E. B. Malone1, J. R. Baldwin2, J. Richman1, R. B. Lancaster1, H. Krontiras1, C. C. Parker1 1University Of Alabama At Birmingham,Department Of Surgery,Birmingham, AL, USA 2UAB Medicine,Perioperative Services,Birmingham, AL, USA
Introduction:
Historically, at a single institution, a 98-instrument head and neck biopsy tray has been used for all breast lumpectomy cases. Observations revealed that many of the instruments included in the head and neck tray were not utilized during these breast cases. Right-sizing instrument trays reduces processing and replacement costs as well as physical strain and turnover times. With the significant number of surgical breast lumpectomies performed annually, a simple tray downsizing could significantly reduce costs and physical strain.
Methods:
Surgical technicians identified instruments needed for a standard breast lumpectomy procedure. Breast surgeons reviewed the list of instruments and made final recommendations. Three of thirteen existing head and neck trays were converted to specific breast lumpectomy trays. The number of breast lumpectomies documented in 2016 was pulled from the institution’s health information system. Instrument quantities were gathered using the institution’s instrument management software. Tray weights were taken on a central sterile scale and instrument processing cost was estimated by a healthcare consultant.
Results:
The new breast lumpectomy trays included 50 instruments compared to the historically-used 98-instrument trays. The reprocessing costs for the instruments decreased from $49.98 to $25.50 resulting in a cost-savings of $24.48 per tray use. With 404 breast lumpectomies performed at the institution in 2016, the annual reprocessing savings totaled $9,890. The weight of the new breast lumpectomy tray was reduced from 27 to 16 pounds. The setup time decreased by 3 minutes, with the head and neck tray requiring 7 minutes for setup and the breast lumpectomy tray requiring 4 minutes.
Conclusion:
Downsizing from a head and neck tray to a specific breast lumpectomy tray demonstrated a reduction in reprocessing cost, tray weight, and set-up time. Fewer instruments resulting in lighter trays allow for safer handling and transport by surgical personnel. In the current healthcare environment, it is important to maximize operating room efficiency and minimize cost. The downsizing of instrument trays accomplishes these goals in a simple way.