Hedden Kathryn, Harrer Samantha, Choi Jong Hyun, Gentile Pietro M, Shahi Alisina, Brown Matthew L
Department of Orthopaedic Surgery, Cooper University Health Care, Camden, NJ, USA.
Department of Orthopaedic Surgery, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
Arch Bone Jt Surg. 2024;12(9):660-664. doi: 10.22038/ABJS.2024.77381.3575.
Despite an increased demand for total joint arthroplasty (TJA), rising health-care costs and bundling of payments by payers have shifted the focus to improving operating room (OR) efficiency. This study aimed to assess the efficacy of an efficiency model that optimized instrument trays on decreasing OR turnover time (TOT) and the benefits made possible by this improved efficiency.
All primary TJA procedures performed by a single fellowship-trained surgeon from January 2022 to August 2023 were reviewed. The surgeon partnered with Zimmer Biomet to condense the total knee and total hip arthroplasty instrument trays from seven to three trays each. Patient in OR time and patient out of OR times were collected and used to calculate TOT. Mean TOTs pre-efficiency model implementation (January - October 2022) and post-efficiency model implementation (March - August 2023) were compared. Annual cost savings were calculated based on an average cost per one minute of OR time of $47.99 and an average cost for the Sterile Processing Department (SPD) to process a single TJA tray of $79.41.
Following implementation of the efficiency model, the average OR TOT significantly decreased by 19 minutes (P < 0.0001), a greater than 44% reduction in TOT. At this surgeon's current case volume, conservatively estimated at 280 primary TJA cases per year, annual savings in OR and SPD processing costs were $169,597 and $88,939, respectively. Moreover, this led to increased case volume per operative day.
A small-scale intervention such as optimizing instrument trays for TJA is a valuable and sustainable solution to improve efficiency in the OR by decreasing OR TOT, thereby generating considerable cost-savings and opportunity to increase surgical volume.
尽管全关节置换术（TJA）的需求不断增加，但医疗保健成本的上升以及支付方的捆绑支付已将重点转移到提高手术室（OR）效率上。本研究旨在评估优化器械托盘的效率模型在减少手术室周转时间（TOT）方面的效果以及这种提高的效率所带来的益处。
回顾了2022年1月至2023年8月由一位接受过专科培训的外科医生进行的所有初次TJA手术。该外科医生与捷迈邦美合作，将全膝关节和全髋关节置换术的器械托盘从每个七种精简为三种。收集患者进入手术室时间和离开手术室时间，并用于计算TOT。比较了效率模型实施前（2022年1月至10月）和实施后（2023年3月至8月）的平均TOT。根据手术室时间每分钟平均成本47.99美元以及无菌处理部门（SPD）处理单个TJA托盘的平均成本79.41美元计算年度成本节省情况。
效率模型实施后，平均手术室TOT显著减少了19分钟（P < 0.0001），TOT减少了超过44%。以该外科医生目前的病例数量保守估计每年280例初次TJA病例计算，手术室和SPD处理成本的年度节省分别为169,597美元和88,939美元。此外，这导致了每个手术日的病例数量增加。
诸如为TJA优化器械托盘这样的小规模干预措施是一种有价值且可持续的解决方案，可通过减少手术室TOT来提高手术室效率，从而产生可观的成本节省并增加手术量的机会。
