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Reducing Waste During Midurethral Slings: A Quality Improvement Initiative
Sarah Ashmore1, C Emi Bretschneider2, Oluwateniola Brown2
1Section of Urogynecology and Reconstructive Pelvic Surgery, University of Chicago, Pritzker School of Medicine.
Urogynecology (Philadelphia, Pa.)
|May 1, 2025
Summary
Reducing surgical waste during synthetic midurethral sling (MUS) procedures through audits and custom packs significantly cut waste and costs. This quality improvement initiative offers a sustainable approach to surgical waste management.
Area of Science:
- Environmental Science
- Healthcare Management
- Surgical Innovation
Background:
- The healthcare industry contributes significantly to greenhouse gas emissions, with operating rooms being major sources of waste.
- Surgical procedures, such as synthetic midurethral sling (MUS) operations, generate substantial disposable waste.
- Optimizing resource utilization in surgery is crucial for environmental sustainability and cost reduction.
Purpose of the Study:
- To implement a quality improvement initiative aimed at decreasing surgical waste during MUS procedures.
- To identify and reduce the volume of unused disposable items and underutilized instruments in MUS surgical packs.
- To assess the impact of waste reduction strategies on both environmental impact and healthcare costs.
Main Methods:
- A waste audit was conducted during 20 isolated MUS surgical procedures to document used and unused disposable items and instruments.
- Utilization rates for all items were determined, with a focus on identifying those with less than 20% usage.
- Surgical trays and packs were updated based on utilization data, creating custom packs with items having a utilization rate greater than 20%.
Main Results:
- Initial audits revealed that 10 of 21 nondisposable instruments and 7 of 26 disposable items had utilization rates below 20%.
- The updated custom MUS surgical packs incorporated 12 of 15 added disposable items with utilization rates exceeding 20%.
- Median surgical waste weight per case decreased from 5.6 kg to 4.9 kg (P = 0.04), resulting in an average saving of $348.93 per case.
Conclusions:
- A comprehensive waste audit, coupled with surgical pack optimization and staff education, effectively reduced waste and associated costs in MUS surgery.
- This quality improvement initiative demonstrates a successful strategy for minimizing surgical waste and enhancing cost-efficiency in operating rooms.
- The findings support the adoption of tailored surgical supply management to address environmental concerns within the healthcare sector.
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