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减少床边浪费:一项由住院医师主导的减少诊断性腹腔穿刺术浪费和成本的项目。

Reducing Waste at the Bedside: A Resident-Led Project to Decrease Waste and Cost From Diagnostic Paracentesis.

作者信息

Gottesman Sara, Mensah Barbara, Jagannathan Priyanka, Hyman Charles, Agrawal Deepak

机构信息

is a PGY-4 Chief Resident, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.

is a PGY-3 Resident, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA.

出版信息

J Grad Med Educ. 2024 Dec;16(6 Suppl):145-148. doi: 10.4300/JGME-D-24-00034.1. Epub 2024 Dec 13.

Abstract

Physicians have a responsibility to reduce the environmental harms from health care waste. Residents contribute to waste during bedside procedures. To calculate waste and estimated cost reduction with the introduction of a novel resident-designed paracentesis kit at a single academic center in Texas in 2023. We calculated waste through observation of bedside diagnostic paracentesis performed by internal medical residents, tracking which components were discarded without use from the hospital-provided kit. Residents designed a novel kit containing only procedural essentials. We calculated possible waste reduction when using the novel kit, as well as potential cost savings by comparing the average cost of the current hospital kit across multiple medical equipment retailers to the summed cost of the components of the novel kit. Sixteen items were discarded without use from the commercially available kit, out of 29 total items. The estimated cost saving per diagnostic paracentesis was $95. This resident-led development of a diagnostic paracentesis kit was successful in decreasing both waste and cost, while involving residents in improving the environmental impact of their practices.

摘要

医生有责任减少医疗保健废弃物对环境的危害。住院医师在床边操作过程中会产生废弃物。为了计算2023年在德克萨斯州的一个学术中心引入一种由住院医师设计的新型腹腔穿刺套件后的废弃物量和估计的成本降低情况。我们通过观察内科住院医师进行的床边诊断性腹腔穿刺来计算废弃物量,追踪医院提供的套件中哪些组件未被使用就被丢弃。住院医师设计了一种仅包含操作必需物品的新型套件。我们通过比较在多家医疗设备零售商处当前医院套件的平均成本与新型套件组件的总成本,计算了使用新型套件时可能的废弃物减少量以及潜在的成本节约。在总共29件物品中,有16件未被使用就从市售套件中被丢弃。每次诊断性腹腔穿刺估计节省成本95美元。这种由住院医师主导开发的诊断性腹腔穿刺套件在减少废弃物和成本方面取得了成功,同时让住院医师参与到改善其操作对环境的影响中来。

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