Cost Savings Research Articles

Exploring the open-source impact on Bangladesh academic library service sustainability

Purpose This study investigates the impact of open-source software (OSS) on the sustainability of academic library services in Bangladesh. It aims to understand how OSS can address budget constraints, technological demands and the need for enhanced service delivery in these libraries. Design/methodology/approach An in-depth qualitative research approach was used, involving semi-structured interviews with library administrators, IT staff and librarians from various academic institutions across Bangladesh. Findings The study reveals that OSS adoption is primarily driven by financial imperatives and the need for flexible, customizable solutions tailored to specific institutional needs. Key benefits identified include significant cost savings, improved customization and flexibility of services and enhanced community support and collaboration. However, challenges such as a lack of in-house technical expertise, resistance to change among staff and stakeholders and inadequate IT infrastructure impede successful OSS implementation. Practical implications To harness the full potential of OSS, academic libraries must invest in capacity building through targeted training programs, improve IT infrastructure and foster a culture of collaboration and knowledge-sharing within the library community. These strategies are essential to overcoming existing barriers and ensuring long-term sustainability. Originality/value This research contributes to the understanding of OSS’s role in enhancing the sustainability of academic library services. It provides practical recommendations for academic libraries seeking to leverage OSS for improved service delivery and operational efficiency.

The bright side of supplier concentration: Investor attitudes towards the reopening policy in China

Supplier concentration (SUC) has disadvantage of vulnerability along with cost savings and efficiency. While current scholarship focus on the vulnerability of firms with centralized suppliers during the COVID-19 epidemic, there is no empirical study that explores the impact of post-disaster SUC on firm value as countries removing regional isolation policy. I focus on the impact of COVID-19 reopening policy on investor attitudes towards SUC after the resolution of a supply chain disruption crisis. I try to examine whether investors still perceive SUC as a risk signal or as a positive signal for rapid recovery. Using the event shock of China’s reopening announcement and data on A-share listed companies, I find that SUC has a positive impact on cumulative abnormal returns at reopening. I also find that positive effect of SUC is more prominent for firms that benefit from a larger reduction in transaction costs due to the reopening policy. I also analyze the moderating effect and find that information intermediaries such as analysts and media attention amplify the positive effects of SUC. My research provides new perspective on achieving post-disaster value enhancement through SUC.

An Analysis of Potential for Reducing Operational Costs Through The Use of LED Lighting in Indonesian Hotel

Indonesia has significant tourism potential, which drives the growth of the hospitality industry and increasing energy needs. Large energy consumption in hotels, especially in lighting systems, leads to high operational costs and carbon emissions. This study aims to analyze the potential for reducing operational costs through the use of LED lighting at the Bumi Sawunggaling Hotel, Bandung. The methods used include field observation and energy consumption measurement using a Power Quality Analyzer (PQA) for one week, with data taken every 30 minutes. The results of the study show that the hotel's electrical energy consumption reaches 923.45 kWh per week at a cost of IDR 1,334,166. By replacing conventional lighting with LED, hotels can reduce energy consumption by up to 80%, which translates to operational cost savings of 30% or more. The conclusion of this study emphasizes that the application of LED technology not only provides financial benefits but also supports environmental sustainability. The implication of this study is the importance of adopting energy-saving technologies such as LEDs in the hospitality sector as a strategic step to reduce costs and carbon emissions and improve the hotel's reputation as an eco-friendly business, besides that it is very important for Hotel Bumi Sawunggaling to replace its conventional lighting with LED lights to achieve higher energy efficiency. LED lights are known for their superior energy efficiency compared to traditional incandescent lamps or CFL (Compact Fluorescent Lamp) lamps.

Projected Cost Savings With Optimal Medication Adherence in Patients With Cardiovascular Disease Requiring Lipid-Lowering Therapy: A Multinational Economic Evaluation Study.

