Meet ICT's EAB Member, Marjorie Wall, EDBA, CRCST, CIS, CHL, CSSBB

Introducing the Infection Control Today's (ICT's) Editorial Advisory Board members—a diverse group of professionals dedicated to advancing infection prevention and control practices. This series highlights each member's unique expertise and contributions to the field.

From groundbreaking research to innovative strategies, these experts are at the forefront of enhancing health care safety. Join us as we learn their insights, experiences, and visions for the future, providing valuable knowledge and inspiration to elevate infection control protocols.

In this installment, we hear from Marjorie Wall, EDBA, CRCST, CIS, CHL, CSSBB.

I serve as the associate director of sterile processing at Cedars-Sinai in Los Angeles, California. Additionally, I am the former president of the Healthcare Sterile Processing Association (HSPA), which has approximately 40,000 members worldwide. I've been in the field for about 25 years and have been very successful.

But I'd like to share a little about my journey with you because that's not where I started or what makes me who I am. So, believe it or not, I started in the field in the [19]90s. I don't want to age myself any more than I already have, but I did start in the [19]90s, and I was a cocky college student at the University of Georgia, and one of my friends from high school asked me if I needed a weekend job.

And I said, “Yes, I would love a weekend job.” I got a job in sterile processing, working every weekend. They put me through a 2-week training program, and I was so confident and amazing and a superstar. I mean, I was a math major on a full scholarship. I knew what I was doing, and the first weekend, I worked by myself. I reprocessed some Synthes DHS Hip Instruments.

I was proud. I washed them. I inspected them. I did all the steps, used the count sheet, and ensured everything was there. I sterilized them using the right parameters and sent them to the operating room [for] the following Monday.

The following Monday, they used those instruments on a patient. When they went to use the first tray, they found contaminated instruments and bioburden. The second tray I processed was the same way.

As you would expect, the same thing happened. My boss [told me the department] flashed the instrument. They sent him to get washed, and then they flashed them, and they finished the surgery. My boss called me into the office the next day when I worked and asked me what happened. She told me that I would have been fired if I hadn't been brand new.

The experience shook me. Later, I found out the patient did have a surgical site infection, so the patient was harmed. And again, I was this overconfident 20-year-old in Georgia, so it upset me that I had harmed someone, which impacted the core of who I am. I realized I wasn't just in a weekend job to get through school. I was in this field, in this position where it was so important that I knew and did my very best and knew everything that I could learn to make sure that patients had the best care they could receive.

As I grew in the field, eventually becoming a manager, supervisor, manager, and director, it became less about me making sure I was my best, although that pressure is still there. (Believe me; ask anyone who knows me, and they'll tell you how hard I am on myself.) But it's also about making sure my employees are set up for success, that we have training programs where SPD [sterile processing department] professionals get the information they need to be successful, where we have technology and innovation that gives people all the information they need when they need it, where we have things like six sigma and process improvement that create workflows that ensure patients are getting consistent outcomes for every procedure from every instrument tray that's used on them.

This event that happened to me put me in a position to want to improve the industry and make things better, which is where I started doing article writing and podcasts. I got my doctorate. My dissertation, which was on the giving of disruptive technology and health care industry, and even currently, where I go to Harvard Med School for a post-doctorate master’s, all of this work that I do, all of the impact that I've made in the industry, comes from this motivation of wanting to make sure our patients get the best care possible, and our sterile processing professionals are set up for success to do that.

Trending Topics in SPD

With that said, I'd like to jump into some of the trending topics in the SPD field right now; our industry is changing radically every day. What is the latest, latest, and greatest hottest technology solution? The big topics we're going to see in the coming year will be automation, creating robotics, and automated processes that will get more consistent outcomes. We will see a lot more conversations about artificial intelligence and visual recognition, especially when it comes to instrument identification and bioburden or broken instrument identification; those will become consistently bigger and bigger topics. We're also going to start seeing things like CO Pilot Assist, where several processing people have AI systems or technology solutions that help them get all the real-time information they need to understand manufacturers’ instructions for using the instruments and devices they're processing.

Many hospitals have 100,000 instruments SPD techs are expected to know, and they will have this technology at their fingertips to help them succeed in those roles. The other big topic outside of innovation and technology is the professionalization of the steward processing field. Historically, SPD people have been seen as an entry-level job where, much like me back in the day, I came in with no experience, 2 weeks of training, and I was told, “Good luck. You got this.”

We know that's not the case anymore. It's a true profession, and it takes a strong knowledge base to succeed. So we're seeing more and more people getting certifications, going for education, attending conferences, reading articles, creating or listening to podcasts, and all of this is an effort for sterile processing professionals to increase their knowledge base and be professionals.

One of the things that I'm proud of in the field right now, which, again, is a very big trending topic, is we're seeing more and more doctors of sterile processing, so there are a ton of people that are going out getting advanced education, whether it's bachelors, masters and even doctorates, that are industry leaders in the sterile processing field. And I'm here, and I love seeing that we're also seeing a shift in how sterile processing departments are perceived historically. SPD was either materials management or perioperative services.

We're seeing more and more departments becoming their own, standalone departments under a [vice president] of operations or a COO [chief operating officer] with system leaders over those departments at the field level or with VPs in those hospitals, as well as senior directors. We're seeing this elevation of the field, and we're also seeing the professionalization of the field, which is all very exciting.

What gets to me is that historically, SPD has been seen as a technology job, a technician job. We'll start seeing people consider it more of a technologist job. It's not just something you can train people to do a task; it requires technical knowledge and expertise to perform that function. We will start seeing that continue to grow and develop, and people will talk about it like crazy.

The next couple of years are going to be very exciting.

What Would Dr Wall Like to See in Infection Control Today

Some of the technical topics that I'd like to see covered in Infection Control Today magazine are important because we need them. That resource is the body of knowledge for SPD and infection control professionals to access and grow their knowledge base. So, I'd like to see more about flexible scopes, especially the push to move from high-level disinfection to sterilization.

I'd like to see more about the new AAMI ST58 standard released on chemical sterilization. It's a big topic there as well. Then you know more and more of those technical, scientific topics, like st 108, with water and steam quality endotoxins. One that I came across recently was using UV light as a high-level disinfection methodology, which is new, innovative, and exciting. And when I was in Cleveland, I saw a presentation on how alcohol may not be the best drying agent for flexible scopes.

So all of these are very technical concepts, very scientific concepts, and I love seeing Infection Control Today magazine as a way to cover those topics, put them in a format and a shape that practitioners so sterile, processing professionals, epidemiology professionals, can read and take back with them and apply in their everyday worlds. And that's how we will transform the industry and improve things for patients and our employees.