Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room
Background: Over-crowded surgical trays result in perioperative inefficiency and unnecessary costs. While methodologies to reduce the size of surgical trays have been described in the literature, they each have their own drawbacks. In this study, we compared three methods: (1) clinician review (CR),...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | North American Spine Society Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666548423000100 |
| _version_ | 1797796319275778048 |
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| author | Setti Belhouari, HBSc Jay Toor, MD, MBA Aazad Abbas, HBSc Johnathan R. Lex, MB, ChB Michael R. Mercier, MD, MHS Jeremie Larouche, MD, MSc |
| author_facet | Setti Belhouari, HBSc Jay Toor, MD, MBA Aazad Abbas, HBSc Johnathan R. Lex, MB, ChB Michael R. Mercier, MD, MHS Jeremie Larouche, MD, MSc |
| author_sort | Setti Belhouari, HBSc |
| collection | DOAJ |
| description | Background: Over-crowded surgical trays result in perioperative inefficiency and unnecessary costs. While methodologies to reduce the size of surgical trays have been described in the literature, they each have their own drawbacks. In this study, we compared three methods: (1) clinician review (CR), (2) mathematical programming (MP), and (3) a novel hybrid model (HM) based on surveys and cost analysis. While CR and MP are well documented, CR can yield suboptimal reductions and MP can be laborious and technically challenging. We hypothesized our easy-to-implement HM would result in a reduction of surgical instruments in both the laminectomy tray (LT) and basic neurosurgery tray (BNT) that is comparable to CR and MP. Methods: Three approaches were tested: CR, MP, and HM. We interviewed 5 neurosurgeons and 3 orthopedic surgeons, at our institution, who performed a total of 5437 spine cases, requiring the use of the LT and BNT over a 4-year (2017–2021) period. In CR, surgeons suggested which surgical instruments should be removed. MP was performed via the mathematical analysis of 25 observations of the use of a LT and BNT tray. The HM was performed via a structured survey of the surgeons’ estimated instrument usage, followed by a cost-based inflection point analysis. Results: The CR, MP, and HM approaches resulted in a total instrument reduction of 41%, 35%, and 38%, respectively, corresponding to total cost savings per annum of $50,211.20, $46,348.80, and $44,417.60, respectively. Conclusions: While hospitals continue to examine perioperative services for potential inefficiencies, surgical inventory will be increasingly scrutinized. Despite MP being the most accurate methodology to do so, our results suggest that savings were similar across all three methods. CR and HM are significantly less laborious and thus are practical alternatives. |
| first_indexed | 2024-03-13T03:31:16Z |
| format | Article |
| id | doaj.art-53f8bd5f13bd4f75bf5e4816229b9932 |
| institution | Directory Open Access Journal |
| issn | 2666-5484 |
| language | English |
| last_indexed | 2024-03-13T03:31:16Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | North American Spine Society Journal |
| spelling | doaj.art-53f8bd5f13bd4f75bf5e4816229b99322023-06-24T05:19:17ZengElsevierNorth American Spine Society Journal2666-54842023-06-0114100208Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating roomSetti Belhouari, HBSc0Jay Toor, MD, MBA1Aazad Abbas, HBSc2Johnathan R. Lex, MB, ChB3Michael R. Mercier, MD, MHS4Jeremie Larouche, MD, MSc5Temerty Faculty of Medicine, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, Canada; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaTemerty Faculty of Medicine, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, Canada; Division of Orthopaedics, Department of Surgery, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, CanadaTemerty Faculty of Medicine, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, Canada; Division of Orthopaedics, Department of Surgery, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, CanadaTemerty Faculty of Medicine, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, Canada; Division of Orthopaedics, Department of Surgery, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, CanadaTemerty Faculty of Medicine, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, Canada; Division of Orthopaedics, Department of Surgery, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, Canada; Corresponding author. Department of Surgery, University of Toronto, 149 College Street, 5th Floor, Toronto, ON, Canada, M5T 1P5. Tel.:+1 413-426-4472.Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Division of Orthopaedics, Department of Surgery, University of Toronto, 149 College St, 5th Floor, Toronto, Ontario, CanadaBackground: Over-crowded surgical trays result in perioperative inefficiency and unnecessary costs. While methodologies to reduce the size of surgical trays have been described in the literature, they each have their own drawbacks. In this study, we compared three methods: (1) clinician review (CR), (2) mathematical programming (MP), and (3) a novel hybrid model (HM) based on surveys and cost analysis. While CR and MP are well documented, CR can yield suboptimal reductions and MP can be laborious and technically challenging. We hypothesized our easy-to-implement HM would result in a reduction of surgical instruments in both the laminectomy tray (LT) and basic neurosurgery tray (BNT) that is comparable to CR and MP. Methods: Three approaches were tested: CR, MP, and HM. We interviewed 5 neurosurgeons and 3 orthopedic surgeons, at our institution, who performed a total of 5437 spine cases, requiring the use of the LT and BNT over a 4-year (2017–2021) period. In CR, surgeons suggested which surgical instruments should be removed. MP was performed via the mathematical analysis of 25 observations of the use of a LT and BNT tray. The HM was performed via a structured survey of the surgeons’ estimated instrument usage, followed by a cost-based inflection point analysis. Results: The CR, MP, and HM approaches resulted in a total instrument reduction of 41%, 35%, and 38%, respectively, corresponding to total cost savings per annum of $50,211.20, $46,348.80, and $44,417.60, respectively. Conclusions: While hospitals continue to examine perioperative services for potential inefficiencies, surgical inventory will be increasingly scrutinized. Despite MP being the most accurate methodology to do so, our results suggest that savings were similar across all three methods. CR and HM are significantly less laborious and thus are practical alternatives.http://www.sciencedirect.com/science/article/pii/S2666548423000100Surgical instrumentsSurgical traysSpine surgeryOptimizationStandardizationCost savings |
| spellingShingle | Setti Belhouari, HBSc Jay Toor, MD, MBA Aazad Abbas, HBSc Johnathan R. Lex, MB, ChB Michael R. Mercier, MD, MHS Jeremie Larouche, MD, MSc Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room North American Spine Society Journal Surgical instruments Surgical trays Spine surgery Optimization Standardization Cost savings |
| title | Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room |
| title_full | Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room |
| title_fullStr | Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room |
| title_full_unstemmed | Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room |
| title_short | Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room |
| title_sort | optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating room |
| topic | Surgical instruments Surgical trays Spine surgery Optimization Standardization Cost savings |
| url | http://www.sciencedirect.com/science/article/pii/S2666548423000100 |
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