SSR-IPI™: A Systems-Based Framework for Surgical System Reliability and Infection Prevention Infrastructure

This manuscript introduces the Surgical System Reliability and Infection Prevention Infrastructure (SSR-IPI™), a systems-based framework designed to improve reliability, infection prevention, and operational performance in surgical and sterile processing environments. The framework defines five interdependent domains of system performance: infrastructure reliability, instrument reprocessing integrity, workforce competency architecture, digital and cyber resilience, and governance alignment. It integrates established healthcare quality and safety models, including the Donabedian framework, High Reliability Organization (HRO) principles, and Reason’s Swiss Cheese Model. SSR-IPI™ advances a systems-level approach to patient safety by addressing the structural and operational conditions that contribute to failure in sterile processing and perioperative services. Notably, it introduces digital and cyber resilience as a novel domain in sterile processing system design. This work aligns with AAMI standards, including ANSI/AAMI ST108, and contributes to the evolving body of knowledge in healthcare systems engineering, infection prevention, and global surgical safety.