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Dear,
To answer your question I quote "Principles and Methods of Sterilization in Health Sciences", second edition, by John Perkins.
"For many years, processing activities were carried out in hospitals with facilities for steam sterilization in the operating rooms and water, instrument and utensil sterilization in the patient care units, it was assumed that a perfectly satisfactory supply processing system had been achieved. With this arrangement, it cannot be denied that many sterilization facilities had been provided, but who operated these numerous sterilizers? Under such conditions it was difficult to establish and maintain anything approaching standardization of sterilizing techniques throughout the institution. Thus, the situation where the operation of the sterilizers was everyone's business but no one's responsibility constituted one of the valid reasons for establishment of the comprehensive Central Service Department. The department continues to assume a greater role in the function of the hospital."
And Perkins continues about the advantages of a central service department: "The recognized advantages of centralization are efficiency, economy, and safety. When properly organized, the system promotes efficiency through good supervision of cleaning, maintenance, and sterilization of materials. The problem of standardization, uniformity, and coordination of materials and procedures are more easily controlled because the work is under constant supervision...
A central service department is also economical because it avoids duplication of equipment infrequently used. The life of materials is prolonged through efficient handling and the better methods of preparation and sterilization. Procedures do not vary from day to day with changing personnel. The use of personnel, working under competent supervision, with assembly-line methods and mechanical equipment, results in marked savings for the hospital. One group of workers whose primary function is the preparation of supplies can be trained to perform correct technics when the system is highly standardized and adequately supervised. This relieves professional personnel for other duties, not the least of which are patient care activities.
A summary of the advantages of centralization of sterile supplies would be incomplete without the recognition that it contributes to safer and more exacting processing procedures. The old decentralized system of sterilization on several floors and in several departments by many people was not conducive to monitoring of personnel activity to prevent sterilization failures. Cases have been recorded where loads of supplies were inadequately exposed to sterilizing condtions, some where steam was never admitted to the chamber of the sterilizer, and in more than a few instances, the entire process of sterilization had been omitted. The evidence against oversterilization of supplies is equally as bad from the standpoint of destructive effect on materials. Here no hazard is involved insofar as unsterile supplies are concerned but the destruction of materials has incurred unnecessary costs for the hospitals. These unsatisfactory practices do not always occur through the fault of the individual but rather because of interference with other, and perhaps imperative duties. Centralization has taken the operation of sterilization out of the class of "everybody's business and no one person's individual resonsibility, " and placed it in a highly specialized class with both supervision and responsiblity...".
The book has more than 30 years but the arguments, apart from another vision on the personnel, didn't loose their value, on the contrary. Because badly performed cleaning and sterilization processes can have dramatic consequenses for the patient, more and more requirements are rightly imposed on sterilization equipment, processes and personnel. Validation and reproducibility of the processes, tracebility, adequately controlled production circumstances e.g. can only be achieved in a central sterilization department.
Best regards,
Wim Renders
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