Poor adherence to chronic cardiovascular treatments can impede targeted clinical outcomes. This study estimates the potential benefits of improving adherence among patients with cardiovascular disease requiring secondary prevention in Mexico, Thailand, and China. We performed Markov model simulation for patients with cardiovascular disease in 3 countries from health care and societal perspectives over a lifetime horizon. Two scenarios were compared: (1) optimal adherence based on a meta-analysis of 51 randomized controlled trials and (2) status quo. The association between adherence and cardiovascular disease outcomes derives from a dose-response meta-analysis of 4 051 338 patients. Outcomes include the accumulated number of cardiovascular events and associated costs in 2022 US dollars, life years, and quality-adjusted life years. Optimal adherence could prevent 42 (95% credible interval [CrI], 29-56) cardiovascular events in Mexico, 34 (95% CrI, 24-50) in Thailand, and 63 (95% CrI, 43-89) in China per 1000 patients over a lifetime. Incremental effectiveness per patient was 0.60 (95% CrI, 0.47-0.74) life-years in Mexico, 0.68 (95% CrI, 0.37-0.94) quality-adjusted life years in Thailand, and 0.93 (95% CrI, 0.44-1.27) quality-adjusted life years in China. Cost savings from societal perspective amounted to $412 (95% CrI, $211-$723), $316 (95% CrI, $187-$541), and $700 (95% CrI, $355-$1144) per patient for Mexico, Thailand, and China, respectively. Findings remained cost saving in deterministic and probabilistic sensitivity analyses. Achieving optimal adherence in patients with cardiovascular disease requiring lipid-lowering therapy saves costs and improves health outcomes in Mexico, Thailand, and China. These findings support national health care systems implementing strategies to improve adherence in these countries.

Economic Analysis of Catheter-Directed Thrombolysis for Intermediate-Risk Pulmonary Embolism.

Pulmonary embolism is associated with a significant burden of morbidity, mortality, and health care costs. Catheter-directed thrombolysis has emerged as a promising option for patients with intermediate-risk pulmonary embolism which aims to improve outcomes over standard anticoagulation. We constructed a decision-analytic model comparing the cost-effectiveness of catheter-directed thrombolysis to anticoagulation alone for the management of intermediate-risk pulmonary embolism. Cost-effectiveness was determined by calculating deaths averted and incremental cost-effectiveness ratios (ICER). Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. The main outcome was ICER (US dollars/deaths averted). In the base case analysis, derived using systemic lysis data, the cost associated with catheter-directed thrombolysis was estimated at $22,353 with a probability of survival at 1 month of 0.984. For the anticoagulation alone strategy, the cost was $25,060, and the probability of survival at 1 month was 0.958. Overall, catheter-directed thrombolysis resulted in savings of $104,089 per death averted (ICER,-$104,089 per death averted). Sensitivity analysis revealed that catheter-directed thrombolysis would no longer be cost-effective when its associated mortality is greater than 0.042. In the probabilistic analysis, at a willingness-to-pay of $100,000, catheter-directed thrombolysis had a 63% chance of being cost-effective, and in cost-effectiveness acceptability curves, it was cost-effective in 63%-78% of simulations for a willingness to pay ranging from $0 to $100,000. If the assumptions made in our model are shown to be accurate then CDT would be cost-effective and may lead to considerable cost savings if used where clinically appropriate.

The digitalization of emergency department triage: the perspectives of health professionals and patients.

Digitalization in the healthcare sector offers several organizational advantages, ranging from enhanced service quality to cost savings. However, its adoption often progresses slowly and faces challenges, especially in critical settings like emergency departments, requiring prompt, clear, and efficient communication. As such, this study aims to comprehensively assess the factors influencing the preference for digitalized tools over traditional methods from the perspectives of both service providers and users. We employ two ad hoc stated preference surveys in which we ask respondents to reveal their preference in simulated triage scenarios. Three main alternatives are proposed: traditional procedures, a fully digitalized solution with no direct patient-professional interaction, and a hybrid option that combines traditional and digital aspects. Scenarios and alternatives vary according to predetermined attributes, selected among the features acknowledged to impact the triage efficiency and efficacy: the possibility to communicate in a known language, the completeness of information retrieved from the patient, the time dedicated to triage activity, and the level of privacy. Responses are analyzed by means of discrete choice models. Our findings reveal a preference for the hybrid approach, wherein patients use digital tools to input relevant information, followed by an interview with healthcare professionals. Nevertheless, distinct alternative- and case-specific features can favor the preference toward other kinds of triage. Respondents prefer shorter triage times and the opportunity to interact in a known language, while the level of privacy does not significantly impact their choices. Interestingly, the presence of an algorithm assigning urgency code diminishes the probability that healthcare professionals select the fully digitalized option. This study provides important insight into the utilization of digital tools in emergency departments. The results can be used by hospital managers and policy makers to develop digital tools that meet the needs of both users and healthcare professionals. This, in turn, may result in cost savings and improved quality of service.

