When HPN asked sterile processing (SP) professionals what topics they wanted covered in 2025, one request stood out: A deeper look into offsite reprocessing—not just the concept, but the real-world complexities of making it happen.
This article features insights from a diverse group of stakeholders directly involved in offsite reprocessing, including an instrument manufacturer, a sterile processing department (SPD) equipment and supply provider, a Canadian sterilization service provider, a U.S.-based single-use device reprocessor, and both a U.S. health system and Canadian hospital that have successfully transitioned to offsite models.
They commented on common offsite reprocessing misconceptions and pitfalls and provided advice and resources to healthcare organizations and SPD teams considering offsite reprocessing, whether a transition to a health system-owned facility or outsourcing to a third-party company.
Common misconceptions
Given the complexities and challenges of sterile processing, it is no surprise that healthcare organizations and SPD team members have differing ideas as to the pros and cons of offsite reprocessing. Our team of expert contributors shared these common misconceptions.
It’s easy
Jennifer Greisen, Principal of Strategic Solutions, Surgical Asset Management for Aesculap, Inc., leads national initiatives focused on sterile processing department (SPD) centralization and enterprise-wide transformation within complex health systems. Greisen highlighted a common misconception in moving offsite: the belief “that it’s as simple as relocating sterile processing.” She went on to say:
“In reality, success depends on meticulous planning, especially around logistics. Offsite reprocessing becomes a business in itself, focused on fill rates, production schedules, and distribution timelines. Without real-time visibility and carefully defined handoff processes between the hospital and the offsite facility, even minor breakdowns can disrupt surgical schedules, increase case delays, and create friction between departments.”
It’s less expensive
Sara Vinson, MBA, CRCST, director of Sterile Processing for UF Health Shands Hospital in Gainesville, Fla., HPN’s 2025 SPD of the Year, led her hospital on the transformational change of centralizing instrument reprocessing to a 57,000 square foot offsite reprocessing center (read their full story in the April 2025 issue of HPN).
Vinson said many believe that with an offsite move a healthcare organization will “save money, need less staff, or need less overall equipment,” but in reality:
“You are likely able to reduce redundancy in equipment if you are able to decommission existing equipment, but you will likely need additional staff for new roles necessary to support changes in logistics (e.g., transporting case carts to and from the loading dock). Increases in inventory will be necessary to support longer turnaround times for reprocessing.”
It's risky
Ajay K. Jain, MBA, is managing partner for SteriPro International, an accredited, ISO 9001 and ISO 13485 certified company providing leading practice reprocessing and sterilization services from its facility in Mississauga, Ontario, and on-site at its partner hospitals. He said the prevailing fear is:
“Quality will slip, and my tray won’t return on time. But in practice, a well-run offsite reprocessing center does the opposite. Instrument-level bar-code tracking timestamps every hand-off; dynamic courier loops mirror operating room (OR) start times; and live dashboards surface exceptions instantly. Our clients record a 99.98% on-time delivery while reducing cost per procedure and gaining full transparency into every instrument’s journey.”
Fear that tech jobs will be lost
Heather Macmillan, clinical manager of the Perioperative Program for Pembroke Regional Hospital in Pembroke, Ontario, Canada, commented on her experience moving offsite with SteriPro International.
She said a common misconception of offsite reprocessing is largely around loss of medical device reprocessing (MDR) technician jobs or scope of practice, stating “This was a particularly true misconception for our site when we made the move to reprocess offsite and no jobs were lost.” In Cananda, a medical device reprocessing technician (MDRT) is an equivalent to a sterile processing (SP) technician in the U.S.
It's a hand off
Lars Thording is senior vice president of Innovative Health, an advanced, U.S. Food and Drug Administration (FDA) regulated reprocessing company focused on electrophysiology devices. While the company has traditionally focused on reprocessing single-use devices, Thording said they are increasingly asked by healthcare organizations to reprocess reusable devices.
