Impact of optimizing and creating dedicated breast surgical instrument trays using LEAN methodology

Abstract

AbstractObjectivesFor surgery to proceed smoothly and expediently, one often neglected factor is the ready availability of relevant surgical instruments. While breast surgery techniques have evolved over the years, surgical instrument trays (SITs) are rarely revised. Consequently, the type and range of surgical instruments in the standard SITs have become inappropriate for surgeons. This results in an increased number of unused instruments (instrument wastage). This study aimed to assess the impact of a dedicated breast SIT using LEAN methodology on operating theater (OT) efficiency and cost savings.MethodsA dedicated breast SIT was assembled using LEAN methodology. The utilization of the dedicated breast SIT was audited by looking at the instrument wastage, OT SIT set-up time, SIT processing time, and cost SIT cost charged to the patient. Data were analyzed using an independent T-test and paired T-test.ResultsBy using LEAN methodology, three commonly used breast SITs with 119 instruments were combined into a single breast SIT with 61 instruments. The mean instrument wastage was reduced from 57.75% to 17%. The processing cost of each SIT was reduced from $71.75 (U.S. dollars) and $41 (major surgery and minor surgery) to $12.86 (P < 0.001). The SIT processing time data time decreased from 140.5 min to 32 min (P < 0.001). Based on a mean volume of 395 breast surgeries per year, a potential cost saving of $17 040 annually may be achieved.ConclusionOptimizing SITs using LEAN methodology can reduce cost and improve efficiency in OT, leading to significant benefits to staff and patients.