R. Sorber1, D. Stobierski2, G. Dougherty2, C. Kang3, Y. Lum1,2 1The Johns Hopkins University School Of Medicine,Department Of Surgery,Baltimore, MD, USA 2Johns Hopkins University School Of Medicine,Bloomberg School Of Public Health,Baltimore, MD, USA 3The Johns Hopkins University School Of Medicine,School Of Nursing,Baltimore, MD, USA
Introduction:
Increasing concerns regarding healthcare costs have triggered interest in reducing operating room waste, but the overall level of awareness of costs among the team members making intraoperative decisions regarding supply selection remains unclear. This work characterizes the knowledge of supply costs among surgeons as well as operating room staff in a large academic hospital and seeks to examine the contribution of operating room role and years of experience with regards to cost awareness.
Methods:
This work is a cross-sectional study of surgeons, surgical trainees, operating room nurses and surgical technicians (n=372) across all surgical specialties at the Johns Hopkins Hospital. Participants completed a survey reporting frequency of use and estimated cost for the eleven commonly used surgical supplies. They were also asked to render opinions on the role of cost in surgical decisionmaking and their desire for increased access to cost information. Responses were stratified by respondent role as part of the surgical team and years of experience. All data was analyzed using Stata to perform ANOVA and Χ2 testing as well as linear regression modeling.
Results:
Cost estimates ranged widely, with most respondents overestimating supply costs of most inexpensive items by 1.3-3.2 times the actual cost and underestimating the two most expensive items (0.87-0.89 times actual cost). There was no significant difference in accuracy of cost estimation when stratified by role, years of experience, item, or frequency of item use. The vast majority of respondents (88.7%) expressed agreement that cost should factor into surgical decisionmaking as well as a desire to learn more regarding cost of common supplies.
Conclusion:
Accurate knowledge of the cost of common surgical supplies is severely limited among surgeons, surgical trainees and operating room staff with no correlation to years of experience or frequency of use. While concerning, this lack of knowledge coexists with a strong desire to augment cost awareness. Improved access to cost information across disciplines has high potential to inform surgical decisionmaking and potentially decrease operating room waste.