Operative costs, reasons for operative waste, and vendor credit replacement in spinal surgery

Abstract

Background:In 2012, Epstein et al. documented that educating spinal surgeons reduced the cost of operative waste (explanted devices: placed but removed prior to closure) occurring during anterior cervical diskectomy/fusion from 20% to 5.8%.[5] This prompted the development of a two-pronged spine surgeon-education program (2012-2014) aimed at decreasing operative costs for waste, and reducing the nine reasons for operative waste.Methods:The spine surgeon-education program involved posting the data for operative costs of waste and the nine reasons for operative waste over the neurosurgery/orthopedic scrub sinks every quarter. These data were compared for 2012 (latter 10 months), 2013 (12 months), and 2014 (first 9 months) (e.g. data were normalized). Savings from a 2013 Vendor Credit Replacement program were also calculated.Results:From 2012 to 2013 and 2014, spinal operative costs for waste were, respectively reduced by 64.7% and 61% for orthopedics, and 49.4% and 45.2% for neurosurgery. Although reduced by the program, the major reason for operative waste for all 3 years remained surgeon-related factors (e.g. 159.6, to 67, and 96, respectively). Alternatively, the eight other reasons for operative waste were reduced from 68.4 (2012) to 12 (2013) and finally to zero by 2014. Additionally, the Vendor Replacement program for 2013 netted $78,564.Conclusions:The spine surgeon-education program reduced the costs/reasons for operative waste for 2012 to lower levels by 2013 and 2014. Although the major cost/reasons for operative waste were attributed to surgeon-related factors, these declined while the other eight reasons for operative waste were reduced to zero by 2014.

Data Analysis of Plastic Surgery Instrument Trays Yields Significant Cost Savings and Efficiency Gains

“…In support of surgeon acceptance to these process improvement initiatives, high satisfaction has consistently been reported among the surgical team 4,5,22,27,28 . Surgeons have the unique purview and ability to identify opportunities to improve resource utilization in the OR, and with the ever-increasing focus on improving value in health care, surgeons have an opportunity to take the lead in those efforts 1,5,6,9,16,20,23,31,36 . Many surgeons are unaware of the costs associated with reusable surgical instrumentation and, when adequately informed, can make impactful decisions regarding instrument tray configuration while ensuring that patient quality of care and outcomes remain optimal 30,37 .…”

“…4,5,22,27,28 Surgeons have the unique purview and ability to identify opportunities to improve resource utilization in the OR, and with the ever-increasing focus on improving value in health care, surgeons have an opportunity to take the lead in those efforts. 1,5,6,9,16,20,23,31,36 Many surgeons are unaware of the costs associated with reusable surgical instrumentation and, when adequately informed, can make impactful decisions regarding instrument tray configuration while ensuring that patient quality of care and outcomes remain optimal. 30,37 An evidence-based approach, such as is supported by the technology platform described in this study, enables data-driven decisions in a resource-efficient manner to help drive those efforts by surgical leadership.…”

The Environmental Impact of Spine Surgery and the Path to Sustainability

“…Increased awareness through operating personnel education is an effective strategy to achieve this. 59 All waste is destined for landfill. Hazardous waste requires treatment beforehand.…”

“…Evidence suggests that there are large variations in waste production between surgeons proving prevention is possible. Increased awareness through operating personnel education is an effective strategy to achieve this 59…”