Dyas Adam R, Lovell Kelly M, Balentine Courtney J, Wang Thomas N, Porterfield John R, Chen Herbert, Lindeman Brenessa M
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
J Surg Res. 2018 Sep;229:15-19. doi: 10.1016/j.jss.2018.03.038. Epub 2018 Apr 16.
Operating room efficiency can be compromised because of surgical instrument processing delays. We observed that many instruments in a standardized tray were not routinely used during thyroid and parathyroid surgery at our institution. Our objective was to create a streamlined instrument tray to optimize operative efficiency and cost.
Head and neck surgical instrument trays were evaluated by operating room team leaders. Instruments were identified as either necessary or unnecessary based on use during thyroidectomies and parathyroidectomies. The operating room preparation time, tray weights, number of trays, and number of instruments were recorded for the original and new surgical trays. Cost savings were calculated using estimated reprocessing cost of $0.51 per instrument.
Three of 13 head and neck trays were converted to thyroidectomy and parathyroidectomy trays. The starting head and neck surgical set was reduced from two trays with 98 total instruments to one tray with 36 instruments. Tray weight decreased from 27 pounds to 10 pounds. Tray preparation time decreased from 8 min to 3 min. The new tray saved $31.62 ($49.98 to $18.36) per operation in reprocessing costs. Projected annual savings with hospitalwide implementation is over $28,000.00 for instrument processing alone. Unmeasured hospital savings include decreased instrument wear and replacement frequency, quicker operating room setup, and decreased decontamination costs.
Optimizing surgical trays can reduce cost, physical strain, preparation time, decontamination time, and processing times, and streamlining trays is an effective strategy for hospitals to reduce costs and increase operating room efficiency.
手术器械处理延迟可能会影响手术室效率。我们观察到，在我们机构进行甲状腺和甲状旁腺手术时，标准化托盘内的许多器械并未常规使用。我们的目标是创建一个简化的器械托盘，以优化手术效率和成本。
手术室团队负责人对头颈部手术器械托盘进行了评估。根据甲状腺切除术和甲状旁腺切除术中的使用情况，将器械分为必要或不必要两类。记录了原始手术托盘和新手术托盘的手术室准备时间、托盘重量、托盘数量和器械数量。使用每器械0.51美元的估计再处理成本计算成本节约情况。
13个头颈部托盘中有3个被转换为甲状腺切除术和甲状旁腺切除术托盘。最初的头颈部手术套装从两个托盘98件器械减少到一个托盘36件器械。托盘重量从27磅降至10磅。托盘准备时间从8分钟降至3分钟。新托盘每次手术的再处理成本节省了31.62美元（从49.98美元降至18.36美元）。仅器械处理一项，预计在全院实施后每年节省超过28,000.00美元。未衡量的医院节省包括器械磨损和更换频率降低、手术室设置更快以及去污成本降低。
优化手术托盘可降低成本、减轻身体负担、减少准备时间、去污时间和处理时间，简化托盘是医院降低成本和提高手术室效率的有效策略。
