From Cancelled Surgeries to Public Trust—
What happens when water fails
Jeff Paquet, CEO
Last month, the news out of Vermont showed us the steep cost of ignoring water quality. At Northwestern Medical Center, surgeries were delayed and sterilization processes halted due to water-related failures in the sterile processing department. Patients faced cancellations, surgeons scrambled, and the hospital had to go public with explanations no leader ever wants to make.
This is not an isolated story. Across the country, sterile processing departments are facing similar risks. Too often, water is viewed as a utility—always available, always safe. But in reality, water is the hidden ingredient in every surgical case. When quality lapses, the result is not just inconvenience; it’s cancelled procedures, lost revenue, and, most importantly, compromised patient safety.
The ANSI/AAMI ST108 standard now provides the roadmap hospitals need, but adopting it requires commitment. It means investing in evaluations, monitoring, and infrastructure improvements before an incident forces the issue.
At VERDA, we believe water quality management is about more than compliance—it’s about resilience. We help facilities put safeguards in place so their names never make headlines for the wrong reasons. The true cost of inaction is not measured in parts per million—it’s measured in patient outcomes and public trust.
Behind the Standards:
Insights from AAMI Sterilization Standards Week 2025
Wendy Schultz, Water Quality Manager
This September, I attended my first AAMI Sterilization Standards Week in Arlington, Virginia. While I walked in unsure what to expect, I left with a much clearer understanding of how the critical standards we rely on every day come together. Here are some of the highlights:
How They Work Together: AAMI, ANSI, & ISO
My first session was the New Meeting Participant Orientation, given by Matt Williams, the Vice President, Standards at AAMI, which finally clarified for me the working relationship between AAMI, ANSI, and ISO, and gave me some general background on how standards are created and managed:
- AAMI (Association for the Advancement of Medical Instrumentation): gathers a committee of experts (e.g., clinicians, engineers, industry representatives) to draft a new standard for a medical device. AAMI submits its completed draft to ANSI.
- ANSI (American National Standards Institute): reviews AAMI’s process (not the technical content) to confirm it followed the rules for consensus and due process. It grants national approval in the U.S. (hence, the “ANSI/AAMI” designation). ANSI also represents the U.S. at the global level.
- ISO (International Organization for Standardization): AAMI also manages the U.S. “Technical Advisory Groups” (TAGs) for many ISO committees related to medical devices. This means AAMI organizes the U.S. experts who will contribute to international standards. Their input is then formally presented to ISO by ANSI. The U.S. experts are meeting this week (Oct 20-24) in Xu Hui Qu , China.
This collaboration often results in “harmonized standards”’, which are documents adopted by all three organizations (e.g., ANSI/AAMI/ISO 11137- Sterilization of Health Care Products) I also discovered that the standards are reviewed every 5 years, and Technical Information Reports (TIRs), which are guidance documents, are reviewed every 3 years.
Document Update: What’s New with TIR119 and ST90?
We spent a significant amount of time diving into two major guidance documents.
- Water Quality (AAMI TIR119): Tuesday’s Water Quality for Reprocessing Medical Devices session was the highlight. Co-chaired by Terra Kremer (Johnson & Johnson) and Erin Kyle (AORN), the group worked through a sea of comments on the long-awaited AAMI TIR119 – Guidance on Healthcare Implementation and Use of ANSI/AAMI ST108. We resolved most comments, and this document, which is packed with practical information we’ve been waiting for, is now set to move forward as a committee draft for Spring 2026.
- Quality Systems (ST90 Draft): I also attended the Quality Systems for Device Reprocessing session, which reviewed the draft of Appendix 1 of ST90, showcasing the solid work completed by the task group members.
Additionally, during the Closing Plenary: Matt Williams discussed changes coming soon that will expedite and streamline the process of adopting national standards.
The Surprising Element: Professional Collaboration
What genuinely surprised me most was the sheer size of the committees and the process itself. It was fascinating to watch professionals from competing organizations hash out technical details with real professionalism, even when they strongly disagreed. It was a powerful reminder of the commitment across the industry to patient safety.