Building Information Modeling Adoption in the Palestinian Construction Industry: Influencing Factors, External Determinants, and Technology Acceptance

ABSTRACT Building Information Modeling (BIM) is a worldwide spreading technology for the Architecture, Engineering, and Construction (AEC) industry that allows for continuous modification and improvement of building models, resulting in improved quality and cost savings in the project. The study aims to investigate the adoption pattern of BIM in the Palestinian market and identify significant factors that influence the adoption process, including top management support, organizational culture, and the number of experts and technicians. A structured questionnaire was developed, distributed electronically, and 168 valid responses were received, leading to a margin error of 4.4% and a response rate of 67.2%. A model, based on the Technology Acceptance Model (TAM) was developed and partial least squares structural equation modeling (PLS-SEM) was utilized to evaluate the measurement model’s reliability and validity, test hypotheses regarding the relationships between constructs, and assess the impact of various factors on the intention to adopt BIM within the construction industry. Six external influences on acceptance are highlighted. Individual and organizational acceptance drivers are identified, including top management support, ease of use, and competitive landscape. Government policies impact adoption and results stress internal and external considerations for BIM adoption.

Comparative Analysis of Market Clearing Mechanisms for Peer-to-Peer Energy Market Based on Double Auction

This paper aims to develop an optimisation-based price bid generation mechanism for the sellers and buyers in a double-auction-aided peer-to-peer (P2P) energy trading market. With consumers being prosumers through the continuous adoption of distributed energy resources, P2P energy trading models offer a paradigm shift in energy market operation. Thus, it is essential to develop market models and mechanisms that can maximise the incentives for participation in the P2P energy market. In this sense, the proposed approach focuses on maximising profit at the sellers, as well as maximising cost savings at the buyers. The bids generated from the proposed approach are integrated with three different market clearing mechanisms, and the corresponding market clearing prices are compared. A numerical analysis is performed on a real-life dataset from Ausgrid to demonstrate the bids generated from sellers/buyers, as well as the associated market clearing prices throughout different months of the year. It can be observed that the market clearing prices are lower when the solar generation is higher. The statistical analysis demonstrates that all three market clearing mechanisms can achieve a consistent market clearing price within a range of 5 cents/kWh for 50% of the time when trading takes place.

A Systematic Review of the Costs of Drug-Associated Acute Kidney Injury and Potential Cost Savings with Nephrotoxin Stewardship Prevention Strategies.

There is a scarcity of information related to the financial impact of acute kidney injury (AKI), and even more so the economics of drug-associated AKI (D-AKI). Our goal was to provide a comprehensive summary of the economic burden of D-AKI by evaluating the costs of D-AKI compared to not developing AKI and cost savings associated with nephrotoxin stewardship approaches. Following the PRISMA guidelines, a literature search was conducted using PubMed to identify articles from database inception through November 2023. The main outcomes included AKI incidence, resource use, and cost of nephrotoxin stewardship programs/D-AKI event or no event. Key findings were summarized based on whether the study compared the cost of D-AKI vs. no AKI or identified potential cost savings associated with a nephrotoxin stewardship method to prevent D-AKI or worsening D-AKI. All costs were adjusted to USD2023. Twenty-five studies met the inclusion criteria. Eight studies compared the cost of D-AKI to no AKI. Total admission costs of patients who developed D-AKI ranged from $47,696 to $173,569. Nineteen studies implemented nephrotoxin stewardship with 12 substituting a less nephrotoxic drug; five using therapeutic drug monitoring and two altering drug dosing to limit exposure. Overall, these prevention strategies ranged from $5,171 to $364,973 in total medical cost savings and $17 to $942 in total cost savings per patient-day. The in-hospital economic impact of D-AKI is substantial. Implementing nephrotoxin stewardship strategies to reduce D-AKI is associated with cost savings. Institutions should adopt strategic and efficient nephrotoxin stewardship programs to optimize patient care and reduce costs.

