Bonus: The Next Revolution in Surgery Is Happening Outside the OR
Episode of Bred To Lead · October 23, 2026 · 1 h 6 min
At a live conference session, Jake Tayler Jacobs and Edna Gilliam argue that sterile processing needs verified workforce development, not just certification or temporary staffing.
Summary
Recorded live before perioperative leaders, this bonus episode featured Jake Tayler Jacobs of SIPS Healthcare Solutions and Edna Gilliam, a perioperative and sterile processing executive. Jacobs framed sterile processing departments (SPD) as an integral but neglected part of surgery, tracing how surgery entered hospitals after wartime innovation and how operating room nurses organized nationally in 1949 while SPD went roughly 45 years without a universal career pathway or leadership pipeline.
Jacobs presented Joint Commission data showing SPD-related findings rising from about 20% of hospitals in 2009 to 76% in 2017, and argued that accreditors changed how findings were classified rather than how SPD staff were developed. He described an assessment of 125 SPD leaders across 189 facilities, saying most tested at entry-level despite certifications, long tenure and perfect competency scores, and a survey in which 99.5% of perioperative leaders reported being blind to SPD operations.
Gilliam explained that she learned sterile processing to answer surveyors confidently, initially resisted the SIPS assessment, then took it herself before requiring her leaders to do so; she said the results were eye-opening for her staff and that many SPD problems originate in the OR. Jacobs outlined a belt-based development track built on process, people and performance, argued that temporary staffing and instrument tracking systems alone do not fix SPD, and closed by promoting SIPS's workforce platform.
Chapters
- 0:00
Opening and introductions
A moderator introduces Jacobs and Gilliam, and Gilliam describes her mission of uniting the OR and SPD as one team.
- 4:32
SIPS background and why Gilliam learned SPD
Jacobs introduces his woman-founded consulting firm and Gilliam explains she learned sterile processing to face regulatory surveyors knowledgeably.
Linked moment · 8:36Skip to 8:36 using a listen link in the info box.
8:36SPD as part of surgery and new Joint Commission scrutiny
Jacobs argues SPD is part of surgery and Gilliam describes a mock survey that sought to interview staff with under a year of tenure.
- 15:27
How surgery entered the hospital
Jacobs traces hospitals from religious care institutions to surgery-centered systems shaped by wartime innovation.
- 20:17
OR nursing organizes while SPD is left behind
Jacobs contrasts OR nurses organizing in 1949 with SPD's lack of a career pathway and leadership pipeline.
- 26:48
Joint Commission findings data
Jacobs presents rising SPD-related accreditation findings from 2009 to 2017 and argues development never followed.
- 29:47
Certification versus verification and Gilliam's test
Jacobs describes verifying capability beyond certification and Gilliam recounts taking the AI-scored assessment before her leaders.
- 36:28
Assessing 125 SPD leaders
Jacobs reports that most certified, experienced SPD leaders tested at entry-level skill.
- 43:05
Operational blindness survey
Jacobs presents survey results on perioperative leaders' blindness to SPD and the drivers behind failed interventions.
- 48:03
OR's role in SPD problems
Gilliam and an audience director describe how missing instruments and bioburden often originate in the OR.
- 53:01
The fix: process, people, performance
Jacobs argues instrument tracking is not the sole solution and outlines clearer SOPs and a belt-based development track.
- 1:01:14
Questions for Gilliam and closing
Gilliam explains why a top-ranked department is rebuilding, and Jacobs closes with a pitch for the SIPS platform.
Key points
What was said, by whom, with the exact words. Timestamps jump to the moment.
- Jake Tayler Jacobs
Jacobs argues that temporary staffing does not solve sterile processing problems.
“Temporary staff and staffing is not the solution”
- Edna Gilliam
Gilliam says that when she first became a perioperative director she understood little about SPD beyond instrument cleaning.
“I would be very transparent to say that outside of understanding that that was a department that cleaned surgical instrumentation”
- Edna Gilliam
Gilliam says the new Joint Commission process involves surveyors speaking directly with staff, including employees with under a year of tenure.
“in the new Joint Commission process, they are going to want to speak to your staff”
- Jake Tayler Jacobs
Jacobs contends that modern hospital surgery was shaped by structures returning soldiers brought from the battlefield after World War II.
“after World War II, all these men came with all these ideas of structure from the battlefield and brought it to health care”
- Jake Tayler Jacobs
Jacobs argues that without a career pathway, workers turn on their current workplace.
“If you don't give people something to progress to, they begin to cannibalize where they are”
- Jake Tayler Jacobs
Jacobs states that the Joint Commission first considered sterile processing in 2009.
