239 - Managing Cost: The Little Things That Counts
Clinical Issue: An increase in the case cost related to supplies was not in alignment with the case volume or incoming revenue. Additionally, damage and replacement of instruments increased the department’s cost. Sterile Processing Department (SPD) team were continually at increased risk for injury (near-miss) amounting to 5-10 risk events identified daily.Description of Team:Administrative Director, Assistant Director, Charge Nurses, Surgical Techs, SPD Supervisor and the Director of Material Management and Supply Chain. Preparation and Planning:Preference cards and case supplies were assessed to determine contributing factor related to the increased spend. IntraOp team and SPD staff competency were assessed to determine if there’s a knowledge deficiency involved. The result identified ineffectiveness of the decontamination instrument transportation covers (DITC) causing instruments to fall during transport and the cover was easily penetrable. A hold was placed on the use of the DITC and return to utilizing drapes from the custom packs with decontamination stickers. The plan was in place for six months with monthly assessment.
Assessment: After the six months a decline near-miss events were observed monthly. A quarterly review confirmed a decline in broken instruments, near-miss reduced to < 5 /month and damaged instruments. Implementation:Recommendation to hold purchase on the DITC implemented for 6-months. Utilization of the custom pack & instrument carriers was also implemented.Outcome:The overall savings appeared minimal at $6.45 to $7.47per procedure for the 6 months was 20K-24K and with projected annual savings of 40K-48K on the DITC. Implications for Perioperative Nursing:Revenue management, increase annual saving, reduce in near-miss incident, reallocation of financial resources to improve direct patient care or staff education as needed. Paying attention to low-cost supplies is necessary and adds up to major savings that can be unnoticed.