Measuring intraoperative surgical instrument use with radio-frequency identification

Abstract

Objective Surgical instrument oversupply drives cost, confusion, and workload in the operating room. With an estimated 78%–87% of instruments being unused, many health systems have recognized the need for supply refinement. By manually recording instrument use and tasking surgeons to review instrument trays, previous quality improvement initiatives have achieved an average 52% reduction in supply. While demonstrating the degree of instrument oversupply, previous methods for identifying required instruments are qualitative, expensive, lack scalability and sustainability, and are prone to human error. In this work, we aim to develop and evaluate an automated system for measuring surgical instrument use. Materials and Methods We present the first system to our knowledge that automates the collection of real-time instrument use data with radio-frequency identification (RFID). Over 15 breast surgeries, 10 carpometacarpal (CMC) arthroplasties, and 4 craniotomies, instrument use was tracked by both a trained observer manually recording instrument use and the RFID system. Results The average Cohen’s Kappa agreement between the system and the observer was 0.81 (near perfect agreement), and the system enabled a supply reduction of 50.8% in breast and orthopedic surgery. Over 10 monitored breast surgeries and 1 CMC arthroplasty with reduced trays, no eliminated instruments were requested, and both trays continue to be used as the supplied standard. Setup time in breast surgery decreased from 23 min to 17 min with the reduced supply. Conclusion The RFID system presented herein achieves a novel data stream that enables accurate instrument supply optimization.

Integridade e funcionalidade dos instrumentais cirúrgicos de um hospital público universitário: estudo prospectivo

“…Destarte, esses instrumentais devem ser testados periodicamente e com intervalos menores, considerando o desgaste pelo uso constante. Estratégias como identificação e uso de tecnologias com radiofrequência podem colaborar para rastrear os instrumentais e mensurar seu uso e reprocessamentos 17,18 . Dos instrumentais avaliados, o índice de não conformes (reprovados em pelo menos um teste de integridade e um de funcionalidade), foi de aproximadamente 50%.…”

A Day in the Life of a Surgical Instrument: The Cycle of Sterilization

“… 24 New technologies, like applying radiofrequency tags to instruments, are being developed to enhance institutional capabilities with respect to tracking instrument usage and sterilization. 25 Reducing unnecessary surgical instrument sterilization would increase the longevity of surgical instruments and decrease the costs associated with sterilization. The budget for supplies can consume over 50% of the perioperative budget at academic institutions.…”