Thermal Oxidation Degradation Characteristics and Kinetic Analysis of Waste Shell Powders for Efficient Utilization and Environmental Protection

ABSTRACT The thermal oxidation degradation and kinetic behavior of four waste shell powders: Hyriopsis cumingii, abalone, scallop, and clam were investigated. The thermal oxidation degradation process was elucidated using thermogravimetric analysis, X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and the Coats-Redfern method. This process typically occurs in four stages, with the decomposition of CaCO₃ (Stage III) being pivotal. Notably, clam and scallop powders exhibited the highest CaO yields of approximately 55.1% and 55.0%, respectively. Although abalone powder had a lower yield of 50.2%, it demonstrated the lowest activation energy of 118.08 kJ/mol in Stage III, suggesting potential energy and cost savings during CaO conversion. High-temperature calcination altered the chemical composition and microstructure of the shell powders, resulting in rough and porous CaO surfaces conducive to heavy metal ion and pollutant adsorption. The research provides a theoretical framework and experimental validation for the sustainable utilization of calcined shell powders, fostering efficient shell resource management and environmental protection.

Public health and economic impact of COVID-19 vaccination with the Pfizer-BioNTech COVID-19 Vaccine, KP.2, among adults in 2024/2025 in the United States

ABSTRACT Objectives To assess the public health and economic impact of vaccination with the Pfizer-BioNTech COVID-19 vaccine, KP.2, in 2024/2025 in the United States. Methods A combined cohort Markov-decision tree model was used to estimate the cost-effectiveness and budget impact of vaccination versus no vaccination in adults aged ≥18 years. The adult population was further stratified into 18-64 years and ≥65 years age groups. Public health surveillance data informed the annual proportion of individuals infected with and vaccinated against SARS-CoV-2 and the proportion of those infected who were hospitalized, stratified by age. Other age-stratified clinical, cost, and vaccine effectiveness parameters were informed by literature. The budget impact analysis was based on a hypothetical 1-million-member plan and used a payer perspective. Parameter uncertainty was tested in sensitivity analyses. Results Without vaccination, the model projected 21.4 million new symptomatic cases, 15,793 deaths, 629,098 hospitalizations, $115.5 billion in total costs, and 1 million QALYs lost among adults aged ≥18 years, with the greatest health burden observed among older adults aged ≥65 years (72% of hospitalizations and 86% of deaths) and the greatest economic burden in adults aged 18 to 64 years (62% of total costs). Vaccination was projected to prevent 915,501 cases, 1,057 deaths, and 37,489 hospitalizations, resulting in cost savings of $513 million, 9,173 LYs gained, 56,482 QALYs gained, and a dominant ICER. In the budget impact analysis, vaccination was estimated to result in total incremental cost savings for the population aged ≥ 65 years and a modest budget increase for the population aged 18 to 64 years. Conclusions Vaccination with the Pfizer BioNTech COVID-19 vaccine, KP.2, is a cost-effective measure from the societal perspective at a willingness-to-pay threshold of $50,000 that could reduce the health and economic burden of COVID-19.