Protecting Equipment Starts with Water
When Nine-Month-Old Sterilizers Look Nine Years Old
Renee Vander Weele, Director of Clinical Services
I visited a hospital sterile processing department last month where the team was concerned about their brand-new equipment. Their sterilizers had been installed less than nine months ago, yet what I saw inside those chambers looked more like nine years of wear and tear. Tarnished metal, scaling, and corrosion were already taking hold.
The same story unfolded across the department: washers with orange discoloration, sonic cleaners with rusting and chemical buildup, and surgical instruments with staining and pitting. Even the rigid containers used for sterilization were showing “baked on” residue, caused by wipes that left behind chemicals which hardened during steam cycles.
The culprit wasn’t the equipment—it was the water. High pH, elevated conductivity, sulfates, and improper final rinse water were silently attacking the passivated layers of both instruments and machinery. Without a proper water management program in place, even the best technology can’t perform as designed.
This visit was a reminder that buying new equipment is not the same as protecting an investment. Without proper water treatment and monitoring, capital purchases deteriorate at alarming rates, forcing hospitals into costly cycles of premature repairs, replacements, and surgical delays.
The ANSI/AAMI ST108 standard exists to prevent this exact scenario. It provides clear guidance for managing Utility Water, Critical Water, and Steam in sterile processing. Following it means more than passing a compliance audit—it means safeguarding the life of instruments, equipment, and ultimately, patient safety.
At VERDA, we help hospitals turn these findings into action. Through routine testing, continuous monitoring, and tailored Water Quality Management Plans, facilities can ensure their “nine-month-old” sterilizers actually look nine months old—not nine years.
Because in the end, water doesn’t just clean instruments—it protects investments and, more importantly, the patients those instruments serve.
New Joint Commission Requirements
How are Water Management System requirements going to change?
P. Ted Cantin, Director of Research & Development
On June 30th the Joint Commission (JC) announced that it would be making significant changes to the standards it uses to accredit hospitals and critical access hospitals. The intent of the update is to guide compliance with JC accreditation and align it more closely with the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoP’s). The JC completed the update process on September 29th, and it will become effective at the beginning of next year (Jan. 1st, 2026) for all accreditation, certification and verification programs.
The focus of the accreditation restructuring, dubbed “Accreditation 360” is the revision and restructuring of JC’s Life Safety (LS) and Environment of Care (EC) standards. In addition to a complete overhaul of the numbering system, the EC and LS chapters have been consolidated into a single chapter entitled “Physical Environment” (PE). The good news is that while most of the JC standards are vastly different than previous versions, the Water Management System standards have not changed.
VERDA is on both the ANSI/AAMI ST 108 and ASHRAE 188 Standards Committees that establish and maintain the healthcare industry standard best practices for water systems. Knowledge and innovation will define how hospitals meet and exceed these to ensure the best outcome for patients. At VERDA, we are committed to helping hospitals do this to move from reactive troubleshooting to proactive excellence.
Where Water Quality Meets Real-World Experience:
Follow VERDA on LinkedIn
Kenneth Mayer, Director of Marketing
If you’re looking for real-world insights on how hospitals and sterile processing departments are navigating ANSI/AAMI ST108, the VERDA Water Quality Systems LinkedIn page is where the conversation is happening.
Each week, our team shares practical guidance and lessons learned from the field—covering everything from implementing ST108 standards to troubleshooting daily water quality challenges. You’ll find expert commentary from our water quality specialists, stories from hospitals leading the way in compliance, and quick tips to help your team strengthen its water management program.
We also highlight relevant industry news, emerging trends, and best practices for ensuring the reliability of your critical water systems. Whether you’re part of a Sterile Processing Department, Facilities Engineering, or Infection Prevention team, our posts are designed to inform and inspire ongoing improvement in water quality and patient safety.
Follow VERDA Water Quality Systems on LinkedIn to stay current, stay compliant, and stay ahead.