At the 2026 HSPA Annual Conference in Baltimore, the VERDA Water Quality Systems team spoke with sterile processing professionals from across the country about one topic that continues to gain momentum inside healthcare organizations: water quality management and ANSI/AAMI ST108 compliance.
As part of those conversations, VERDA conducted independent market research with conference attendees representing SPD directors, managers, supervisors, technicians, educators, infection prevention professionals, and healthcare leadership. Respondents were asked: Where do you feel the least confident in your current approach to water quality?
43% of respondents said they are least confident that their facility is fully compliant with ST108.
That number deserves attention—not because it suggests facilities are ignoring water quality, but because it highlights how difficult compliance has become in real-world SPD operations.
What made the finding even more interesting is that many of those same respondents indicated they already have water treatment infrastructure in place, including RO and DI systems.
In other words, the uncertainty is no longer simply about equipment.
The uncertainty is about everything surrounding the equipment.
The Industry Is Moving Beyond “Do We Have an RO System?”
Historically, many healthcare organizations viewed water quality as largely a facilities-driven utility function. If an RO system was installed and operational, the assumption was often that the department was covered.
ANSI/AAMI ST108 has changed that conversation.
Today, SPD leaders are increasingly expected to understand:
- Whether testing frequencies are appropriate
- If sampling procedures are being performed correctly
- How out-of-specification results are managed
- Whether documentation would withstand an audit
- Which department owns responsibility for corrective actions
- How water quality impacts instruments, washers, and sterilizers
- Whether current practices truly align with evolving standards
The result is a growing realization across healthcare organizations:
Water quality compliance is not a one-time infrastructure project. It is an ongoing operational process.
The Confidence Gap Is Operational, Not Just Technical
The survey data revealed several additional trends that help explain why confidence levels may be lower than expected.
Among respondents:
- 44% said coordinating testing and sampling requires the most time and effort
- 30% cited waiting on lab turnaround times
- 29% said interpreting results and determining next steps remains difficult
- 27% expressed concerns about the reliability or accuracy of testing
- 25% said responsibilities are not clearly defined between departments
Taken together, these findings point toward a broader operational challenge—not merely a technology challenge.
Many SPD leaders are being asked to oversee increasingly complex water quality programs while simultaneously managing staffing shortages, instrument turnaround pressures, survey readiness, and growing documentation expectations.
For many facilities, the issue is not a lack of commitment.
The issue is bandwidth, clarity, and structure.
Shared Ownership Often Creates Shared Confusion
Another important insight from the survey centered around accountability.
When asked who is responsible for water quality in their SPD:
- 83% identified Facilities
- 41% identified SPD
- Others identified Infection Prevention and Clinical Leadership
The responses suggest that water quality often spans multiple departments—which makes sense operationally—but can also create uncertainty around ownership and decision-making.
When responsibilities are fragmented, several questions emerge:
- Who owns testing schedules?
- Who reviews results?
- Who initiates corrective actions?
- Who documents compliance activities?
- Who is accountable during an audit?
As regulatory expectations continue evolving, hospitals may need to move toward more clearly defined governance models around Critical Water management.
SPD Leaders Are Asking for Visibility and Support
Perhaps most importantly, the research showed that SPD professionals are not simply identifying problems—they are actively looking for solutions.
When asked what they would prioritize solving over the next 12 months:
- 34% said improving visibility into water quality data
- 27% prioritized simplifying ST108 compliance
- 27% wanted faster response when issues occur
Additionally:
- 45% said a fully managed water quality compliance service would provide value
- 50% preferred a hybrid approach that combines internal oversight with external support
These findings suggest many healthcare organizations are recognizing that sustainable compliance may require a more collaborative and structured approach moving forward.
Not necessarily outsourcing responsibility—but strengthening internal teams with specialized expertise, clearer workflows, and more proactive management processes.
What This Means for Healthcare Organizations
The 43% statistic is not a sign of failure.
It is a sign that sterile processing professionals are becoming more aware of the complexity surrounding water quality management—and more honest about the challenges involved in maintaining confidence across systems, processes, documentation, and compliance expectations.
In many ways, that awareness is healthy.
Because organizations that acknowledge uncertainty are often the ones most willing to improve.
As ST108 adoption continues maturing across the industry, healthcare organizations will likely need to focus less on whether they simply “have a system” and more on whether they have:
- A sustainable process
- Reliable oversight
- Clear accountability
- Actionable visibility into water quality performance
- A response plan when issues occur
The facilities that succeed long-term will likely be the ones that treat water quality not as a background utility—but as a managed clinical support function directly connected to sterile processing outcomes.
And based on the conversations at HSPA, many SPD leaders already understand that shift is underway.