Date of Award

8-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Industrial Engineering

Committee Chair/Advisor

Dr. Kevin M Taaffe

Committee Member

Dr. Sudeep Hegde

Committee Member

Dr. Lawrence Fredendall

Committee Member

Dr. Emily Tucker

Abstract

The Sterile Processing Department (SPD), also known as the Central Sterile Services Department (CSSD), is an essential part of hospitals and healthcare facilities and is responsible for ensuring the cleanliness, sterility, and proper functioning of medical instruments. Sterile processing departments (SPDs) are key drivers of productivity, effectiveness, safety, and infection control in hospitals. A well-designed SPD workflow can enhance patient safety, reduce operating room (OR) delays, and improve productivity. To understand the flow of sterile processing and interactions between the OR and SPD, process maps and task analyses were developed through direct observations of the basic SPD functions: decontamination, assembly, sterilization, storage, and case cart preparation. In this research, we focus on the following functional units and personnel behavior factors: (1) Surgeon / OR behavior, (2) SPD behavior, and (3) Administration behavior. Each functional unit can be the source of challenges, such as (1) duplicate tray requests, replacement tray needs, on-time start pressures, (2) flash sterilization, fast tracking trays, staff shortages, and (3) wages, training, and turnover, respectively. Using the instrument tray as the basis for assessing flow through the SPD and the OR, we explore the behavioral decisions originating from the three functional units mentioned. Historical data, statistical analysis, and simulation modeling are employed to assist administrators in analyzing the impact of the following on sterile processing: surgical volume and schedules, tray and instrument requirements, staffing, equipment capacities, and cart-washing requirements. In some instances, OR personnel request additional trays beyond what is needed to make sure they have every instrument they might possibly need. This results in putting undue strain on the SPD’s inventory of trays and its ability to process dirty trays and instruments. This risk-averse approach to instrument and tray requests can lead to front-line staff considering workarounds to sterilization or other procedures in order to deliver instruments to the ORs on time. For this reason, we identify the likelihood of surgical delays and the required tray turnaround times at various levels of surgical volumes and additional tray requests. This study demonstrates how simulation modeling can be effectively leveraged to inform employee retention strategies and structured onboarding programs, as well as using data-driven methods to guide resource allocation and tray inventory decisions.

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