Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.
Department of Pediatric Emergency Medicine, Western University, London, ON, Canada.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241267719. doi: 10.1177/19160216241267719.
In the emergency department (ED), there are pre-assembled tonsillar hemorrhage trays for management of post-tonsillectomy hemorrhage and peritonsillar abscess. After use, the tray is sent to the medical device reprocessing (MDR) department for decontamination, sterilization, and re-organization, all at a significant cost to the hospital and environment.
The goal of this project was to reduce unnecessary instruments on the tonsil hemorrhage tray by 30% by 1 year and report on the associated cost and carbon dioxide (CO) emissions savings.
This quality improvement project was framed according to the Institute for Healthcare Improvement's Model for Improvement. ED and Otolaryngology-Head & Neck Surgery staff and residents were surveyed to determine which instruments on the tonsil hemorrhage trays were used regularly. Based on results, a new tray was developed and compared to the old tray using MDR data and existing CO emissions calculations.
Tray optimization resulted in a total cost reduction from $1092.63 to $330.21 per tray per year, decreased processing time from 12 to 6-8 minutes per tray, and decreased CO emissions from 6.11 to 2.85 kg per year for the old versus new tray, respectively. Overall, the new tray contains half the number of instruments, takes half the time to assemble, produces 50% less CO emissions, and will save the hospital approximately $100,000 over 10 years.
Healthcare costs and environmental sustainability are collective responsibilities. Surgical and procedure tray optimization is a simple, effective, and scalable form of eco-action.
在急诊科（ED），有预先组装好的扁桃体出血托盘，用于处理扁桃体切除术后出血和扁桃体周围脓肿。使用后，托盘会送到医疗器械再处理（MDR）部门进行去污、消毒和重新整理，这会给医院和环境带来巨大的成本。
该项目的目标是在 1 年内将扁桃体出血托盘上的不必要器械减少 30%，并报告相关的成本和二氧化碳（CO）排放节约。
本质量改进项目是根据医疗改进研究所的改进模型制定的。ED 和耳鼻喉科-头颈外科的工作人员和住院医师接受了调查，以确定扁桃体出血托盘上哪些器械经常使用。根据调查结果，开发了一个新的托盘，并使用 MDR 数据和现有的 CO 排放计算方法对旧托盘进行了比较。
托盘优化使每个托盘的总成本从每年 1092.63 美元降至 330.21 美元，处理时间从每个托盘 12 分钟缩短至 6-8 分钟，CO 排放量从旧托盘的每年 6.11 公斤降至新托盘的每年 2.85 公斤。总的来说，新托盘的器械数量减少了一半，组装时间缩短了一半，CO 排放量减少了 50%，医院在 10 年内将节省约 10 万美元。
医疗保健成本和环境可持续性是共同的责任。手术和程序托盘优化是一种简单、有效和可扩展的生态行动形式。
