HSPA President Arlene Bush on Throughput, Standards, and Why Sterile Processing Must Celebrate Wins in 2026

Sterile processing is often discussed only when something goes wrong. A tray defect. A missing instrument. A delayed case. But in this wide-ranging conversation with Infection Control Today^®(ICT^®), Arlene Bush, CRCST, CER, CIS, CHL, SME, DSMD, CRMST, the current president of Healthcare Sterile Processing Association (HSPA), makes a different case for 2026. If the field wants retention, resilience, and safer outcomes, it must start recognizing what works and how often.

Bush is nearing the end of her presidency, calling it “a true labor of love,” and reflecting on what she has learned from serving the association, working with industry partners, and supporting her chapter network. Even with only “a couple of more months” left in her term, she remains focused on momentum: expanding education, strengthening certification, and pushing leadership to recognize sterile processing as the high-skill patient safety discipline it is.

A Global View of Sterile Processing

Bush recently attended the World Federation for Hospital Sterilisation Sciences Congress in Hong Kong, where she said it was valuable “to sit at the table with other industry leaders who have input on sterile processing globally.” What stood out was not just innovation, but how different the practice looks outside the US. “The US has the [Food and Drug Administration],” she said. “I think some people forget that.”

She also pointed to rapid product evolution, including “new robotic stuff,” and “new shorter biologicals,” emphasizing how cycle times that were once “hours long are no longer so.” For sterile processing teams under constant pressure, getting time back matters, but Bush grounded the conversation in the core mission: “to deliver safe, sterile equipment to every patient every time.”

The Case for Celebrating Throughput, Not Just Defects

One of Bush’s biggest themes was morale, and how sterile processing measures itself. “No one talks about the 2000 trays you did last week,” when everything went right, she said. “They talk about the one tray that was [wrong].” Her goal for 2026 is to shift that mindset and make throughput visible.

Bush described reviewing department totals and being surprised by the volume, even during the holidays. What mattered to her was not just the number of surgeries, but the instrumentation processed “with little to no defects.” Her challenge to leaders is practical: “It’s hard to change a number you can’t see.”

Certification Growth, and Why Membership Matters

Bush highlighted growth in certification as a marker of the field’s professionalization. “We’re like 67,000 [or] 68,000 certificate holders,” she said, noting that about “28,000 are actual members.” She encouraged certificants to consider membership, pointing out that for “the extra $10” members can vote and access reduced pricing and benefits.

She also previewed changes to certification requirements and urged technicians to follow HSPA town halls and podcasts for the most current updates. Her message was clear: Education is not optional in a field where standards, device design, and instructions for use (IFUs) are constantly changing.

IFUs Must Be Achievable, and Staff Need Real Access

Bush repeatedly returned to a point that other infection control and prevention personnel hear in different forms across the hospital: Policies and instructions only work if they can be followed. “It needs to be achievable,” she said. “It needs to be interpretable, and it needs to be effective.” When IFUs are unrealistic, she encouraged technicians to call manufacturers directly. “This is the way you wrote this IFU; it can’t work that way,” she said, adding that some vendors change and others refuse.

She also underscored how access affects adherence, sharing her own experience as a late-night technician who “never got access to the [Association for the Advancement of Medical Instrumentation (AAMI)] standards book” because it was “behind the door in the supervisor’s office.” Her commitment now is access for all shifts: “Doesn’t matter if it’s 3 o’clock in the morning or 9 AM.”

Rounding as Competency, Culture, and Prevention

Bush described rounding as one of the most effective tools leaders have to reinforce standard work, identify drift, and prepare staff for surveys. She gave concrete examples, from submersion decisions to rinse times to stopping when uncertain. “If you don’t know if it swims, don’t make it swim,” she said.

She also coached staff on what to say when asked a question they cannot answer. “Please don’t say ‘I don’t know,’” she said. Instead, staff should point to where the information lives: IFUs, policy, bottle label, or a supervisor.

However, Bush also reframed rounding as relationship-building rather than interrogation. Sometimes it is as simple as, “How was your weekend?” because approachability creates psychological safety. “That’s rounding,” she said. “You broke ice.”

Leadership, Mental Health, and The Human Stakes

Some of the most powerful moments came when Bush discussed leadership responsibility in high-stress departments. “You don’t know what people are facing at home,” she said. She shared an experience in which noticing a change in behavior, raising it with another leader, and acting quickly helped prevent a tragedy. “Mental health is a real, real thing,” she said, urging leaders to be attentive and compassionate.

Her summary advice for 2026 was simple and unusually direct for a technical field: “Just be nicer in 2026.”

Bringing It Back to the Patient

Bush repeatedly connected sterile processing decisions to patient harm, even though the department rarely sees patients directly. “We’re the only department in the hospital that doesn’t actually get to see a patient,” she said. “But what we do is so important.”

When discussing distractions like phones and earbuds, she framed it in personal terms: “Do you have somebody you love a whole, whole lot?” If so, treat every tray like it is for them. “You never think it’s going to be you…until it is,” she said.

For sterile processing personnel, infection preventionists, and perioperative leaders, the interview reads as both a technical roadmap and a cultural one. The thread running through it is trust: trust in training, trust in standards, trust in each other, and trust that sterile processing is visible not only when something fails, but also when it succeeds thousands of times in a row.