Rounding Up Safety: A Multidisciplinary Approach to Infection Prevention

Every sterile processing leader eventually encounters a phenomenon: adherence drift. It does not arrive loudly. It creeps quietly during periods when everything seems to be running smoothly. Teams get comfortable. Standards loosen incrementally. And by the time the problem becomes visible, it is already entrenched. In the sterile processing department (SPD), where our instruments touch patients across every corner of the hospital, drift is not a minor inconvenience; it is a patient safety risk.

The solution I have found most effective is structure, multidisciplinary environment of care (EOC) rounding. When the right people walk through your department together, with clear criteria, defined roles, and a commitment to follow through, it becomes one of the most powerful tools a department leader can build.

Building the Right Team

Effective rounding is not a solo exercise. The team should include environmental services (EVS), infection prevention (IP), facilities and safety departments, SPD, and, depending on your facility, operating room (OR) leadership. Each department brings a lens that SPD Leadership simply does not have on its own.

EVS evaluates whether terminal cleaning is happening correctly, whether floors show signs of load sticker residue, and whether vents are being maintained. IP tracks regulatory adherence and confirms that staff understand the metrics being monitored. The facilities department identifies physical integrity issues, including door seals, faucets, floor drains, and eye wash stations, before they become survey findings. Safety checks for blocked electrical panels and physical hazards. SPD serves as the subject-matter expert in its own domain, both showcasing the team's work and holding itself accountable alongside the others.

Structure: The 5 Ws

A useful framework for designing your rounding program is the 5 Ws.

• Who rounds all the departments named above?
• What they do: criteria-based observation using a standardized checklist, think The JC Tracker format, covering clean areas, dirty areas, back hallways, sterilization records, washer testing logs, Immediate Use Steam Sterilization (formerly known as flash sterilization) (IUSS) documentation, bioburdens, RDLs and tech adherence.
• When: a monthly all-call round lasting 1 to 2 hours is a strong starting point cadence, adjusted based on your survey window, turnover rate, and adherence trends.
• Where: SPD departments, OR sterile cores, and back hallways, the full footprint of where instruments live and travel.
• Why: To maintain the regulatory standards set by the Association for the Advancement of Medical Instrumentation, the Association of periOperative Registered Nurses, the Occupational Safety and Health Administration OSHA, the Colorado Department of Public Health and Environment, and The Joint Commission, while giving leadership a fresh perspective on areas where familiarity has created blind spots.

Meeting Structure and Accountability

Consistency is everything. The rounding meeting needs a designated time and place that works across departments, and it must be held on a regular cadence, because the moment the cadence drifts, so does the program. Assign clear ownership: one person tracks rounding data, one runs the meeting, one takes notes during rounding, and one (ideally from SPD) documents all work orders and follow-up items, a clear point of contact, and an accountability trail, rather than letting verbal requests disappear.

Rounding data are often tracked through IP’s monthly adherence meeting, which is fine, if the data are truly being captured and reviewed. Questions to answer after every round: How do we score? Are tickets being placed? Are they being followed up on to prevent small issues from becoming regulatory failures?

Engagement Strategies That Work

Three approaches have made a meaningful difference in sustaining engagement over time.

• First, bring rounding directly into team huddles. Make scores and findings visible. Invite a tech to round alongside the group; the shift in perspective and ownership is immediate.
• Second, assign a grade, the way health departments score restaurants, and post it where the team can see it. The environment staff work in is their responsibility too, not just leadership’s. Visible scoring creates pride and shared ownership in a way that a memo never will.
• Third, run periodic secret shopper rounds: bring in someone from another department, unannounced, to inspect using the same criteria as a standard round. People who work in a space daily go blind to it. A fresh set of eyes almost always surfaces something worth addressing.

The Bigger Picture

SPD is not just a processing department. It’s a critical link in the chain of patient safety, and that link requires continuous, structured attention. Multidisciplinary rounding does not eliminate all risk, but if it builds the kind of shared accountability that catches drift early, supports staff, and demonstrates to surveyors that your department is not waiting to be found; it is already looking.

The rounds work when you do them consistently. Build the team, set the cadence, and trust the process.