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Crosswalks for Reprocessing Standards, Guidelines, and Recommended Practices

Sterile processing (SP) managers and supervisors must routinely update their departmental policies and procedures (P&P) to ensure they are following the most current evidence-based standards, guidelines, and recommended practices. Developing P&P should be an interdisciplinary process, depending on the stakeholders involved for each particular policy. For instance, creating P&P around care and handling of instruments should involve the operating room and infection prevention representatives. There are numerous published standards, guidelines, and recommended practices around reprocessing. Deciding on which ones to follow should be based on current evidence-based publications. There are many ways to help decipher how these published standards or guidelines relate to each other. Crosswalks can be very helpful when comparing these documents.

According to the Cambridge Dictionary, a crosswalk is a place on a road, especially one where there is a lot of traffic, at which vehicles must stop to allow people to walk across the road.1 The definition can cross over to compare processing standards, guidelines, and practices that relate to each other. Healthcare professionals have many such crosswalks available to them that can be useful in walking across standards and guidelines, especially when creating P&P. Here is a list of some of the ones that can be especially helpful regarding sterilization and high-level disinfection.

The Association of periOperative Registered Nurses (AORN) offers a crosswalk from their guidelines to the Association for the Advancement of Medical Instrumentation (AAMI) for instruments, high-level disinfection, packaging, processing flexible endoscopes, and sterilization. Table 1 shows an example taken from the AORN Guidelines and Tools for the Sterile Processing Team.

AAMI has a crosswalk comparing ST79:2017 Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities and related The Joint Commission (TJC) standards. This crosswalk is in AAMI’s publication titled Sterile Processing in Healthcare Facilities: Preparing for Accreditation Surveys, found in Annex A and G. Table 2 offers a sample of that crosswalk.

TJC offers crosswalks that compare their standards to the Centers for Medicare and Medicaid Services (CMS) standards. TJC to CMS crosswalks are available for hospitals, critical access hospitals, ambulatory, and office-based surgery via the online Comprehensive Accreditation and Certification manuals. Table 3 shows a glimpse of those crosswalks.

These crosswalk tools can prove to be helpful in the creation of policies and procedures. Understanding the link between TJC, CMS, AORN, and AAMI published standards, guidelines, and recommended practices can help healthcare facilites follow best practices and be prepared for an accreditation survey. 


  1. Full definition of Crosswalk. Available at https://dictionary.cambridge.org/us/dictionary/english/crosswalk. Accessed 9/19/2019
  2. Guidelines and Tools for the Sterile Processing Team. Available at https://aornguidelines.org/books/otherbooks?view=guidelinesandtools
  3. Seavey, R. Association for the Advancement of Medical Instrumentation. Sterile Processing in Healthcare Facilities: Preparing for Accreditation Surveys. 3rd edition 2017
  4. 2019 Joint Commission and CMS Crosswalk: Comparing Hospital Standards and CoPs. Available at: https://www.jcrinc.com/2019-joint-commission-and-cms-crosswalk-comparing-hospital-standards-and-cops-2019/. Accessed 9/19/2019

Rose Seavey, MBA, BS, RN, CNOR, CRCST, CSPDT, is president/CEO of Seavey Healthcare Consulting and formerly the director of the SPD at The Children’s Hospital of Denver. Rose served on the AORN board of directors and is a past president ASHCSP. She received numerous awards and was named as one of the Who’s Who in Infection Prevention by Infection Control Today. Ms. Seavey is the author of Sterile Processing In Healthcare Facilities: Preparing for Accreditation Surveys, published by AAMI. She serves on several AAMI committees helping to write national standards.

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