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Related Experiment Video

Updated: May 29, 2026

Standardization of Basket Use in Sialendoscopy: A Ten-Year Retrospective Study
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Standardization of Basket Use in Sialendoscopy: A Ten-Year Retrospective Study

Published on: June 6, 2025

Using a data-matrix-coded sponge counting system across a surgical practice: impact after 18 months.

Robert R Cima1, Anantha Kollengode, James Clark

  • 1Surgical Services, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota, USA. Cima.Robert@Mayo.edu

Joint Commission Journal on Quality and Patient Safety
|September 24, 2011
PubMed
Summary
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A data-matrix-coded sponge (DMS) system effectively prevented retained surgical items (RSIs) in a high-volume practice. This technology improved sponge counting efficiency and patient safety without disrupting workflows.

Area of Science:

  • Surgical Safety
  • Medical Device Technology
  • Patient Outcomes

Background:

  • Retained surgical items (RSIs), particularly sponges, remain a concern despite counting protocols.
  • Inaccurate sponge counts are a common source of RSIs.
  • Technological solutions are being developed to enhance counting accuracy and prevent RSIs.

Purpose of the Study:

  • To evaluate the effectiveness of a data-matrix-coded sponge (DMS) system in preventing sponge RSIs.
  • To assess the impact of DMS implementation on surgical workflow and efficiency.
  • To determine the reliability and staff acceptance of the DMS technology.

Main Methods:

  • A randomized-controlled trial and a larger validation trial were conducted to assess the DMS system's function, efficiency, and ergonomics.

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  • The DMS system was implemented institutionwide across 128 operating/procedure rooms to ensure concurrent use.
  • Data were collected over 18 months post-implementation to evaluate RSI occurrences and counting times.

    • Main Results:

    • The DMS system completely eliminated sponge RSIs during the 18-month study period (p < .001).
    • Sponge counting time per case decreased significantly, from an average of 11 to 4 seconds after initial cases.
    • Despite a slight increase in total sponge counting time per operation, overall operative time did not increase.

    Conclusions:

    • The data-matrix-coded sponge system proved to be a reliable and cost-effective technology for eliminating sponge RSIs in a high-volume surgical setting.
    • Implementation of the DMS system did not disrupt surgical workflows or prolong operative durations.
    • Staff reported acceptable satisfaction levels and a high degree of trust in the DMS system, indicating its potential to improve patient safety.