Sterile processing departments are no longer architectural afterthoughts dropped into a windowless room on a facility’s bottom floor. They’re bright, high-tech spaces where skilled instrument techs perform one of surgery’s most important jobs.

“Ours is like a big, well-lit laboratory with lots of windows, so everybody can look in,” says Pietro A. Memmo, MD, co-owner and assistant director of the brand-new Orthopedic Associates of Hartford Surgery Center in Rocky Hill, Conn. “Sterile processing is a critical part of our operation, so we want people to be able to watch what’s going on.” Dr. Memmo and other surgical leaders who recently opened new facilities offer these tips for building must-see sterile processing spaces.

The more space you can reasonably designate for sterile processing, the better. The original plan for the WVU Medicine Berkeley Medical Center in Martinsburg, W.Va., which opened in early 2018, was to handle gastroenterology and ophthalmology cases exclusively. But before long the center was also performing neurosurgery, urology, gynecology and pain management procedures.

With additional service lines came a previously unanticipated need for new equipment. “Now we’re a full-service surgery center, so we’ve had to make some changes, including adding a washer-disinfector and autoclave,” says Nicole Sinsebox, RN, director of outpatient surgery at the center. “We had to run additional lines for washers, which meant we had to block off the area so they could do the construction. That caused some delays.”

Lesson learned. “I’d suggest to people who are opening new centers that they plan for more than what their original scope was,” says Ms. Sinsebox, “because there are definitely additional costs associated with changing the original design of the central sterile area.”

It also pays to be absolutely certain that architects, builders and reps are on the same page. “We should have gotten better information from our reps as to where piping and water connectors needed to be,” explains Ms. Sinsebox. “At the last minute we had to do some reconfiguring, and we ended up with a less preferable flow as a result. Have everybody look at the design, not just the construction team. The original construction didn’t fit the way we needed to configure the equipment.”

Dr. Memmo and his colleagues wanted the sterile processing department to have the same level of cleanliness as the ORs. “So, we installed epoxy floors and Whiterock walls,” he explains. “It’s a seamless environment that can be cleaned easily and has very little chance of bacteria build-up.”

If an infection occurs, you owe it to yourself and your patients to isolate any suspect equipment immediately.

“All our equipment has code numbers,” says Dr. Memmo. “We’re able to track all the equipment trays. We can identify when a piece of equipment was sterilized, and which autoclave it was sterilized in. We know which tray was with which patient, and who was working that day. Everything is trackable.”

Though the Berkeley Medical Center had been open for less than a year, storage space became a critical challenge when it expanded its offerings. “We had to kind of backtrack and find creative ways to create storage,” says Ms. Sinsebox. “When we were planning for just GI and ophthalmology, we didn’t need too much storage, because they don’t have that much equipment, but the other specialties added additional needs.”

To achieve peak efficiency, says Dr. Memmo, you need enough space to store excess equipment and excess instrument trays, so you have enough inventory to match your case volume. “If doctors are ever waiting around for instruments, or if a case needs to be delayed because instruments aren’t ready, that’s a failure,” he says. “We try to go the extra distance.” That means, among other things, having enough storage and enough trays to facilitate what he calls “dual occupancy” — the ability to perform concurrent surgeries in adjacent ORs while support staff take care of pre-op prep and post-op turnover.

You’ll never be able to anticipate every design need, so seek out feedback and insights from as many related disciplines as possible. “One of the biggest things is getting input from the staff involved in the process and having people who have actually worked in sterile processing,” says Ms. Sinsebox. “I suggest also looking at other surgery centers, and asking them about flow, or what they would have done differently.” There are no do-overs, but if given the opportunity, Ms. Sinsebox says she’d apply what she gleaned from her recent experience.

“There’s a learning curve,” she says. “If I were to do it again, I’d definitely make sure to involve multiple discipline areas — surgical techs, central sterile techs, nurses — and get their input on flow and have them look at the blueprint before construction begins.”

“You want to keep employees happy, you want them to do a good job and you want them to have pride in their work,” says Dr. Memmo.

To that end, height-adjustable tables and automatic loaders at his facility minimize ergonomic injuries that can be caused by bending and lifting. “When items go into the autoclaves, they’re on a cart with a floating table,” he says. “You park it up against the autoclave, press a button, and it slides in nice and slowly and is locked in. The same thing happens when it comes out. There’s no heavy lifting, and there’s minimal human touch.”

Bright lights and piped-in music also enhance the setting. “We’ve provided the kind of environment where staff actually enjoy doing the job,” says Dr. Memmo.

No job in a surgical facility is more important than making sure complex instruments are perfectly reprocessed every time. A poorly designed sterile processing department will, at best, hamper efficiency. At worst, poor planning and a poor design can result in techs sending improperly sterilized instruments back to the OR, a nightmare scenario no facility wants to face. OSM