To save $28M each year, fix this problem in operating rooms

"Hospitals should explore methods to incentivize surgeons to plan more often," says researcher Anand Nair. (Credit: Getty Images)

New research reveals the amount of money that goes to waste in hospital operating rooms.

It also offers solutions to save hospitals—and the country—millions of dollars each year.

Unplanned supplies add five to 10 minutes to each surgery, the paper finds. Planning the necessary supplies for a surgery could save an average $1,800 per surgery—nearly $28 million annually.

“This problem is due to the fact that quality of care has always taken precedence over cost—and rightly so,” says lead author Anand Nair, professor of operations and supply chain management at Michigan State University. “However, with increasing pressure on health care organizations, they are trying to find ways to jointly increase quality and reduce costs.”

The researchers found that not only do unplanned costs affect a hospital’s bottom line, but they can also endanger patients under anesthesia with potentially harmful complications.

Plan ahead to cut surprise costs

The team spent more than 250 hours observing hospital operating rooms, taking note of processes, preparation, and performance of 92 surgeries. Ultimately, they found that the greatest issue stems from a lack of standardization for the planning processes.

“In most hospitals, every surgeon is allowed to make their own decisions in terms of equipment and supplies,” Nair says. “Surgeons are comfortable using certain supplies due to their past experiences; this increases the variance among items and the number of items that hospitals need to carry in inventory.”

Surgeons request equipment and supplies they need on what’s called a physician preference card, or PPC.

With different surgeons requesting preferred equipment for procedures, hospitals end up fulfilling multiple personalized requests, Nair explains. Additionally, without a standardized planning process, teams must address supply shortages during surgery, which can reduce quality, increase costs, and present possibilities of potential security lapses.

“If a doctor doesn’t have what they immediately need, a surgical team member must find it, which becomes an unplanned cost—and potentially a health risk if they leave the area,” Nair says. “On the other hand, if a surgeon requests something that isn’t necessary for the surgery, it’s simply a waste of money.”

Nair explains that some surgeons err on the side of caution and carry supplies in case they might be needed. While this is important given the critical nature of surgeries, a more standardized use of PPCs—along with audits of what supplies are on them—will allow hospitals to reduce redundancies.

Nair says that minor changes in processes can add up to big savings.

“Managing medical supplies is a critical aspect of the health care supply chain,” Nair says. “Mechanisms need to be put in place to provide more learning opportunities from such operational failures for long-term benefits to happen.”

Communication in operating rooms

Another complication in hospital rooms is that surgical teams change often, which makes it difficult to communicate which supplies on the PPC aren’t consistently used. Open communication among surgical teams helps anticipate needs and reduces unplanned costs in a surgery.

The researchers acknowledge that savings aren’t always immediate, but that progress happens along the way during any procedure.

“Our research should encourage hospitals to embrace systems that can better track unplanned costs and plan ahead,” Nair says. “Hospitals should explore methods to incentivize surgeons to plan more often. This may be achieved by providing visibility about unplanned costs and workarounds, offering greater control on administering supplies, and rewarding for unplanned cost reduction.”

The paper appears in the Journal of Operations Management. Additional researchers are from Rutgers University and Michigan State University.

Source: Michigan State University