Limits...
Reducing otolaryngology surgical inefficiency via assessment of tray redundancy.

Chin CJ, Sowerby LJ, John-Baptiste A, Rotenberg BW - J Otolaryngol Head Neck Surg (2014)

Bottom Line: As a result of this relentless increase in healthcare spending, ways to increase efficiency and decrease cost are constantly being sought.Our optimized trays, on average, reduced tray size by 57%.By selectively reducing our trays, we plan to reduce tray content by an average of 57%.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology- Head & Neck Surgery, Western University, 268 Grosvenor Street, London, ON N6A 4V2 Canada.

ABSTRACT

Background: Health care costs in Canada continue to rise. As a result of this relentless increase in healthcare spending, ways to increase efficiency and decrease cost are constantly being sought. Surgical treatment is the mainstay of therapy for many conditions in the field of Otolaryngology- Head and Neck Surgery. The evidence suggests that room exists to optimize tray efficiency as a novel means of improving operating room throughput.

Methods: We conducted a review of instruments on surgical trays for 5 commonly performed procedures between July 5th, 2013 and September 20th, 2013 at St Joseph's Hospital. The Instrument Utilization Rate was calculated; we then designed new 'optimized' trays based on which instruments were used at least 20% of the time. We obtained tray building times from Central Processing Department, then calculated an overall mean time per instrument (to pack the freshly washed instruments). We then determined the time that could be saved by using our new optimized trays.

Results: In total, 226 instrument trays were observed (Table 1). The average Instrument Utilization Rate was 27.8% (+/- 13.1). Our optimized trays, on average, reduced tray size by 57%. The average time to pack one instrument was 17.7 seconds.

Conclusions: By selectively reducing our trays, we plan to reduce tray content by an average of 57%. It is important to remember that this number looks at only 5 procedures in the Department of Otolaryngology- Head and Neck Surgery. If this was expanded city-wide to the rest of the departments, the improved efficiency could potentially be quite substantial.

No MeSH data available.


Related in: MedlinePlus

The sterilization process. The time for separation and re-packaging of instruments is the most variable.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4263198&req=5

Fig1: The sterilization process. The time for separation and re-packaging of instruments is the most variable.

Mentions: Many parts of the sterilization process are fixed times, regardless of the number of instruments to be processed. The most variable part, which is when the instrument trays are rebuilt, was the focus of this study. The time to build a tray is recorded to allocate the proportion of the CPD cost to each surgical department. It is this part of the cleaning process that is most time-consuming, most variable and most sensitive to the number of instruments on the instrument tray. At London Health Sciences Centre (LHSC) and St. Joseph’s Healthcare (SJHC) in London Ontario, instruments arrive in CPD and are first quickly rinsed and opened, to allow a more thorough cleaning and removal of gross debris. This stage is known as decontamination and the time is, in most cases, negligible. The trays are then placed into a large washer for a fixed amount of time, regardless of how many instruments are present. Next, the instruments are removed and the trays are rebuilt. If multiple trays are used together for a procedure these instruments are separated and re-packaged into their distinct trays. Lastly, the trays are placed in a sterilizer for a fixed amount of time, and then wrapped and stocked in their appropriate locations. The standard CPD flow is shown in Figure 1.Figure 1


Reducing otolaryngology surgical inefficiency via assessment of tray redundancy.

Chin CJ, Sowerby LJ, John-Baptiste A, Rotenberg BW - J Otolaryngol Head Neck Surg (2014)

The sterilization process. The time for separation and re-packaging of instruments is the most variable.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4263198&req=5

Fig1: The sterilization process. The time for separation and re-packaging of instruments is the most variable.
Mentions: Many parts of the sterilization process are fixed times, regardless of the number of instruments to be processed. The most variable part, which is when the instrument trays are rebuilt, was the focus of this study. The time to build a tray is recorded to allocate the proportion of the CPD cost to each surgical department. It is this part of the cleaning process that is most time-consuming, most variable and most sensitive to the number of instruments on the instrument tray. At London Health Sciences Centre (LHSC) and St. Joseph’s Healthcare (SJHC) in London Ontario, instruments arrive in CPD and are first quickly rinsed and opened, to allow a more thorough cleaning and removal of gross debris. This stage is known as decontamination and the time is, in most cases, negligible. The trays are then placed into a large washer for a fixed amount of time, regardless of how many instruments are present. Next, the instruments are removed and the trays are rebuilt. If multiple trays are used together for a procedure these instruments are separated and re-packaged into their distinct trays. Lastly, the trays are placed in a sterilizer for a fixed amount of time, and then wrapped and stocked in their appropriate locations. The standard CPD flow is shown in Figure 1.Figure 1

Bottom Line: As a result of this relentless increase in healthcare spending, ways to increase efficiency and decrease cost are constantly being sought.Our optimized trays, on average, reduced tray size by 57%.By selectively reducing our trays, we plan to reduce tray content by an average of 57%.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology- Head & Neck Surgery, Western University, 268 Grosvenor Street, London, ON N6A 4V2 Canada.

ABSTRACT

Background: Health care costs in Canada continue to rise. As a result of this relentless increase in healthcare spending, ways to increase efficiency and decrease cost are constantly being sought. Surgical treatment is the mainstay of therapy for many conditions in the field of Otolaryngology- Head and Neck Surgery. The evidence suggests that room exists to optimize tray efficiency as a novel means of improving operating room throughput.

Methods: We conducted a review of instruments on surgical trays for 5 commonly performed procedures between July 5th, 2013 and September 20th, 2013 at St Joseph's Hospital. The Instrument Utilization Rate was calculated; we then designed new 'optimized' trays based on which instruments were used at least 20% of the time. We obtained tray building times from Central Processing Department, then calculated an overall mean time per instrument (to pack the freshly washed instruments). We then determined the time that could be saved by using our new optimized trays.

Results: In total, 226 instrument trays were observed (Table 1). The average Instrument Utilization Rate was 27.8% (+/- 13.1). Our optimized trays, on average, reduced tray size by 57%. The average time to pack one instrument was 17.7 seconds.

Conclusions: By selectively reducing our trays, we plan to reduce tray content by an average of 57%. It is important to remember that this number looks at only 5 procedures in the Department of Otolaryngology- Head and Neck Surgery. If this was expanded city-wide to the rest of the departments, the improved efficiency could potentially be quite substantial.

No MeSH data available.


Related in: MedlinePlus