, and inconsistent data use — explains why SPD remains reactive. Nearly one in three facilities underuse data for quality improvement, and 20% don’t use count sheet or production data at all. Yet 82% of respondents expect tracking solutions to deliver a significant or transformational impact on efficiency. The opportunity — and the failure mode — are both obvious: we collect data, but we don’t always turn it into reliable action.Two interlocking failures: governance and usability.
Adoption stalls for two reasons that leaders can fix: Governance failure. Standards like ST108 don’t live in a regulatory vacuum. They require governance from committees, documented decision authority, and routine review of trends and corrective actions. For water, that means a Water Quality Committee that includes SPD, Facilities, Infection Prevention and Risk. For tracking, it means enterprise alignment around data definitions, acceptance criteria and escalation thresholds. Governance replaces anecdotes with accountability.Usability & integration failure. The benchmark makes clear that integration is the single biggest technical roadblock: 61.5% of organizations cite compatibility with existing systems as a major challenge. Staff resistance and training needs follow close behind. Installing technology without designing workflows and training people to use it reliably simply creates new opportunities for human error.
A practical playbook for moving from fragile to future-ready- Treat utilities and data as clinical programs, not maintenance chores. Water quality is not “Facilities’ problem.” ST108 places SPD at the center because SPD sees the first signs of cleaning failure. Make SPD a required seat at the Water Quality Committee and map every water use point in reprocessing (sinks, ultrasonic cleaners, washers, final rinses, steam). Capture results consistently, trend them and link them to clinical outcomes and device damage logs. Documentation isn’t bureaucratic overhead, it’s defensible evidence of control.
- Standardize data and governance before you scale tech. Define what “tray ready” or “count complete” means across departments. Standardize data formats, ownership and retention so tracking feeds are useful downstream. When systems share a common language, dashboards become decision tools rather than vanity reports. The benchmark shows the greatest return comes when facilities move beyond tests and sheets and into analytics that proactively prevent failure.
- Phase implementations with human factors front and center. Expect compatibility challenges and staff resistance. Choose pilots that minimize system-to-system change early (for example, integrate barcode workflows where possible, then layer RTLS or RFID), invest in hands-on training, and design change packages that make the new process demonstrably easier for frontline teams. Phased rollouts de-risk integration and build champions.
- Measure what matters — then act. Move from raw collection to routine review: turn count sheets, turnaround time, damage trends, and water metrics into recurring agenda items with clear owners and KPIs. Use analytics to find drift before it produces a sentinel event. Centralized performance intelligence platforms — the sort of analytics that tie water, equipment performance and tracking data together — deliver the defensible view regulators and leaders want.
