Bridging clinical competency and supply chain integrity: A perioperative credentialing continuum for modern surgical services

Dear Editor, The perioperative environment is a complex, high-stakes setting in which clinical practice, operational workflows, and supply chain reliability intersect. Surgical care depends not only on clinical competency but also on the integrity of the operational systems that support it. Despite this interdependence, current credentialing frameworks emphasize clinical knowledge and skills almost exclusively. As a result, the operational and supply chain functions that influence safety, efficiency, and cost stewardship remain insufficiently addressed. Credentialing in perioperative practice has historically focused on clinical readiness, including skills validation, ongoing education, and adherence to safety standards. Although these safeguards are essential, they represent only a portion of the competencies required to support the surgical care continuum. Operational and supply chain personnel remain largely outside formal credentialing structures, resulting in ambiguous expectations and variable performance. Yet many of the same principles used in clinical credentialing—standardization, validation, accountability—align naturally with the operational processes that govern preference card accuracy, product selection, and supply chain reliability. Drawing from my experience as a perioperative nurse, value analysis leader, and consulting director, these parallels demonstrate that operational integrity is inseparable from safe and efficient surgical care. To address this gap, I propose a Perioperative Credentialing Continuum consisting of foundational, operational, and collaborative competencies. Foundational competencies encompass the essential knowledge, behaviors, and communication standards required across all perioperative roles. They include documentation accuracy, situational awareness, effective communication, and a thorough understanding of surgical workflows. These elements represent core professional expectations that support team-based decision-making and reliable surgical preparation. Operational competencies include preference card management, technology utilization, data integrity, and standardization of processes. Collaborative competencies focus on interdisciplinary communication, cross-functional problem solving, and participation in shared governance. Integrating these domains reframes perioperative competency assessment to incorporate operational reliability and data-driven decision-making. Implementing this continuum requires addressing cultural barriers, clarifying role expectations, and integrating competency development into existing governance structures. Leadership engagement and transparent communication are essential to sustaining adoption. Embedding these competencies within evaluation systems supports both clinical and nonclinical team members in upholding safety, promoting efficiency, and contributing to resilient surgical services.A representative perioperative optimization initiative demonstrates the value of this approach. A multidisciplinary team applied credentialing principles to optimize preference cards, resulting in increased accuracy, reduced procedural delays, enhanced team engagement, and more consistent data-driven decisions. This experience demonstrates the practical benefits of incorporating structured competency expectations into operational processes. Expanding credentialing standards to encompass operational and supply chain roles aligns directly with the mission of the Competency & Credentialing Institute (CCI) by reinforcing interdisciplinary accountability, improving patient outcomes, and supporting lifelong professional development growth and strengthens the overall readiness of surgical services. A more comprehensive credentialing approach strengthens the readiness and sustainability of today’s surgical services. Acknowledgments The author would like to thank the perioperative and supply chain teams who contributed insights through their operational improvement efforts. Conflicts of interest statement Amanda Akers is a perioperative consultant and a member of the Competency & Credentialing Institute Certification Council. Funding source None. Author contributions The author made all contributions to this manuscript and accepts full responsibility for its content.