Thording highlighted that while hospitals often think outsourced reprocessing means handing over the problem, the reality is more complex. “There is this perception that a hospital can wash its hands of the issue of compliance with standards and IFUs by outsourcing,” he said. “But that’s not enough. There must be a system of accountability in place.”
It’s an all-in-one fix
Randalyn Harreld is national clinical education manager, U.S. for SteelcoBelimed, a global leader in providing medical and surgical instrument sterilization, disinfection and cleaning products and services. She said a common misconception with moving offsite is “That it solves all your problems with reprocessing capacity and spacing issues.” The reality according to Harreld:
“It’s not a ‘solve your problems’ solution. It takes a lot of planning and coordination to be successful. It also requires an increase in many things like staffing, supplies, and budget. For instance, if you're handling a high volume of loaned instrument trays, especially with growing volumes, careful coordination with vendor representatives is essential to streamline the process.”
She also pointed out the operational impact of physical distance: “When you introduce additional space between the reprocessing center and the end users, you must account for added time in the workflow to accommodate transportation and delivery windows.”
Common pitfalls
Like anything in life, it is hard to fully comprehend the challenges of moving to offsite reprocessing until going through it firsthand. Having made the move in their own hospital or supported other organizations in the transition, those interviewed for this article shared the common pitfalls they have experienced.
Lack of evidence breeds hesitancy
According to Jain, hospitals that don’t have a concrete picture of their in-house SPD expenses and key performance indicators (KPI) have trouble justifying a move offsite. He stated:
“Hospitals often underestimate the fully loaded cost—and defect rate—of in-house SPD. Once the true baseline is clear, the offsite reprocessing center value proposition of higher quality, elastic capacity, and lower unit cost becomes undeniable.”
Assuming quality operations opens the door for risk
Thording cautioned healthcare organizations against assumptions that all professional reprocessing companies are operating to the highest standards, including adherence to instrument and device manufacturers’ instructions for use (IFU).
“If you can move off-site reprocessing to a company that operates with accountability and transparency, that’s an improvement,” said Thording. “But the hospital must make sure that accountability actually exists.”
Undervaluing change management and accountability threatens quality assurance
Macmillan advised against taking too lightly the level of change required when moving to offsite reprocessing and urged healthcare organizations to keep their third-party reprocessing companies accountable for quality standards, stating:
“Change can be difficult for any organization, but to move to an offsite reprocessing partnership does really create a sense of fear, largely about trust in another facility. Establishing a collaborative partnership founded on trust is essential for ensuring adherence to processes and procedures.” Another key element is keeping staff engaged in conversations and being open and transparent about incoming changes. “They are key in the change management process, and they are the experts in the work, so they need to be front and center”.
“It is crucial for the organization to recognize themselves as the customer and engage in courageous conversations. Open and honest communication is critical to a successful partnership such as follow up with discrepancies, commitment to contractual obligations, tapping into education support, on-site support, having regular touch point meeting to follow-up on KPIs and quality, etc.,” she added.
Underestimating resources risks falling short
Vinson warned against underestimating the volume of instrument and device inventory required for offsite reprocessing, noting how, “In some cases, a hospital might not fully understand their inventory requirements due to bad data or lack of process oversight.”
Harreld emphasized how healthcare organizations often underestimate the full budget required for offsite reprocessing, particularly when it comes to staffing and supplies. She highlighted the importance of reevaluating existing staffing models, noting the potential need for adjustments in headcount, roles, or scheduling at the new location. Human resource planning, she stressed, should go beyond technician staffing to include the structure and responsibilities of the leadership team. Key questions to consider during planning include:
“Where will the SPD manager be located? Will they have an office at the offsite location, or remain at the main hospital? Do you need additional leadership to support offsite operations?”
“Ensuring you have adequate staff and leadership structure is key to daily management,” said Vinson. “Shift leads, educators, instrument coordinators, etc. all play key roles in ensuring priorities are met and instrumentation is processed at the highest quality.”
