Date of Award


Document Type


Degree Name

Master of Science (MS)


Industrial Engineering

Committee Chair/Advisor

Sudeep Hegde

Committee Member

Kevin Taaffe

Committee Member

Kenneth Catchpole


The Sterile Processing Department (SPD) is the part of the hospital that is responsible for decontaminating, assembling, and sterilizing surgical trays for use in the Operating Rooms (ORs). Errors in the SPD can lead to delayed surgeries or patient harm. The SPD is a complex system, with multiple interconnected subdepartments and roles. Complex systems require coordination between stakeholders. This study aims to discover how an organization can adapt to scale, and how information flows support these adaptations. In this study, observations, semi-structured interviews, and on-the-job interviews were conducted with members across the SPD and OR to elicit pressures, adaptations, and their corresponding information flows to understand the how coordination supports adaptive capacity in the SPD. A qualitative data analysis was conducted to find themes related to adaptations and coordination. Themes involving pressures include missing instruments and lack of proper staffing. Frequent adaptations include role evolution, prioritization, and anticipation. Coordination themes include unreliable artifacts and mistrust between the OR and the SPD. Maps of the adaptive workflows were created to visualize how pressures affect the textbook workflow, the responsive adaptations to overcome the pressures, and the information flow paths that support these adaptations. These findings can be used to provide insights to improve coordination and adaptive capacity of the SPD.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.