Evaluating the implementation of rigid sterilization containers in a Dutch central sterile supply department: a scenario-based cost and workflow analysis

The transition from single-use blue wrap to rigid sterilization containers is becoming more common in healthcare settings to reduce packaging waste and align with sustainability goals. However, there is a lack of comprehensive evaluations that integrate workflow dynamics, capacity implications, and financial outcomes. This study investigates the operational and economic impacts of implementing rigid sterilization containers in a high-volume central sterile supply department. A comparative, scenario-based analysis was conducted using detailed workflow mapping and cost modeling. Operational data was collected over three weeks to establish baseline metrics for packaging time, autoclave loading efficiency, and washer-disinfector utilization. The financial analysis incorporated equipment investment, labor, consumable costs, and infrastructure needs under different implementation scenarios. Introducing rigid sterilization containers reduced the average packaging time per instrument set by 61% and increased the autoclave capacity per cycle by 25%. The sterilization cost per set decreased by 40.4%, from €2.75 to €1.64. Based on typical usage patterns, the breakeven point for the initial investment was reached after approximately six years. However, the transition introduced new pressure points in the cleaning process, particularly when using large-capacity washer-disinfectors. Maintaining uninterrupted processing required either the addition of a new washer-disinfector or targeted workflow interventions. Rigid sterilization containers can deliver substantial efficiency improvements and cost savings, supporting their role as a viable, sustainable alternative to disposable wrapping materials in large-scale sterilization services. However, these benefits depend on system-wide coordination involving infrastructure adjustments and process redesign. Strategic planning and collaboration across hospital departments are essential for successful implementation. Future research should explore the effects on clinical operations, supply chain performance, and environmental impact.