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Surgical tray reduction for cost saving in pediatric surgical cases: A qualitative systematic review
Charlene Dekonenko1, Tolulope A Oyetunji1, Rebecca M Rentea1
1Children's Mercy Hospital- Kansas City, Kansas City, MO 64108, USA.
Insights
Standardizing pediatric surgical instrument trays and doctor preference cards (DPC) significantly cuts costs. This approach reduces instruments by up to 70% without compromising patient safety or operating room efficiency.
Area of Science:
- Pediatric Surgery
- Health Economics
- Surgical Operations Management
Background:
- Standardizing surgical instrument trays and doctor preference cards (DPC) is proven to reduce costs in adult surgical cases.
- Implementation in pediatric surgery is complex due to varied patient ages, potentially limiting cost savings.
- This review highlights the importance of examining standardization in pediatric surgical settings.
Purpose of the Study:
- To systematically review the impact of standardizing surgical instrument trays and doctor preference cards (DPC) in pediatric surgery.
- To evaluate the cost-effectiveness of such standardization initiatives.
- To assess the effect on operating room efficiency and patient safety.
Main Methods:
- A systematic review of articles published between 2000 and 2018 was conducted.
- Databases searched included MEDLINE (PubMed), Embase, Cinahl, Cochrane, and Scopus.
- Articles were screened using predefined inclusion and exclusion criteria.
Main Results:
- Five articles met the inclusion criteria for the review.
- Standardization and discontinuation of disposable instruments led to a 40%-70% reduction in surgical instruments per set.
- This resulted in an average cost saving of 20% (approximately US $200) per case, with no reported intraoperative complications or safety concerns.
Conclusions:
- Standardization of operating room (OR) doctor preference cards (DPC) and surgical instrument trays in pediatric surgery effectively lowers supply costs.
- These standardization efforts do not negatively impact operating room time or patient safety.
- The findings support the adoption of standardized practices in pediatric surgical settings to achieve financial efficiencies.
Background:
Standardization of surgical instrument trays and doctor preference cards (DPC) are known to reduce the cost of adult surgical cases. The practice in pediatric surgery may be more complex owing to a wide range of patient age, leading to difficulty with practice implementation and loss of potential financial savings, which underscore the importance of the review of this topic.
Methods:
A systematic review of pediatric surgical tray standardization and cost-effectiveness was performed. Original and review articles from 2000 to 2018 were extracted from MEDLINE (via PubMed), Embase, Cinahl, Cochrane, and an electronic search through Scopus. After screening by inclusion and exclusion criteria, articles were selected and reviewed.
Results:
Five articles were included. On average, discontinuation of disposable instruments and standardization of equipment resulted in a removal of 40%-70% of surgical instruments per set. This yielded a cost savings of 20% (an average US $200), with no intraoperative complications or perceived safety issues.
Conclusions:
Standardization of operating room (OR) doctor preference cards (DPC) and surgical instrument trays in pediatric surgical cases result in lower operative supply costs without impacting OR time or safety.
Level Of Evidence:
Level 3.