Examining Strategies Developed by Insurance Companies for Addressing Carbon Emissions in the Automotive Supply Chain in the UK

The automotive supply chain is one of the top eight value chains that cause 50% of global emissions. Despite its significance, limited literature has researched the role of insurance companies in addressing automotive supply chain emissions. This research explores strategies developed by insurance companies for addressing carbon emissions in the automotive supply chain in the UK. It employs a qualitative multiple case study approach and conducts in-depth analysis of main drivers, barriers, and strategies in four insurance companies in addressing automotive supply chain emissions. It finds that cost savings and competitive advantage, changing mindset, impending regulation, market changes, and increased connectedness are the main drivers. But further progress is slowed down by five main barriers: ‘the complexity of tracking and quantifying emissions’, ‘conflicts of interest in the supply chain’, ‘skill shortage’, ‘lack of accountability’, and ‘profit prioritisation’. To overcome this, the study establishes five main strategies for insurance companies to follow: ‘circular business model with green parts and repair-over-replace methodologies’, ‘supply chain collaboration’, ‘quantifying emissions and setting key performance indicators’, ‘higher weighting for ESG in tenders and policies’, and ‘education and awareness’. If followed correctly, businesses will be able to achieve ‘emission reductions’, ‘gain competitive advantage’, and ‘reduce costs in the supply chain’. Taking into account these findings and the academic literature, this study develops a framework for insurance companies to mitigate automotive supply chain emissions. This is one of the first papers to study carbon emissions in automotive supply chains from the perspective of the insurance industry. It provides practical implications for the insurance industry in developing carbon emission strategies in automotive supply chains.

The role of motivation and knowledge in promoting green consumer behavior in Saudi Arabia and Pakistan

This research explores the factors influencing consumers’ intentions and behaviors toward purchasing green products in two culturally and economically distinct countries, Saudi Arabia and Pakistan. Drawing on Ajzen’s Theory of Planned Behavior (TPB), the study examines the roles of altruistic and egoistic motivations, alongside environmental knowledge, in shaping green consumer behavior. Altruistic motivation, driven by concern for societal well-being and environmental sustainability, is found to have a stronger impact on green purchase intention and behavior in both countries, particularly in Pakistan. Egoistic motivation, which focuses on personal benefits like health and cost savings, also contributes but with a lesser influence. The research employs a cross-sectional survey design, collecting data from 1000 respondents (500 from each country) using a stratified random sampling technique. The collected data were analyzed using structural equation modeling (SEM) to examine the relationships between variables and test the moderating effects of environmental knowledge. The results reveal that environmental knowledge significantly moderates the effect of both altruistic and egoistic motivations on green purchase intention, enhancing the likelihood of eco-friendly consumption. These findings underscore the importance of environmental education in promoting sustainable consumer behavior. The originality of this study lies in its comparative analysis of green consumerism in two distinct contexts and its exploration of motivational factors through the TPB framework. Practical implications suggest that policymakers and marketers can develop strategies that appeal to both altruistic and egoistic drivers while enhancing consumer knowledge of environmental issues. The study contributes to the literature by expanding TPB to include the moderating role of environmental knowledge in understanding green consumption behavior across diverse cultures.

Deep learning enables the use of ultra-high-density array in DNBSEQ.

DNBSEQ employs a patterned array to facilitate massively parallel sequencing of DNA nanoballs (DNBs), leading to a considerable boost in throughput. By employing the ultra-high-density (UHD) array with an increased density of DNB binding sites, the throughput of DNBSEQ can be further expanded. However, the typical imaging system of the DNBSEQ sequencer is unable to resolve adjacent DNBs spaced smaller than the resolution limit, resulting in poor base-calling performance of the UHD array and hindering its practical application. In this study, we propose a deep-learning-based DNB image super-resolution network named DNBSRN to address this problem. DNBSRN has a specifically designed structure for DNB images and employs a histogram-matching-based preprocessing approach. For the eight DNB image datasets generated from the DNBSEQ sequencer using UHD arrays with 360nm pitch, the base-calling performances are significantly improved after super-resolution reconstruction by DNBSRN and reached a comparable level to those of the regular density array. In terms of reconstruction speed, DNBSRN takes only 7.61ms for an input image with 500 × 500 pixels, which minimizes its influence on throughput. Furthermore, compared with state-of-the-art super-resolution networks, DNBSRN demonstrates superior performance in terms of both the quality and speed of DNB image reconstruction. DNBSRN successfully addresses the DNB image super-resolution task. Integrating DNBSRN into the image analysis workflow of DNBSEQ will allow for the application of UHD array, hence enabling a considerable improvement in throughput as well as tremendous savings in unit reagent cost.

