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The Financial And Environmental Impacts Of Optimizing Surgical Instrument Kits In Plastic Surgery
Colby J. Hyland, MD, Simon Talbot, MD.
Mass General Brigham, Boston, MA, USA.
PURPOSE: Surgical device reprocessing can contribute to added time, financial costs, and environmental impacts of plastic surgery care. This study evaluated the financial and environmental impacts of an initiative to optimize surgical instrument kits used within an academic plastic surgery division.
METHODS: A quality improvement initiative was conducted within an academic plastic surgery division in conjunction with Aesculap, Inc. Surgical instrument kits were optimized in iterative meetings with surgeons, surgical staff, and project managers. Kits were reviewed, additional instruments added where needed, rarely used instruments removed, and kits combined to minimize the number of instruments for counting and reprocessing. Optimized kits were implemented in November 2023. Impacts were assessed at six months. Time savings (based on an 8-hour work day)
and environmental impacts were estimated from existing literature. Implied costs were determined from institutional data. CO2 equivalents were determined from the Environmental Protection Agency calculator.
RESULTS: Thirty-two initial instrument kits were consolidated to 12 final instrument kits after optimization. At six months post-implementation, there was a reduction in reprocessing of 11,627 (6%) instruments. Time savings were 2 days and 7 hours (operating room) and 6 days, 7 hours (sterile reprocessing). Cost savings were $139,718 (operating room) and $13,371 (sterile reprocessing). Reduced reprocessing corresponded to an elimination of 7,092 kg CO2 emissions, equivalent to 18,138 miles driven by an average gasoline-powered vehicle.
CONCLUSION: Optimizing surgical instrument kits improved financial and environmental impacts of plastic surgery care delivery. Academic and private plastic surgery practices should consider similar initiatives to improve healthcare value.
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