With January upon us, it’s the time of year many of us start taking stock of the things we would like to improve or change in our lives. While most resolutions are focused on personal aspirations, it may be a perfect time to consider professional goals as well. One topic facing many Central Sterile Supply Departments (CSSD) and OR departments is how to improve the relationship between the two areas. It’s not easy building interdepartmental teamwork at any company or institution, and developing a strong partnership between the Central Sterile Supply Department and OR departments can be inherently challenging for multiple reasons.

There have been many recent articles about how effective leadership strategies can create a cohesive Central Sterile Supply Department/OR team. Before addressing strategies for team building, let’s first look at some of the circumstances that can lead to frictions between the OR and CSSD areas.

1. Competing goals and priorities: OR needs instruments, supplies and devices on time; CSSD wants to make sure no corners are cut in the reprocessing steps. Without both departments being respectful of each other’s priorities it becomes very challenging to develop effective quality improvement strategies.

2. Physical separation: Working in separate areas can foster interdepartmental friction in several ways:

a. Effective communication becomes more challenging.
b. Exposure of staff members’ to the tasks and pressures associated with each other’s roles is limited, which can contribute to misperceptions about the other department’s level of competency and commitment to responsibilities.

3. Culture differences: CSSD and OR operate on different time schedules. The OR is busy during the day, and the Central Sterile Supply Department is typically running in high gear during the evening and night shifts. A lack of sensitivity to when the other department is operating at peak productivity in terms of expectations can lead to strained relationships, (Moffitt, 2014).

4. Lack of interdepartmental knowledge: When staff members of each department do not have a clear understanding of the roles and responsibilities of co-workers outside their own respective area, it is difficult to promote collaborative solutions to workflow obstacles.

5. Intertwined responsibilities: As it relates to patient care, any time an aspect of a staff member’s responsibility is out of his or her control, it can be tempting to point a finger at a co-worker perceived to be causing a road block, rather than focus on how to meet a need.

6. Poor relations between members of management: If managers don’t get along, respective staff’s often see their colleagues as competitors or enemies, (Woodward, 2010).

7. Ineffective communication channels between CSSD and OR about upcoming equipment needs: This may be the number one barrier to creating friction between the departments, (Saver, 2015).

These are some of the common sources of interdepartmental tension to consider. Of course there are many other circumstances that can stand in the way of creating an effective OR/CSSD partnership. Identifying the obstacles is the first step in the process of improving work place relationships. Once the points of friction have been pinpointed, it is much easier to mount an effective plan of attack on how to alleviate these challenges. Every facility situation is unique and there are no silver bullets when it comes to developing team-building strategies. However, some ideas to consider that have worked for others in the industry working to break down CSSD/OR relationship barriers include:

1. Have regular, scheduled department leadership meetings: Managers can set the tone to promote a team approach to challenges through regular meetings or rounding together in both departments to identify challenges, (Saver, 2015).

2. Establish a job-shadowing program: Allow staff members to learn a little about what it’s like to walk in each other’s shoes. It’s important to pick the right staff members with proper expertise to orient staff from outside the department around their respective areas. If done well, shadowing can go a long way in building rapport between departments, (Moffitt, 2014).

3. Have a system or process to document complaints and issues: Staff should have access to a quality control system or process to easily document/ “open a case” when things don’t go well. This helps keep communication factual, and simplifies follow up between departments. If possible, incorporate the ability to include pictures in the reporting process for clarity and accuracy. Having a quality control reporting process also provides the opportunity to document closure when resolutions have been found.

4. Schedule joint staff meetings and training sessions: Bring members of both departments together to discuss issues and strategize together on possible solutions. Offer joint training for topics that impact both departments. This provides opportunities for staff to get to know each other and learn more about each other’s responsibilities.

5. Establish cross-functional teams to address key projects that impact both departments, (Moffitt, 2014).

6. Consider a software solution that both departments can access to support loaner tray management: Loaner trays are problematic assets to handle, as well as common sources of interdepartmental frustration, (Saver, 2015). Having a software solution that documents delivery time, associates the tray to a specific case, and captures images of what was delivered and returned, can be a great tool to help support and enforce loaner policies while eliminating finger pointing.

7. Show gratitude: Take the time to recognize staff contributions that have made a difference. This can be a fun, positive way to develop cooperation between departments, (Cumbay, 2015).

8. Challenge staff to be an example of professional, respectful behavior toward colleagues: Sharing negative feelings and opinions typically pulls everyone down and for the most part, is not helpful. If staff attitudes toward each other are an issue, calling out the pattern and then asking everyone to self-monitor their own behavior may be a surprisingly simple solution that can improve the situation.

Without question, CSSD and the OR departments both work tirelessly toward delivering the highest quality of patient care. But because the departments, by design, have competing priorities, as well as barriers often inherent to their environment, it is understandable why adversarial relationships have been known to develop. The good news is that by identifying the points of friction, and working together, CSSD and OR leaders can take steps to create a strong partnership between their respective departments that ultimately improve employee satisfaction and make a positive impact on patient care.


Cumbay, Traci. “6 Ways to Build Effective Cross-Group or Interdepartmental Communicaton”. www.Dummies.com. John Wiley & Sons, Inc., 2015. Web. Oct. 30, 2015. http://www.dummies.com/how-to/content/6-ways-to-build-effective-crossgroup-or-interdepar.html.

Moffitt, Brian. “Break down the Silos”. TD Magazine, March 8, 2014. Web. October 28, 2015. https://www.td.org/Publications/Magazines/TD/TD-Archive/2014/03/Webex-Break-Down-the-Silos.

Saver, Cynthia. “OR Manager Special Report Sterilization & Disinfection: Creating a Powerful Partnership between the OR and the SPD”. OR Manager and Access Intelligence, Web. November 2015. http://store.ormanager.com/by-category/books/sterilization/sterilization-disinfection.html.

Woodward, Anita. “Improving Inter-Departmental Relations”. A. Woodward & Associates – Newsletter, January 2010. Web. October 28, 2015. http://anitawoodward.com/newsletters/Jan-2010.htm.