Challenges of Medical Devices Reprocessing - ASP University
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Efficiency in healthcare refers to do more and better with less resources to provide health services who are cost-effective, safe and based on high standards of care.1

Efficiency can be achieved with the implementation of strategies that reduce the number of unnecessary resources, optimize workflows, and adopt innovation.2

Efficiency in healthcare has become a cornerstone, as technologic advances and greater coverage creates pressure on limited budgets, and ecologic aspects must also take into consideration.1

Increasing efficiency in healthcare contributes to their economic sustainability, competitiveness, while reducing environmental damage and lastly improving quality of care and quality of life.3,4

In each day, millions of invasive procedures take place and millions of reusable medical devices are reprocessed throughout the World. The appropriateness of reprocessing of medical devices is a pillar for quality and safety of care, reducing the incidence of Healthcare Associated Infections (HAI), namely Surgical Site Infections (SSI), which are responsible for 18% of all HAI in Europe.5-9

Without the reprocessing of reusable medical devices most procedures could not take place. Such reprocessing is also central for the adoption of a circular economy strategy, lowering the climate damage.10-12

Reprocessing is a complex process with several steps and different players that requires efficient technologies, proficient human resources and good health technology assessments.13-15

The Central Sterilization Services Department, where multiple strategies can be adopted in different moments, including the adoption of low temperature sterilization can contribute to maximize efficiency. 18-20

We will also cover the importance of good traceability and material handling systems to improve efficiency in this field.21

Taking as a point of departure the global concept of Efficiency in Healthcare, its applicability and implications for medical devices reprocessing, in this Webinar Series, Efficiency in Medical Devices reprocessing: the road ahead, we will dive into the different scenarios where medical devices are used and need to be reprocessed: the operating room and the applicability of the lean principles to increase efficiency in the global process of reprocessing.16,17

Prof. Francesco Venneri

Medical Device Reprocessing Efficiency impact in Healthcare: an overview

Mr. Manuel Valente

Applying Lean principles at the OR to improve MD reprocessing efficiency


Strategies at the CSSD to improve MD reprocessing efficiency


Traceability and material handling systems as tools to improve MD reprocessing efficiency.


Health Technology Assessment role on MD Reprocessing efficiency
Medical Device Reprocessing Efficiency impact in Healthcare: an overview

Prof. Francesco Venneri

Clinical Risk Manager and Patient Safety Officer

Florence Healthcare System, Italy


General analysis of the impact of DM Reprocessing efficiency on healthcare systems (Single vs Multiple Use, process automatization, fastest turnaround, etc.)  that have contributed to reducing the SSI related to MD reprocessing, in the last decade.



Impact of HAI and SSI
in healthcare
The importance of MD reprocessing
in the prevention of SSI
Efficiency in healthcare definitions and perspectives:
affordability, sustainability and value based healthcare
Efficiency of MD reprocessing:
impact and optimization strategies


  • What is the HAI and SSI impact in healthcare?
  • How does efficacy and efficiency influence quality healthcare outcome?
  • What are the milestones considering that:
    Sustainability and value-based healthcare are the challenges of the future and MD reprocessing may have an important role in assuring these goals.
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References :

1. European Observatory on Health Systems and Policies, Cylus, Jonathan, Papanicolas, Irene & Smith, Peter C. (‎2017)‎. Identifying the causes of inefficiencies in health systems. Eurohealth, 23 (‎2)‎, 3 – 7. World Health Organization. Regional Office for Europe.
2. Efficiency: What It Means in Economics, the Formula To Measure It (, Accessed on the 10th January 2023
3. Mortimer, F., Isherwood, J., Wilkinson, A., & Vaux, E. (2018). Sustainability in quality improvement: redefining value. Future healthcare journal, 5(2), 88–93.
4. Zarulli V, Sopina E, Toffolutti V, Lenart A (2021) Health care system efficiency and life expectancy: A 140-country study. PLoS ONE 16(7): e0253450.
5. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017 (Pag. 7, Table 3) 3.
6. Special Report Top 10 Patient Safety 2020 – Executive-Brief, ECRI, page 9, 5. Device Cleaning, Disinfection, and Sterilization.
7. Surgical site infections linked to contaminated surgical instruments. The Journal of hospital infection, 81(4), 231–238.
8. Infections and exposures: reported incidents associated with unsuccessful decontamination of reusable surgical instruments. The Journal of hospital infection, 88(3), 127–131.
9. Badia, J. M., Casey, A. L., Petrosillo, N., Hudson, P. M., Mitchell, S. A., & Crosby, C. (2017). Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. The Journal of hospital infection, 96(1), 1–15.
10. Andrea J. MacNeill, et al. Transforming The Medical Device Industry: Road Map To A Circular Economy. Health Affairs,
11. WHO Europe. Circular Economy and Health: opportunities and risks. Geneva, 2018.
12. G.M. Kane, C.A. Bakker, A.R. Balkenende. Towards design strategies for circular medical products. Resources, Conservation and Recycling, Volume 135, 2018, Pages 38-47,
13. Emily A. Hildebrand, L. Bryant Foster, Russell J. Branaghan. Chapter 19 – The Human Factors of Reprocessing Reusable Medical Equipment,Editor(s): Mary Beth Privitera, Applied Human Factors in Medical Device Design, Academic Press,2019,Pages 303-314,ISBN 9780128161630,
14. Introduction to Health Technology Assessment.
15. ASP Webinar#5 Series 2 factsheet: Health Technology Assessment for medical devices reprocessing improvement. Jonathan Hart. Available on:
16. Dyas, A. R., Lovell, K. M., Balentine, C. J., Wang, T. N., Porterfield, J. R., Jr, Chen, H., & Lindeman, B. M. (2018). Reducing cost and improving operating room efficiency: examination of surgical instrument processing. The Journal of surgical research, 229, 15–19.
17. Rothstein, D. H., & Raval, M. V. (2018). Operating room efficiency. Seminars in pediatric surgery, 27(2), 79–85.
18. McCreanor, V., & Graves, N. (2017). An economic analysis of the benefits of sterilizing medical instruments in low-temperature systems instead of steam. American journal of infection control, 45(7), 756–760. 13.
19. Alfred, M., Catchpole, K., Huffer, E., Fredendall, L., & Taaffe, K. M. (2020). Work systems analysis of sterile processing: decontamination. BMJ quality & safety, 29(4), 320–328.
20. Alfred, M., Catchpole, K., Huffer, E., Fredendall, L., & Taaffe, K. M. (2021). Work systems analysis of sterile processing: assembly. BMJ quality & safety, 30(4), 271–282.
21. Martins, F., Ribeiro, M., Implementation and use of automated traceability system in the central sterile supply department. Rev. SOBECC, São Paulo. JAN./MAR. 2017; 22(1): 52-58. DOI: 10.5327/Z1414-4425201700010009.