Operating room waste: disposable supply utilization in neurosurgical procedures

Corinna C. Zygourakis Department of Neurological Surgery,
Center for Healthcare Value,

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Seungwon Yoon Brown University, Providence, Rhode Island

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Victoria Valencia Center for Healthcare Value,
Division of Hospital Medicine,

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Christy Boscardin Center for Healthcare Value,
Department of Medicine, and

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Christopher Moriates Center for Healthcare Value,
Division of Hospital Medicine,

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Ralph Gonzales Center for Healthcare Value,
Department of Medicine, and
Continuous Process Improvement, University of California, San Francisco, California; and

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Michael T. Lawton Department of Neurological Surgery,

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OBJECTIVE

Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., “waste”) in neurosurgical procedures.

METHODS

Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed.

RESULTS

Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230–$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department.

CONCLUSIONS

This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.

ABBREVIATIONS

IQR = interquartile range; OR = operating room; UCSF = University of California, San Francisco.
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  • 1

    Centers for Disease Control Prevention: Health, United States, 2013 Hyattsville, MD, National Center for Health Statistics, 2014. http://www.cdc.gov/nchs/data/hus/hus13.pdf#116) [Accessed March 7, 2016]

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Cotton RT, Cohen AP: Eco-conservation and healthcare ethics: a call to action. Laryngoscope 120:48, 2010

  • 3

    McGain F, Jarosz KM, Nguyen MN, Bates S, O'Shea CJ: Auditing operating room recycling: a management case report. A A Case Rep 5:4750, 2015

  • 4

    Penn E, Yasso SF, Wei JL: Reducing disposable equipment waste for tonsillectomy and adenotonsillectomy cases. Otolaryngol Head Neck Surg 147:615618, 2012

  • 5

    Rosenblatt WH, Ariyan C, Gutter V, Silverman DG: Case-by-case assessment of recoverable materials for overseas donation from 1318 surgical procedures. JAMA 269:26472649, 1993

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Southorn T, Norrish AR, Gardner K, Baxandall R: Reducing the carbon footprint of the operating theatre: a multicentre quality improvement report. J Perioper Pract 23:144146, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Stall NM, Kagoma YM, Bondy JN, Naudie D: Surgical waste audit of 5 total knee arthroplasties. Can J Surg 56:97102, 2013

  • 8

    Wan EL, Xie L, Barrett M, Baltodano PA, Rivadeneira AF, Noboa J, et al.: Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications. World J Surg 39:2935, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Wormer BA, Augenstein VA, Carpenter CL, Burton PV, Yokeley WT, Prabhu AS, et al.: The green operating room: simple changes to reduce cost and our carbon footprint. Am Surg 79:666671, 2013

    • PubMed
    • Search Google Scholar
    • Export Citation

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