D49. Utilization Fraction of Ambulatory Hand Procedures: Cost Reduction through Surgical Instrument Tray Optimization

PURPOSE: Our objective is to evaluate the utilization fraction (UF) of surgical instruments during a commonly performed ambulatory hand surgery case as an avenue for cost reduction, increased operating room efficiency, and systems quality improvement. METHODS: The total number of instruments opened at the start of each case was recorded. Instruments were then grouped as used or not used during the procedure, and used instruments were counted. Total sterile processing costs were estimated at 1. 56 per instrument according to data from our institution's central sterilization processing (CSP) department. RESULTS: Nineteen hand procedures performed by 2 surgeons were included in this study. An average of 120. 1 ± 10. 9 instruments were opened at the start of each case, while an average of 12. 6 ± 5. 4 instruments were used per case. This yielded a UF of 10. 7% ± 4. 8%. Using our internal CSP estimate, we calculated an annual cost of 16, 863 to reprocess the current hand tray. Using literature data, this cost ranged from 5, 513-34, 484 annually. The same cost calculations were performed for the theoretical optimized tray (incorporating instruments used at least 20% of the time when opened) containing 23. 2 instruments. The annual reprocessing cost of this new tray according to CSP data was 3, 260, demonstrating a cost reduction of 13, 603 or 80. 7%. CONCLUSION: Evaluation of pre-and peri-operative processes is a valuable technique for mitigating increasing healthcare costs and reducing unnecessary healthcare spending. This is broadly applicable to multiple surgical subspecialties and procedures.