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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Streamlining variability in hospital charges for standard thyroidectomy: Developing a strategy to decrease waste.

Lilah F Morris1, Minerva A Romero Arenas2, Jeffrey Cerny3

  • 1Section of Surgical Endocrinology, Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX; Northwest Medical Center, Tucson, AZ.

Surgery
|December 3, 2014
PubMed
Summary
This summary is machine-generated.

Standard thyroidectomy shows significant cost variability. A multidisciplinary strategy improved efficiency, reduced waste, and cut costs by optimizing perioperative processes for better patient care.

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Area of Science:

  • Surgical Process Improvement
  • Health Economics
  • Quality Improvement in Healthcare

Background:

  • Assessed perioperative processes for standard (total) thyroidectomy to identify inefficiencies.
  • Recognized significant variability and waste in current procedures.
  • Aimed to develop a strategy for decreasing variability and waste.

Purpose of the Study:

  • To evaluate the efficiency, consistency, and appropriateness of perioperative processes for standard thyroidectomy.
  • To devise a strategy for decreasing variability and waste in thyroidectomy procedures.
  • To quantify potential cost savings through process improvements.

Main Methods:

  • Multidisciplinary team evaluated <23-hour stay standard thyroidectomy.
  • Utilized nominal group technique, process flowcharts, and root cause analysis.
  • Calculated anticipated decreases in costs, charges, and resource utilization.

Main Results:

  • Median total charge for thyroidectomy was $27,363 with $48,727 variation.
  • Optimized coordination could decrease charges by $1,505; consistent scheduling by $585.49.
  • Reduced instrument usage and modified postoperative orders offered further savings, totaling >$200,000 annually.

Conclusions:

  • Perioperative process analysis revealed substantial variability in standard thyroidectomy.
  • Systematic assessment identified opportunities to improve efficiency and reduce waste.
  • A multidisciplinary strategy can decrease costs and enhance patient-centered care.