From NASS: Awareness Program Could Reduce Spine Surgery Waste

According to information released at a presentation during the 26th annual meeting of the North American Spine Society (NASS) in Chicao, Ill., more than $126 million in surgery costs could be saved each year by implementing a simple awareness program.

For the first time, researchers quantified the incidence of intraoperative waste in spine surgery and examined the efficacy of a surgeon education program. The study, titled “Intra-Operative Waste in Spine Surgery: Incidence, Cost and Effectiveness of an Awareness Program,” found that intraoperative waste adds significant and unnecessary cost to surgery expenses.

“This study should be a wake-up call for all medical professionals and OR staff, but particularly spine surgeons,” said Christopher Kauffman, MD, program co-chair of the NASS Annual Meeting and orthopedic surgeon at the University Medical Center in Lebanon, Tenn. “As these researchers demonstrated, it is possible, even simple, to reign in surgical costs through careful planning and management. The potential savings are significant and surgeons are in a position to not only help with savings but potentially participate in gainsharing programs as a result of these savings.”

In one of the meeting’s “Best Papers,” data were collected during a 25-month period from one U.S. academic medical center (a 15-month observational period and a subsequent 10-month awareness program). The total number of spine procedures and the incidence of intraoperative waste at Beth Israel Deaconess Medical Center were recorded prospectively. Other variables recorded included the type of product wasted, cost associated with the product or implant wasted, and reason for the waste.

Further analysis of the results showed the most common reason for waste and the main driver of the cost burden was “surgeon changed mind.” Surgical implants were associated with a higher-cost-per-item wasted. The awareness program was successful in decreasing the cost burden associated with intraoperative waste by 66 percent. These results were achieved by decreasing the proportion of implants wasted (44.1 percent to 24.5 percent), and decreasing the incidence of surgeons’ change of mind (42.2 percent to 24.1 percent).

A simple educational program proved to be and continues to be effective in making surgeons aware of the import of their choices and the costs related to surgical waste, study author noted.

A first part of the awareness program was to define what constitutes a “wasted” item, and to make everyone—surgeons, operating room personnel, industry representatives—aware of this definition. This allowed them to establish clear guidelines on what could and could not be subsequently used. Spine surgeons were also presented with monthly data associated with surgical waste, on an institutional and an individual level.

The study’s authors are:
• Alexandra Soroceanu, M.D., of Dalhousie University, Halifax, Canada
• Adam Robinson, Beth Israel Deaconess Medical Center, Boston, Mass.
• Elena Canacari, R.N., CNOR, Beth Israel Deaconess Medical Center, Boston, Mass.
• Kevin McGuire, M.D., Beth Israel Deaconess Medical Center, Boston, Mass.