Surgical tray optimization as a simple means to decrease perioperative costs

Farrelly, James S.; Clemons, Crystal; Witkins, Sherri; Hall, W.J.; Christison‐Lagay, Emily R.; Ozgediz, Doruk; Cowles, Robert A.; Stitelman, David H.; Caty, Michael G.

doi:10.1016/j.jss.2017.06.029

Cited by 57 publications

(43 citation statements)

References 10 publications

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“…For example, most surgeons at our institution perform laparoscopic appendectomies similarly and use the same items. Studies have shown that standardization of preference cards can lead to decreased costs across multiple procedures and specialties [20][21][22] , so perhaps cost utilization in such procedures are already maximized. Another consideration in the analysis of our data is the effect of time.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Surgical Receipt Program on the Supply Costs of Five General Surgery Procedures

Zhao

Tyree

Lin

et al. 2019

Journal of Surgical Research

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BACKGROUND-Surgical supplies occupy a large portion of healthcare expenditures but is often under the surgeon's control. We sought to assess whether an automated, surgeon-directed, cost feedback system can decrease supply expenditures for five common general surgery procedures. MATERIALS AND METHODS-An automated "surgical receipt" detailing intraoperative supply costs was generated and emailed to surgeons after each case. We compared the median cost per case for 18 months before and after implementation of the surgical receipt. We controlled for price fluctuations by applying common per-unit prices in both time periods. We also compared the incision time, case length booking accuracy, length of stay, and postoperative occurrences.

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Section: Discussionmentioning

confidence: 99%

Effects of a Surgical Receipt Program on the Supply Costs of Five General Surgery Procedures

Zhao

Tyree

Lin

et al. 2019

Journal of Surgical Research

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“…Reducing instruments and optimizing trays reduce institutional expenditure. 26,27 TKA component overhang is responsible for 27% of all cases of significant knee pain after TKA. 13,20,21 Dennis 28 reviewed the causes of painful TKA and reported that TKA component overhang causes soft tissue impingement, which may inadvertently result in distal femoral osteophytes, extruded bone cement, intra-articular fibrous bands, and irritation of the knee tendons and ligaments.…”

Section: Discussionmentioning

confidence: 99%

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating

et al. 2018

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Patient dissatisfaction after total knee arthroplasty (TKA) is a concern. Surgical error is a common, avoidable cause of failed TKA. Correct femoral and tibial component sizing improves implant longevity, clinical outcomes, knee balance, and pain scores. We hypothesized that preoperative three-dimensional (3D) templating for robot-assisted TKA (RA-TKA) is more accurate than two-dimensional (2D) digital templating. Prospectively collected data from 31 RA-TKAs were assessed to determine accuracy pertaining to implant sizing and positioning. All cases undergoing RA-TKA undergo preoperative CT-scans as per protocol. Three blinded observers retrospectively templated these knees for TKA using standard radiographs. We compared whether 2D templating was as accurate as CT-guided templating. Postoperative radiographs were then evaluated for sizing and positioning. Intraclass correlation coefficients (ICCs) and the effect of learning curve were assessed. Preoperative femoral component 3D templating and retrospective blinded 2D templating accuracies were 96.6% and 52.9%, respectively (: 17.965; odds ratio [OR]: 24.957, 3.250-191.661; < 0.001). Tibial component 3D and 2D templating accuracies were 93.1% and 28.7%, respectively ( 36.436; OR: 33.480, 7.400-151.481; < 0.001). ICC for the three radiograph observers was 0.920 (95% confidence interval [CI]: 0.652-0.890; < 0.001) for the femur and 0.833 (0.717-0.911; < 0.001) for the tibia, showing excellent agreement. We conclude that preoperative CT-based templating for RA-TKA more accurately predicts the size of implants compared with traditional 2D digital templating. This may improve operating room efficiency and cost containment.

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“…A study from Canada demonstrated that reducing redundant instruments from trays for five common otolaryngology procedures saved an estimated CAD 13,000 annually [5]. Additional cost savings can be seen by avoiding instrument purchase and replacement costs through reduced surgical trays and delaying wear and tear of instruments [6].…”

Section: Introductionmentioning

confidence: 99%

Reducing instruments in a vitrectomy surgical tray: cost savings and results from a major academic hospital

et al. 2020

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Background: Unused or rarely used instruments in standard surgical trays can unnecessarily increase costs. Prior studies have demonstrated the practicality and cost savings of reduced instrument tray sizes in various subspecialties. This study describes results and estimated cost savings from a reduced instrument tray used for vitrectomy surgery at a large, tertiary academic medical center. Methods: Common usage patterns of vitrectomy instruments by one retina surgeon were reviewed and a reduced instrument vitrectomy tray was created and implemented in successive vitrectomy surgeries. Need for opening the previously utilized larger tray was recorded. Estimated cost savings of the new trays were calculated based upon per instrument sterilization, processing, and instrument replacement costs. Results: New vitrectomy trays including just 7 instruments (89% reduction compared to original trays) were created and implemented in 189 successive cases. The original tray was never opened. Estimated cost savings from saved sterilization and processing resources is approximately $9588 per year. Assuming 5-and 10-year lifespan per instrument, annual cost avoidance is projected at $7886 and $15,772, respectively. Other indirect benefits relevant to healthcare quality were also noted. Conclusion: A reduced instrument tray can be successfully implemented for vitrectomy surgery and can result in significant indirect benefits as well as direct cost savings from reduced sterilization costs. Our study highlights the substantial impact made by evaluating the usage pattern and making appropriate instrument tray changes for just one retina surgeon. Applying these same methods to other surgeons and specialties can have significant implications on healthcare costs and quality.

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Surgical tray optimization as a simple means to decrease perioperative costs

Cited by 57 publications

References 10 publications

Effects of a Surgical Receipt Program on the Supply Costs of Five General Surgery Procedures

Effects of a Surgical Receipt Program on the Supply Costs of Five General Surgery Procedures

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating

Reducing instruments in a vitrectomy surgical tray: cost savings and results from a major academic hospital

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