Short-sightedness impacts long-term success
Greisen noted that “failing to anticipate future needs and overlooking complex distribution scenarios” is a common pitfall she has seen in the offsite planning process.
“This can lead to inefficiencies such as delays in instrument turnaround times, inconsistent case readiness, bottlenecks in transportation logistics, and misalignment between reprocessing capacity and surgical volume,” said Greisen. “These challenges are often hard to resolve once operations are live and can significantly impact operating room (OR) performance and staff satisfaction.”
She emphasized the importance of accurately projecting surgical volume, instrument demand, and growth, stating, “Misjudging future needs can result in capacity shortfalls and require expensive, unnecessary redesigns that could have been avoided in the first place.”
Your number one piece of advice
All elements and factors that go into a successful offsite move cannot be captured in a single article, particularly because each individual health system or hospital has its own nuances and needs. At a high level, our group of experts offered their number one piece of advice to SPD teams and healthcare organizations considering a move to offsite reprocessing.
Don’t skimp on strategic planning
“Prioritize strategic planning that accounts for both current operational needs and long-term growth,” said Greisen. “Building flexibility into the design from the outset is key to scaling effectively. One common pitfall is designing a facility solely around current case volume or equipment mix without accounting for evolving service lines, technology upgrades, or shifts in surgical demand, which can lead to costly retrofits or workflow disruptions down the line.”
Vinson pointed to the criticality of data quality and access during the offsite planning process, stating: “I cannot over-emphasize the importance of data-driven decision making. Invest in robust tracking systems for inventory management as well as data analytics for predictive and live dashboards.”
“While certainly not required, having a vendor partnership to help in advising in data review and logistics is extremely helpful,” she added. “You have to have good, clean data to review process, inventory, and staffing analysis.”
Macmillan explained how strategic planning for offsite reprocessing must include financial planning. She stated:
“Choosing offsite reprocessing must align with the organization's fiscal responsibility. Therefore, knowing the offsite reprocessing proposal and additional costs, especially for future planning, is essential.”
Engage the right stakeholders
Harreld stressed the importance of involving the right stakeholders early in the planning process, along with setting an appropriate timeline. “Ensure the right people are at the table for planning meetings and that you include vendor partners who can support key areas like data collection, budgeting, staffing models, and equipment capacity,” she advised.
She also highlighted the value of strong leadership engagement: “Having leadership support and a champion involved from the start is critical to success.” While leadership will ultimately be part of the approval process, Harreld emphasized that representatives from all operational areas should actively participate in the planning committee to avoid surprises at go-live. This includes nurse managers, infection control, environmental services, human resources, perioperative leaders, nurse coordinators, central supply, and a surgeon champion.
“Having all the right people involved in the steps is essential,” said Macmillan. “This includes front line members from the operating room (OR) and MDR. Ensure there are regular and frequent meetings in the planning phase with set timelines and action items. Have the offsite partner involved onsite as much as possible to help build trust and confidence with the perioperative teams. Planning appropriate education and transition support is essential.”
Focus on logistics
“Offsite success is 80% logistics planning and 20% stainless steel,” said Jain. “Before signing any lease or contract, map the entire peri-operative supply chain—instrument mix, block schedules, staffing, volume peaks, transport routes, and contingency buffers.”
“While there are many considerations when establishing an offsite or centralized reprocessing center, in my experience, logistical planning is the most critical,” said Harreld. “This includes ensuring instrument traceability and carefully planning transportation methods. It’s essential to involve couriers and drivers in the planning meetings early on, as they play a key role in the success of the operation.”
Harreld also emphasized the importance of mapping delivery routes in detail: “Track each set and assess the delivery pathways. Every region presents unique challenges—flood zones, traffic congestion, highways, and school zones can all impact timely delivery.”
Commenting on offsite reprocessing center design, Greisen noted that it is “more than just the physical layout,” stating:
“It’s also about creating efficient workflows, optimizing equipment placement, and planning for flexibility. A well-designed offsite supports scalability and can minimize unnecessary bottlenecks.”