“2009 was the first year that Joint Commission ever even considered sterile processing”
- Jake Tayler Jacobs
Jacobs claims that by 2017, 76% of hospitals had serious SPD-related accreditation findings.
“But 2017, it was 76% of hospitals had hospital level findings that could shut the hospital down”
- Edna Gilliam
Gilliam says she was impressed that the assessment used AI-scored open-ended questions rather than only multiple choice.
“What impressed me about the test was the open-ended question. And it used AI to really kind of hone in”
- Edna Gilliam
Gilliam recounts that the assessment results were eye-opening for long-tenured staff, who initially rejected the test before coming on board.
“To people that have been doing this muscle memory every day for many, many years, it was eye-opening”
Listen from 35:55 · Professional certification versus competency verification
- Jake Tayler Jacobs
Jacobs says more than 76% of SPD managers and leaders assessed performed at an entry-level technician level.
“more than 76%. of the managers and leaders that run your departments are operating at a tech one level”
Listen from 37:36 · Professional certification versus competency verification
- Jake Tayler Jacobs
Jacobs reports that most of 125 assessed SPD leaders had never been verified despite perfect competency scores.
“95 of the 125 have never been verified before, but all 125 had perfect competency scores”
Listen from 40:49 · Professional certification versus competency verification
- Jake Tayler Jacobs
Jacobs reports that 99.5% of surveyed perioperative leaders said SPD was a black box to them.
“99.5% of Periop leaders said that they were blind to SPD. It was a black box coming in, black box coming out”
- Jake Tayler Jacobs
Jacobs argues that consultants and new technology fail because they do not address underlying workforce problems.
“Temporary fixes do not change permanent damage. You can't put new wood over a termite-infected Foundation”
- Edna Gilliam
Gilliam argues that many problems blamed on SPD, such as bioburden and missing instruments, actually begin in the OR.
“But at the end of the day, when you really look at the relationship, a lot of it begins in the OR”
- Jake Tayler Jacobs
Jacobs argues that hospitals with instrument tracking systems have the same problems as those without, so workforce development is the real solution.
“But those that have an instrument tracking system, they're still having the same problems that those that don't”
- Jake Tayler Jacobs
Jacobs says SPD department managers should reach the brown belt level of the SIPS development track.
“Brown Belt is the level that people should be at to manage a department”
- Edna Gilliam
Gilliam says she is rebuilding her department because SPD is the least recognized department yet deserves recognition.
“they're the department that's least recognized but deserve all the recognition”
- Jake Tayler Jacobs
Jacobs predicts that robotics and automation will drive another evolution in sterile processing.
“Robotics are coming. Automation is coming. So that means sterile processing again is going to see another evolution”
People
In the conversation
- Jake Tayler JacobsPresident and chief operating officer of SIPS Healthcare Solutions, a sterile processing consulting firm; host of Bred To Lead
- Edna GilliamAssistant vice president of perioperative services and sterile processing at a Delaware hospital system; OR nurse by background
Topics
- Sterile processing
- Healthcare workforce development
- Professional certification versus competency verification
- The Joint Commission
- Perioperative nursing
- Operational Blindness (book)
- SIPS Healthcare Solutions
- History of surgery
- Temporary staffing in healthcare
- Surgical instrument tracking systems
- Artificial intelligence
From the publisher
CERTIFIED DOES NOT MEAN VERIFIED TO DO THE JOB Recorded live in front of a room of perioperative leaders, Dr. Jake Tayler Jacobs and Dr. Edna Gilliam make the case that the next professional revolution in surgery is happening outside the OR, in sterile processing. Dr. Edna, a periop leader who learned SPD for herself, explains why she took the assessment before asking her own leaders to. IN THIS EPISODE • How surgery came into the hospital, and why OR nurses organized in 1949 while sterile processing went 45 years without a career path • What surfaced when 125 SPD leaders across 189 facilities were assessed: certifications alone were not enough • Operational blindness: why so many periop leaders see SPD as a black box, and why temporary fixes don't change permanent damage • Process, people, performance: a development track that turns technicians into verified operators KEY TAKEAWAY "If you don't give people something to progress to, they begin to cannibalize where they are." FREE GUIDES FROM SIPS Certification is not verification What is Operational Blindness? Sterile Processing Knowledge Center ━━━━━━━━━━━━ Bred To Lead is powered by SIPS Healthcare Solutions . BredToLead.com SterileByDesign.com SIPSHealthcare.com
Summary, chapters and key points were generated from the episode transcript on October 27, 2026. Quotes are checked word for word against the transcript.