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Achieving reliable instrument reprocessing requires finding the right balance among cost, productivity, and safety. However, there have been few attempts to comprehensively examine sterile processing department (SPD) work systems. We considered an SPD as an example of a socio-technical system – where people, tools, technologies, the work environment, and the organization mutually interact – and applied work systems analysis (WSA) to provide a framework for future intervention and improvement.

The study was conducted at two SPD facilities at a 700-bed academic medical center servicing 56 onsite clinics, 31 operating rooms (ORs), and nine ambulatory centers. Process maps, task analyses, abstraction hierarchies, and variance matrices were developed through direct observations of reprocessing work and staff interviews and iteratively refined based on feedback from an expert group composed of eight staff from SPD, infection control, performance improvement, quality and safety, and perioperative services. Performance sampling conducted focused on specific challenges observed, interruptions during case cart preparation, and analysis of tray defect data from administrative databases.

Across five main sterilization tasks (prepare load, perform double-checks, run sterilizers, place trays in cooling, and test the biological indicator), variance analysis identified 16 failures created by 21 performance shaping factors (PSFs), leading to nine different outcome variations. Case cart preparation involved three main tasks: storing trays, picking cases, and prioritizing trays. Variance analysis for case cart preparation identified 11 different failures, 16 different PSFs, and seven different outcomes. Approximately 1% of cases had a tray with a sterilization or case cart preparation defect and 13.5 interruptions per hour were noted during case cart preparation.

While highly dependent upon the individual skills of the sterile processing technicians, making the sterilization process less complex and more visible, managing interruptions during case cart preparation, improving communication with the OR, and improving workspace and technology design could enhance performance in instrument reprocessing.

Emerging technologies are becoming vital in the very process of innovation. Companies need to be updated to the latest technologies to offer their premium services to customers as well as meet their expectations. In the medical sector, it is a challenge to sustain superiority in service due to a high level of competition and the challenges arising from different forces. Liberty Dental Clinic (LDC), a premium clinic in dental services and solutions, based in the UAE, was able to maintain a premium presence in Dentistry due to a series of developmental thoughts and efforts. It was able to invest and utilize new innovative technologies which many organizations lacked such as implementing the most contemporary Artificial Intelligence “4 Robots” in the Clinics. Creating a pathway for a satisfactory customer journey was embedded at all levels of the hierarchy in the Clinic and customer touchpoints. Using a case study methodology, the drivers behind the success and uniqueness of LDC have been discussed including Leadership, Quality Management, Risk Management, Internal & External Marketing Strategy, Corporate Social Responsibility, Sustainability, Technology and Innovation.