In the past few years, sterile processing (SP) has evolved into a department with the latest technology to help with laborious tasks, new certification requirements, and continuing education mandates. Those of us who have been in the sterile processing field for many years can see the change. Today the wraps are disposable, and many more hospitals are moving toward using rigid containers. Most hospitals have moved the supply functions to materials management, leaving central sterile with only the functions to manage and process surgical instruments.

The SP departments have sophisticated equipment that can sterilize the most heat-sensitive devices in one hour, compared to the six-hour ethylene oxide (EtO) cycle. We have the latest technology to inspect channels and lumens using borescopes that magnify damage, debris, and bioburden. In today’s SPD, sharpening hypothermic needles on a stone is a thing of the past. Instead, product quality is at the center of the process emphasizing new technology for residual soil testing.

Even with significant advancements within sterile processing departments, there seems to be a high level of dissatisfaction among SPD technicians across the nation. Some have taken to SP-geared social media groups to express their displeasure and negative feelings toward their manager or hospital. Where have we gone wrong? Why are technicians struggling to stay engaged despite advancements in the profession?

Heart of the Hopital or On Life Support

Someone once said that central service is the heart of the hospital, but in some hospitals, the central sterile is on life support. Staff is disengaged, unhappy, and unproductive. This has resulted in high turnover as technicians go from hospital to hospital in search of the perfect place to work. But is this an isolated problem within the sterile processing field? Unfortunately, no. A 2022 report by Gallup State of Global Workplace found that 65% of the US workforce is not engaged at work.1 According to the report, disengaged workers present a risk to the organization and need a reason to be inspired or engaged.

Most SPDs are located in hospital basements, which may be a contributing factor to technician dissatisfaction. However, the physical isolation does not relegate the SPDs to function alone, as if on an island in the middle of an ocean. The SPD is a crucial part of the hospital body—its heart—with a very important role in keeping the process, patient, and system alive. The work we do is essential to ensure surgical procedures are successfully performed and treatment is given throughout the hospital.

As we prepare to celebrate Sterile Processing Week, it’s important to look at ways we can help technicians feel more connected and engaged. Let’s discuss a few areas where managers can promote employee engagement:

  • Accountability: Every member of the team should know the expectations of their position, and they should be rated against the adherence to those expectations. The technicians, as well as the manager or supervisor, must ensure that a quality product—a surgical tray—is produced.
  • Education: Continuous learning is the catalyst to process improvement and employee satisfaction. Implement programs that engage the team and make learning fun. One activity that can help the team increase focus on detail is the game Spot It. In the game, participants must identify the item they have versus the item on the card on the table. The player who identifies it first wins. My team enjoys playing that game and it keeps them on alert. Another engaging game involves having technicians observe surgical procedures in the OR, and identify the instruments they saw in use.
  • Opportunities: Everyone wants opportunities to better their status and careers. We must help our team enhance their knowledge and reach personal goals. As managers, we can create career ladders where people can move as they enhance their knowledge and experience. Mentor those who want to be in leadership, take them under your wing, and help them learn the mechanics of managing sterile processing.
  • Create a culture of engagement: To create a culture of engagement, we must create opportunities within the department. The relationship between SPD and the OR plays a major role in developing a culture of engagement. The SPD should make rounds in the OR, communicate with the service leaders, participate in OR meetings, and report quality process outcomes. They should also participate in huddles and ensure that the OR is aware that the SPD is available to offer help when needed.
  • Employee satisfaction: Building a team takes time and patience. The manager must be present in the work area, as the SPD is not a department that can be effectively managed from the office. You must practice “management by walking” and participate in activities throughout the day. Show your team you know how to assemble a tray by pitching in and participating in the assembling process. A leader leads by example and not by being seated in an office. You will see the difference in your team when you take part in the daily tasks.

Success takes time, as well as continuous coaching, teaching, and encouragement. As managers, we should notice those who are highly motivated and passionate about the tasks they do and help them develop into positions that provide career enhancement.


Compensation is and has been a major issue in our profession and it has been a sore point for many of our technicians. In unionized environments, the SP position is classified as service rather than technical, putting them in a lower salary bracket. But SP technicians are technical employees and should be categorized as such, as we must have the right instrument at the right time, and in the right condition, for the success of the surgical procedure.

While we are working with the human resources department to raise the bar for our team, as managers we must create an environment where people feel that they are making a difference and they are essential to the process. I often tell my team what Antoine de Saint-Exupéry said: “What is essential is invisible to the eye.” Similar to essentials such as air, food, and surgical procedures, a central sterile technician may be invisible to the eye but essential to the process.


  1. Harter, Jim. “Employee Engagement vs. Employee Satisfaction and Organizational Culture.” Gallup. Last modified August 13, 2022,