Surgical Instrument Optimization to Reduce Instrument Processing and Operating Room Setup Time

Abstract

Objective As health care expenditures rise, novel ways to increase efficiency are sought. The operating room (OR) represents an area where there is opportunity to optimize work flow and supply use. Evidence suggests that instrument redundancy in the OR tends to be high and that direct cost savings can be achieved by “optimizing” surgical trays. The purpose of this study was to quantify the potential time savings associated with surgical tray optimization. Methods Instrument utilization was reviewed for 4 procedures: tonsillectomy, sinus surgery, septoplasty, and septorhinoplasty. Instruments used in <20% of cases were excluded. Data on tray assembly time in the central processing department and instrument setup time in the OR were prospectively collected over a 3-month period before and after tray optimization. Student’s t test (α = 0.05) was used to determine whether times were significantly different following optimization. Results Tray assembly times were found to be significantly shorter following optimization, with percentage reduction in time ranging from 58% to 66% ( P < .05). In the OR, percentage reduction in setup time ranged from 26% to 37% ( P < .05). Variability in assembly and setup times was also found to be narrower postoptimization. Discussion Tray optimization may reduce stress and adverse events and allow managers to better estimate staffing requirements. Cost-benefits could not be determined given a limited understanding of how departments choose to redistribute time savings. Implications for Practice Measurable and significant time savings can be achieved by assessing instrument utilization rates and reducing tray redundancy, leading to lower performance variability and improved efficiency.

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

“…With surgical care representing about a third of all healthcare spending [ 148 ], and with healthcare costs continuing to rise [ 149 , 150 ], healthcare enterprises are focusing on eliminating inpatient operational inefficiencies and waste to reduce unnecessary costs [ 93 ]. Thus, the OR represents an area with an opportunity to optimize work flow and supply use [ 151 ], and to maintaining an economically viable institution [ 22 ]. By applying process improvement methodologies, such as lean and six sigma, across an entire surgical suite, hospitals are attempting to improve efficiency [ 22 ].…”

Association of Operating Room Costs With Head and Neck Surgical Instrumentation Optimization

“…[8][9][10][11][12] Keeping instruments that may be necessary only in rare circumstances on every surgical tray leads to excess instrument processing and wear and tear of the instrument despite a lack of use, as well as increased tray processing and setup time. 14,15 Prior studies have reported instrument use per Oto case at 20% to 30% of surgical trays and identified that the time to process each additional instrument per tray was 17.7 seconds. 7 In the present study, we demonstrate ready access in a nearby supply room such as the OR core area in sterile peel packs or by creating smaller add-on trays for particular retractors or dissectors that are uncommonly used but occasionally required.…”

Padronização de kits de material cirúrgico para tratamentos de coluna utilizando a abordagem Lean Healthcare approach

“…Considering the importance of the Lean Healthcare approach, the advantages of using surgical kits, the need for and mandatory patient safety protocols, and the fact that Waldhausen, Avansino, Libby, & Sawin (2010), Johson, Smith, & Mastro (2012), Collar et al (2012) and Lunardini et al (2014), have performed research in the field of Lean Healthcare implementation in surgical environments, this research is justified by the need to reduce the preparation time of surgical material and costs with instrument resterilization by means of Lean Healthcare tools. It is also noted that authors such as Byrnes, Schmitt, Tommaso, & Occhino (2017), Cichos et al (2019), Crosby, Lortie, Rotenberg, & Sowerby (2019), and Marchand, Taylor, Salem, Mont, & Marchand (2020), among others, proved in practice the benefits of surgical tray optimization, such as quality assurance and patient safety. Kaizen, VFM, 5S, work standardization, physical process redesign and Kanban were the tools used in the study of Johson et al (2012), which resulted in cost and overtime reduction, improvement in financial performance and planning, among others.…”