Background: For all perioperative areas, the goal is to be productive, efficient, and safe, with minimal waste. The operating room (OR) atmosphere is one of unique balance, focused on patient safety while determined to decrease waste and increase venue. Inventory management of surgical supplies and sterile instruments is one approach to accomplishing these tasks (Ahmadi, Masel, Metcalf & Schuller, 2019).
Assessment: 4006 cases were performed in the OR at our ambulatory care surgical center (ASC) in 2021. The historical practice of pulling numerous individual supplies for cases was tasked to nurses (RN) and operating room assistants (ORA). The idea of stewardship towards time efficiency and supply management was suggested through the implementation of surgical packs at the facility. Utilization of surgical packs is suggested to be able to reduce setup time, maximize storage, boost productivity, and minimize waste while optimizing product utilization and clinical accuracy (Ahmadi, Masel, Metcalf & Schuller, 2019). Data was obtained to determine the amount of time staff spent pulling supplies/equipment for cases, as well as the number of individual supplies ordered.
Implementation: Surgical packs were ordered to meet the needs of cases at the facility. Preference cards were updated to reflect materials to be pulled for cases with surgical pack additions. Follow-up data was collected to determine if there were any notable cost savings through staff time, utilization, and supplies.
Evaluation/results: The amount of time it took staff to pull cases on average dropped from 20-40 minutes/case to 5-7 minutes/case, resulting in a projected savings of 1,589.5 hours of staff time in one year. For RNs to open a case, that time went from 5-10 minutes to 1.5-3 minutes, resulting in a projected 20,979 hours saved. These time savings were applied to the average hourly pay rate for our RNs and ORAs to estimate monetary savings in time of $120,898.97 projected for one year. The facilities use of paper for printing preferences cards decreased on average from 7-8 sheets to 3-4 sheets, resulting in projected savings of $103.76. These total projected savings of $121,002.73 for one year of staff time utilization, and paper was then subtracted by the cost increase, $55,726.88, of buying the surgical packs versus individual items. Through implementation of surgical packs, a projected cost savings of $65,275.84 over the first year of implementation is expected.
Implications in perioperative nursing: Stewardship of time can be as equally important and budget affecting, as savings on equipment items in healthcare. Nursing staff need to be aware of how they are spending their time at work, what tasks seem to be monopolizing their time more than others, and if there are resources or changes in equipment or supplies that could decrease that time spent. Productivity and efficiency are crucial in providing the safe, equipped, atmosphere ASCs strive for.
Reference
Ahmadi, E., Masel, D., Metcalf, A., Schuller, K. (2019). Inventory management of surgical supplies and sterile instruments in hospitals: A literature review. Health Sys (Basingstoke). 8(2): 134-151. Doi: 10.1080/20476965.2018.1496875.