Supply Chain Design for Waste Valorization Through High-Energy-Density Pellet Production in Chile

This study presents the development and application of a mathematical optimization model to improve decision-making in the supply chain for high-energy-density pellet (HEDP) production and commercialization. Focused on the Metropolitan Region of Chile, the research involved a detailed analysis of key supply chain components, including identifying landfills and controlled dumps, waste volume assessments, plant location analysis, technology evaluation, and market potential exploration. The model revealed that the available raw material in the region was sufficient to meet 100% of HEDP demand, with a surplus of 2,161,952 tons remaining after satisfying maximum demand. An optimization analysis of potential plant locations identified Santa Marta as the optimal choice, resulting in annual cost savings of USD 100,000 compared to other sites. This work underscores the role of mathematical optimization in enhancing supply chain efficiency for biomass-based energy products, offering valuable insights for strategic decision-making in similar contexts.

Implementation of AI Transportation Routing in Reverse Logistics to Reduce CO2 Footprint

Purpose: This study explores the implementation of artificial intelligence (AI) in transportation routing within reverse logistics to reduce CO2 emissions. By optimizing routing processes, we aim to enhance the efficiency of logistics operations while minimizing environmental impact. Methodology: we analyze the implications of improved transportation strategies. Furthermore, we discuss the intersection of technological innovation and environmental economics in shaping sustainable practices. Findings: The findings underscore the importance of AI-driven decision-making frameworks (D81) and their role in advancing IT management in logistics. The study on AI-driven transportation routing in reverse logistics highlights significant implications for both businesses and the environment. By optimizing routes, AI reduces fuel consumption and CO₂ emissions, helping companies meet sustainability goals. This leads to cost savings, as AI improves route efficiency and fleet utilization, while also enhancing operational efficiency. AI’s ability to predict and adjust to real-time conditions ensures scalability and adaptability, making it easier to handle increasing returns volumes in e-commerce. Moreover, AI enables better inventory management and resource planning, reducing the need for urgent shipments. It also paves the way for innovations like autonomous vehicles, further transforming reverse logistics. Unique Contribution to Theory, Practice and Policy: The study shows how AI can help businesses comply with environmental regulations, providing a competitive edge. Ultimately, AI integration in reverse logistics contributes to both operational improvements and environmental sustainability, reinforcing corporate social responsibility.

BN SO11 - Optimising Day Case Laparoscopic Cholecystectomy: A GIRFT-Based Audit and Efficiency Analysis

Abstract Background Laparoscopic cholecystectomy (LC) is the gold standard for managing symptomatic gallstone disease and is commonly performed as a day surgery procedure due to its safety and efficiency. Despite its established benefits, recent analyses at our local hospital revealed a decline in the day case rate for elective LC, falling below the national median as highlighted by the Get It Right First Time (GIRFT) data. Method We analysed patient data for elective LC performed between 1st October 2023 and 29th February 2024. The data included patient demographics, length of stay, and reasons for unplanned admissions. Procedures from the hot and emergency lists were excluded from the analysis. To enhance the day case rate, a business case was developed to extend recovery staffing levels and coverage hours in the DSU from 6pm to 9pm. Additionally, we requested the coding team to distinguish elective cases from hot list cases for more accurate future analyses. The impact of these changes will be evaluated in a subsequent audit cycle. Results During the observed period, 86 elective LC cases were performed, with a day case rate of 64% (55/86), exceeding the national median of 60%. The discrepancy with the GIRFT analysis was due to the inclusion of hot list cases in their data. The primary reasons for unplanned admissions included monitoring observations (46%), late afternoon extubations (29%), and intra-operative concerns (18%). The median length of stay for unsuccessful day cases was 1 day. Cost analysis estimated the unplanned admission costs at over £12,000 for LC alone during the observed period, based on the NHS National Tariff 2024/25. Conclusion This audit demonstrated that our day case rate for elective LC surpasses the national median. By identifying key factors leading to unplanned admissions, we implemented targeted interventions, such as extending recovery area hours. These measures aim to further improve the day case rate, enhance patient care, and achieve significant cost savings.

