By: Christina Carpentier, Sterile Processing Manager, Seattle Children’s Hospital

In brief:

• Real culture change in sterile processing is never permanent after one success. Without regular check-ins and reinforcement, old behaviors can resurface.
• To keep progress alive, leaders need to stay present, revisit the vision often and respond early when signs of backsliding emerge.

Progress doesn’t lock in by itself

Culture change in sterile processing is often treated like a milestone: you fix what’s broken, celebrate the win and move forward. But in reality, culture doesn’t work that way. It requires ongoing attention, especially in environments where pressure, pace and staffing are constantly shifting.

Early in my leadership journey, I saw how quickly the sterile processing department (SPD) culture could shift with the right intention. We had changed the tone between SPD and the OR, introduced new tools and created clearer communication channels. The atmosphere felt lighter, and people were more willing to collaborate.

But after a while, I started noticing a change. Not dramatic, but enough to make me pause. Some of the tension was creeping back in. It reminded me that progress doesn’t stick just because we want it to. Culture has a way of drifting when we get stagnant.

The backsliding happens quietly

The setbacks didn’t come from big blowups. They showed up in more subtle ways, such as missed feedback loops, decisions made in isolation and small signs of guardedness returning. Those moments made it clear that without active leadership, people naturally revert to what feels safe and familiar. Sometimes that means leaning back into old habits. Other times it means holding onto what worked previously, even when new people, new workflows and new pressures call for something different.

Leadership is knowing when to re-engage

When I noticed those early signs of drift, I didn’t treat them as failure. I treated them as feedback. One of the biggest examples came after we had restructured job duties across the team. Initially, it worked extremely well. Engagement improved, accountability was clearer and people felt more ownership in their roles. But as time passed and new team members were hired and trained, I started seeing the structure loosen.

Some staff were quietly slipping back into old routines, and certain responsibilities were no longer being performed  consistently. That’s when we regrouped as a leadership team and revisited every restructure decision we had made. We didn’t assume the original plan was wrong, but we recognized that it needed refining to match how the team was actually functioning day to day.

One of the adjustments we made after regrouping was creating clearer checkpoints at the beginning and end of each shift. Team members reviewed their assigned responsibilities for the day and had a way to flag when tasks needed to shift based on workload or staffing realities. That structure brought clarity back into the workflow and helped re-engage the team in owning their roles, rather than defaulting to old routines.

When operational pressure tests the culture

Another area where drift showed up was in case cart processing and point-of-use care. Over the summer, as surgical volume increased, we saw a noticeable decline in pre-cleaning and proper rinsing of instruments coming back to SPD. The OR teams were focused on keeping turnover times moving, which is understandable, but the downstream impact on SPD was immediate.

Rather than letting frustration build, we addressed it by reestablishing clear expectations and shared visibility around case cart conditions. The OR was given a structured way to communicate what was happening at the point of use, and SPD had a clearer line of sight into what was coming back and why. That shift reopened shared accountability between departments. It wasn’t about placing blame. It was about restoring a closed-loop process that had quietly slipped open under pressure.

Reopening the communication loop

Culture work doesn’t stop at system changes. It always comes back to conversation. Our SPD and OR leaders recently met again to talk through current challenges and reconnect around shared expectations. That type of regrouping is what keeps culture alive. Not one big reset, but steady moments of recalibration.

Culture change doesn’t come from a single solution. It’s a long game of reinforcing values, watching for drift and being willing to course correct without defensiveness. The work is never “done.” And that’s not a bad thing! In my view, that’s how progress stays grounded in reality.