Trend to Watch: Instrument Care Is Moving Offsite

It’s been a little over a year since Penn Medicine in Philadelphia opened its Interventional Support Center (ISC), one of the largest instrument reprocessing facilities in the country. Eighty reprocessing techs work in the 110,000-square-foot space to sterilize thousands of instruments each day, everything from basic scissors and clamps to more advanced robotic tools. “Sending instruments to a centralized facility alleviates space concerns at our clinical locations, providing the breathing room hospital departments need to expand their services,” says Chris Pastore, managing director of the center. 

Penn Medicine’s decision to move instrument reprocessing to a single location has freed up more beds for direct patient care. It’s part of an emerging trend as large health systems and independent ASCs weigh the pros and cons of building their own offsite reprocessing centers or partnering with an existing service.

More healthcare providers in the U.S. are expected to opt into third-party instrument care services in the next few years, according to a report from Frost & Sullivan, a research and consulting firm in San Antonio. MarketGlass, a market intelligence platform, says the global sterilization services market is expected to almost double from $2.8 billion in 2020 to more than $4 billion by 2027.

Exploring new solutions to instrument reprocessing is important for surgery centers and health systems that are seeing a steady uptick in demand for outpatient surgeries. Those that have implemented offsite reprocessing programs are realizing wide-ranging benefits, from streamlined instrument care to increased surgical capacity.

The instrument care professionals who run offsite reprocessing centers provide standardized cleaning, sterilization and maintenance/repair services with strict quality control. They pick up soiled instruments, transport them to a large reprocessing facility, clean and sterilize the tools and return repackaged trays that are ready for use in surgery.

As outpatient ORs become popular destinations for common and complex procedures, health systems and independent ASCs are rethinking the instrument reprocessing model. Does it make sense for an expanding health system with multiple surgery centers to build a centralized reprocessing facility? Should freestanding ASCs without the resources or room to expand their sterile processing capabilities partner with an offsite reprocessing service? For most health systems and surgery centers that invest in outsourcing alternatives, the appeal seems to be twofold: creating more space to serve patients while streamlining and standardizing the sterilization process. An ASC that wants to dedicate more square footage to new ORs in response to increasing case volumes can create more in-house space without needing to physically expand, and gaining more room to treat patients can increase profitability.

It makes good strategic sense to work with a company that’s expert in high-quality, on-time tray deliveries.
— Adam Royer

OrthoIllinois Surgery Center in Rockford, Ill., partnered with an offsite reprocessing service, a move that has increased its surgical capacity and reduced instrument backlogs for total joint replacements. “We had reached capacity in our sterile processing department (SPD) and needed to get creative if we were going to process instrument trays quickly enough to accommodate more cases,” says Leanne Brennan, the center’s business manager. 

The Ohio State University Wexner Medical Center will open a freestanding surgical equipment sterilization facility in Columbus in 2026 with an estimated investment of more than $45 million. The 62,000-square-foot space will serve the health system’s main medical center and outpatient care centers. The facility will ultimately be able to accommodate the reprocessing of surgical instruments serving upwards of 48,000 patients per year.

When the new facility is completed, OSU will become one of the largest academic health centers to implement this freestanding model. In addition to instrument reprocessing, the facility will repair, refurbish and maintain instrumentation.

OSU’s goal is to build an instrument care workflow that’s consistent throughout the entire health system. “Offsite instrument reprocessing will allow our team to work more efficiently as we elevate the quality of care to our patients,” says Kim Jones, director of central sterile supply at Wexner Medical Center.

Erlanger Health System in Chattanooga, Tenn., is a multi-hospital system that performs about 35,000 surgeries a year in approximately 60 operating rooms across several campuses. That’s a lot of instruments that need to be reprocessed, and the number will only increase as case volumes continue to climb. “Investing in a state-of-the-art onsite SPD is difficult to do because the return on investment is tied to surgical volume, not instrumentation,” says Adam Royer, BSN, RN, senior director of surgical services at Erlanger Health. “The other challenge is finding enough square footage in a landlocked facility to update and expand the department.”

Mr. Royer determined that a complete overhaul and upgrade of his hospital’s SPD wouldn’t be able to support the facility’s case volumes. Erlanger Health’s other hospitals, which continue to perform record numbers of cases each year, were also nearing instrument reprocessing capacities. He began looking for an offsite location that could support the health system’s current and future instrument reprocessing needs.

Erlanger Health recently inked a long-term partnership with a third-party offsite reprocessing center that will care of the health system’s instruments over the next two decades. Mr. Royer still moved forward with upgrading his hospital’s SPD in its current footprint to maintain some onsite reprocessing capability, which can keep the hospital running at 60% of its case volume capacity.