After a comprehensive review of in-house costs versus off-site sterilization costs, and considering financial and physical constraints, the decision was made to use the contracted service. Through the incorporation of the innovative concept of off-site sterilization. Flushing Hospital Medical Center was still able to provide a high standard of quality care as well as realize a significant cost savings. As hospitals face increasing demands to control costs, they may be forced to explore "uncharted waters" and give serious consideration to the use of outside services for a more efficient and effective CSS department.