Traveler Utilization in U.S. Sterile Processing Departments: A Seven-State Comparative Analysis.

This preprint reports a cross-sectional comparative analysis of temporary staffing (traveler) utilization across 119 healthcare facilities in seven U.S. states: Indiana, Alabama, Florida, Illinois, Michigan, Tennessee, and Texas. The study examines state-level variations in traveler-to-FTE ratios, correlations between FTE counts and traveler utilization, analysis of variance across states, and cost implications of temporary staffing among facilities using travelers. Data were collected through a standardized survey distributed uniformly to all participating facilities (response rate 79.3 percent, 119 of 150 distributed surveys), supplemented by structured interviews with facility administrators and sterile processing department managers. Statistical analyses included Pearson correlation, Spearman rank correlation, ANOVA with Tukey post-hoc testing, chi-square tests, and simple linear regression. The research was determined to be exempt from Institutional Review Board review under 45 CFR 46.104(d)(2) as minimal-risk workforce survey research. Key findings include significant state-level variation in traveler utilization, ranging from 0 to 7.9 percent, a moderately positive correlation between FTE counts and traveler utilization (r equals 0.68, p less than 0.01) that strengthens in larger facilities, and cost increases of 26 to 75 percent over permanent staffing reported by 67.8 percent of facilities using travelers. The paper contributes empirical evidence to healthcare workforce literature on sterile processing staffing strategies and supports customized, data-driven workforce planning. The companion dataset is publicly available on Zenodo: doi:10.5281/zenodo.19652834.