COMPARISON OF CONFOCAL SENSOR FOR DIAMETER MEASUREMENT WITH MEASURING PROBE

The measurement and inspection of products and their dimensions in industry plays an important role in determining the quality of a product. Correct measurement is a key factor in production. Many companies are subject to stringent safety standards and specific product requirements. Accurate measurement ensures compliance with these guidelines, avoiding fines, penalties and legal complications. Effective measurement processes can identify inefficiencies, defects and areas for improvement, leading to cost savings. By detecting defects early in the production cycle, manufacturers can reduce waste and optimize resource utilization thereby reducing overall production costs. A fundamental principle of good measurement is to ensure that the measuring instruments are suitable for the specific application and that they meet the measurement requirements for the measurement parameter. The objective of the experiment is to verify and compare the measurement capability of a confocal chromatic sensor against a measurement probe used in production. The parameter to be measured is the diameter, since the correct diameter plays an essential role in the production of shafts or other cylindrical products. The results contained in the thesis highlight the importance and differences between the different measuring devices and the qualification to use the measurement of a given parameter.

EDI&S SO08 A novel approach to environmentally sustainable surgical theatre by rationalising surgical instrument set – a qualitative analysis

Abstract Background The surgical theatres are a major source of hospital waste generation. The NHS has set a net zero supply chain target by 2045. This aim is supported by the RCS intercollegiate green theatre checklist to reduce the environmental impact of operating theatres. One key area identified in this process, that will support the net-zero target is surgical instrument tray rationalisation. Laparoscopic cholecystectomy was identified as one of the most common surgical procedures performed in England. The purpose of this study was to demonstrate the impact of rationalising the number of surgical instruments, enabling surgeons to drive towards net zero surgery. Method Our Trust participated in this study, in collaboration with NHS England sustainable procurement team and the innovation agency. Total 58 cholecystectomies performed across two sites, Pinderfields and Dewsbury were included in this prospective audit undertaken from January – March 2023. The surgical tray checklists were used to record the actual instrument usage and noted the redundant and supplementary instruments. This data presented to a surgical advisory group, who agreed on routine instruments and proposed removal of redundant. A green pilot tray was approved and used for cholecystectomy. Qualitative questionnaire feedback was collected from surgeons and operation theatre staff from both sites. Results The instrument use matrix revealed almost 50% instruments from the previously used major tray were never used in any of the 58 cholecystectomy surgeries performed. Subsequently, based on the use matrix data, we switched from using major tray containing 84 instruments, to a reduced size tray containing 46 instruments including re-usable metal ports. Survey results revealed tray rationalisation led to easier and faster surgery preparation, improved efficiency and a reduction in waste, thereby reducing the cost to the Trust. It was also noted that having a smaller tray means less time to count instruments during the surgical pause. Conclusion The results of tray rationalisation are very positive and have demonstrated cost savings, carbon reduction and time saved preparing for surgery and the post-operative instrument count. This pilot study has shown that by making the surgical set smaller, savings have been achieved from a reduction of slots required per machine cycle for decontamination. Tray rationalisation goes some way towards the net goal of zero carbon surgery and delivering a sustainable future.

A comprehensive exposition of the synergistic collaboration between the public and private spheres in healthcare

Public–private partnerships (PPPs) are a type of partnerships between the government and the private sector. PPPs promote innovation in healthcare by combining the resources of the public and private sectors. They provide advantages such as improved service, enhanced accessibility, and cost savings. However, they also have drawbacks such as divergent goals, hesitancy, influence imbalances, and limited data. This review focuses to examine types of PPP in healthcare such as service contracts, operations, maintenance contracts, and capital projects, with a focus on their diverse applications and impacts, its benefits, efficiency, cost-effectiveness, challenges, divergence goals, issues about prices, disputes, and the influence of private sector on healthcare quality, access, and costs in Indian scenario. The review also provides a comprehensive and globally relevant exploration of PPP in healthcare, with a special focus on dental care, non-clinical services, and pragmatic insights into its challenges and solutions, offering a valuable resource for stakeholders in the field.