“Overall building design and workflows are vitally important for operational efficiency,” said Vinson. “Think ‘LEAN’ processes and incorporate as much standardization as possible.”
Macmillan noted how the healthcare organization needs to know the inventory and quality of instruments, recommending that there are “Dedicated MDR and OR champions to assist in the setup, training, and knowledge on the partnership processes.”
If outsourcing, ensure accountability
For SPD leaders evaluating reprocessing partners, Thording recommended asking for three things:
- Batch-level reporting on how many turns a device has gone through.
- Functionality testing protocols for every single device and results—did devices pass or fail?
- Documentation of cleaning processes used for each batch.
“These are not just operational details,” Thording explained. “They are the foundation of safe and effective device reprocessing. We test every device for functionality before it returns to the hospital. And we follow the manufacturer’s IFUs to the letter—including using the right chemicals, the right temperature, and cycle counting for every device.”
“It is vital that both parties are transparent, supportive, and accountable,” said Macmillan. She recommends: “Ongoing communication updates, listening to concerns, and asking the right questions so that the teams can feel reassured during the process from start to finish.”
The hospital’s core SPD team should maintain a vital role
Macmillan advises health systems and hospitals considering an offsite move to ensure their core MDR/SPD teams still have a vital role within their organizations.
“Despite not having the reprocessing aspect for the MDR tech, the team maintains a significant responsibility with cleaning, inspection and handling, and overall quality assurance of trays and equipment,” said Macmillan. “Another key factor is to understand the program's needs and the turnaround time for returning the trays. For example: Trays picked up from hospital at 4 p.m. on Monday won't be returned until 4 p.m. on Tuesday. Having the right amount of equipment, including redundancy, to ensure that patient care is not compromised is crucial.”
Available resources
Lastly, HPN asked those interviewed to offer recommended resources healthcare organizations and SPD teams can use when considering offsite reprocessing. Here is what they provided.
Start with the standards
“Begin with AAMI ST79 and the new 2025 AAMI TIR109 on off-site processing,” said Jain. “Augment them by touring mature ORCs, hosting open forums between SPD and OR teams to surface pain points, and commissioning third-party audits for an unvarnished baseline. Progress demands embracing change—the only route to safer, more efficient care.”
Look to real-world resources
“Leverage real-world experience,” said Greisen. “Learn from those who have successfully managed an offsite and break down the issues of current offsite facilities using RCA/Fishbone methodology to unpack and correct what is not working. Just as important is bringing in professionals who specialize in redesigning SPDs and offsite workflows. Their firsthand knowledge from supporting similar transitions at other institutions can help you anticipate challenges, avoid common missteps, and build smarter, more scalable solutions from the start.”
Lean on industry partners
“Utilizing vendor partners and industry professionals for support is a huge benefit,” said Harreld. “There are many companies that offer support in the offsite planning and preparation and can really be a guiding tool as you go through the process - from equipment planning, to budget, to data and analytics, to quality assurance, and staffing models. I highly recommend partnering with a few and not trying to complete the entire thing on your own. We are lucky to have so many resources in this area in the industry.”
“There are several vendors in the marketplace that offer consulting services in this area,” said Vinson. “I recommend doing your due diligence to ensure they are knowledgeable and reputable. There are also vendors that offer full service in building and operating an offsite. You have to review your specific needs and customize to what will solve your unique challenges.”
Maintain success through collaboration
Commenting on her hospital’s experience partnering with an offsite reprocessing company, Macmillan stated:
“Having a dedicated lead between both sites is necessary to maintain clear lines of communication. Organizing site visits for both parties is also valuable and a way to support the transition and build trust. We should hold regular meetings to ensure consistent communication and transparency, sharing reports, including quality review recommendations or discrepancies, and to follow up on incidents that can be shared monthly with both teams.”
Kara Nadeau | Senior Contributing Editor
Kara Nadeau is Sterile Processing Editor for Healthcare Purchasing News.
