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Procedure card standardization and cost, waste, and clinical outcomes in laparoscopic cholecystectomy
Ali Alipouriani1, Sebastian Snowden-Bahr2, William C Bennett1
1Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Objectives:
Operating rooms generate substantial supply costs and waste, often driven by variability in surgeon preference (procedure) cards. Standardizing these cards may reduce waste and costs without compromising patient outcomes.
Methods:
We conducted a retrospective pre-post study, comparing the 6 months before and after implementation of standardized procedure cards. Primary outcomes included documented disposable supply cost per case and variation in listed supplies across cards.
Result:
Among 6099 cases, procedure card standardization was not associated with detected differences in measured clinical outcomes. Median documented supply cost per case per procedure card decreased from $729.23 (IQR, $588.31-$884.60) pre-implementation to $601.12 (IQR, $513.95-$749.53) post-implementation (p = 0.005). Direct waste increased from 40.6 to 46.9 items per 1000 cases, while direct waste cost decreased 23%. Indirect waste decreased from 599.3 to 436.0 items per 1000 cases, with associated cost decreasing 39%.
Conclusion:
Procedure card standardization is safe and associated with reduced supply cost, decreased waste, and improved consistency in supply use, without detected differences in measured clinical outcomes.