The recent Healthcare Purchasing News article highlighting “Power Duos” at Lurie Children’s and Nemours Children’s hospitals offers something the sterile processing community rarely sees in print: proof that structured OR/SPD collaboration measurably improves safety, culture, and reliability.
For context, Immediate-Use Steam Sterilization (IUSS), formerly known as “flash” sterilization is a method for rapidly sterilizing unwrapped surgical instruments—typically at 270°F–275°F for 3–10 minutes—for immediate use in urgent, unplanned, or emergency situations. It is not meant for routine, convenient, or storage purposes.
Their work eliminated IUSS.
It reduced tray defects.
It shifted the narrative from blame to partnership.
But there’s a missing dimension that every SPD and OR leader should now be asking:
Where does water quality fit into this collaboration model?
Sterile Processing and Water Are Inseparable
Reusable device safety does not begin at the sterilizer. It begins in decontamination — and decontamination begins with water.
ANSI/AAMI ST108:2023 elevated water from a background utility to a defined clinical risk variable. It formalized requirements for:
Chemical purity
Microbial control
Endotoxin limits
Monitoring frequency
Documentation
Shared accountability between departments
The hospitals featured in the HPN article eliminated rapid sterilization through structured communication and daily case review (DRILL). That same structured collaboration is exactly what ST108 demands for Critical Water systems.
Because if SPD and OR are aligned — but Facilities and water management are not — the system still has blind spots.
The Next Evolution of the “Power Duo”: Adding Water to the Conversation
Consider the themes from the article:
1. Elimination of IUSS
Reducing IUSS requires reliable tray availability and predictable reprocessing timelines.
But it also requires confidence in:
Final rinse water quality
Endotoxin control
Biofilm management
Monitoring consistency
If water quality is unstable, pressure increases. And pressure drives shortcuts.
2. Data Transparency
Both hospitals emphasized using metrics to reframe emotional claims.
Water quality should follow the same model:
Trend microbial counts
Track endotoxin levels
Document corrective actions
Share reports across SPD, OR, and Facilities
When water data is transparent, conversations shift from “always” and “never” to facts.
3. Frontline Empowerment
At Lurie, a technician suggested a red line to prevent tray pulls before verification.
Imagine similar empowerment around water:
Technicians flagging rinse residue trends
Reporting spotting or staining patterns
Identifying changes after plumbing work
Escalating when rinse quality seems inconsistent
Frontline observation is often the earliest warning sign of a Critical Water issue.
Regulatory Reality: Collaboration Is No Longer Optional
The article correctly notes that The Joint Commission and state agencies are scrutinizing sterile processing more deeply.
ST108 adds a new layer:
Water quality documentation must be defensible.
This is not an SPD-only responsibility.
It is not a Facilities-only responsibility.
It is shared governance. And for most hospitals that is an entirely new frontier.
The strongest programs align:
SPD
OR
Infection Prevention
Facilities
Executive leadership
Just like the “power duos” described in the article.
A Practical Question for Leaders
If your OR and SPD have daily huddles, tray committees, and shared metrics, ask yourself:
Is water quality discussed routinely?
Are Critical Water reports shared across departments?
Does OR leadership understand ST108 requirements?
Can you defend your monitoring program during a survey?
If not, collaboration may still have a blind spot.
The Real Takeaway
The success at Lurie and Nemours proves that structured collaboration improves outcomes.
The next step for many organizations is simple:
Bring water quality into the collaboration model.
Because every tray, every rinse, and every scope depends on it.
Is water quality actively integrated into your OR/SPD collaboration strategy — or is it still operating in the background?
If you need ideas on how to do this, contact us