Optimising Surgical Instrument Trays for Sustainability and Patient Safety by Combining Actual Instrument Usage and Expert Recommendations

Kim E. van Nieuwenhuizen, Teun van Trier, Herman J. Friedericy, Frank Willem Jansen, Jenny Dankelman and Anne C. van der Eijk ()
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Kim E. van Nieuwenhuizen: Department of Gynaecology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
Teun van Trier: Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
Herman J. Friedericy: Department of Anaesthesiology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
Frank Willem Jansen: Department of Gynaecology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
Jenny Dankelman: Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
Anne C. van der Eijk: Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands

Sustainability, 2024, vol. 16, issue 16, 1-11

Abstract: Annually, over 300 million surgeries occur globally, requiring numerous surgical instruments. However, many instruments on the tray are returned to the central sterile supply department (CSSD) unused, creating an unsustainable pattern of unnecessary consumption. To address this, we developed a method for optimising surgical instrument trays (SITs) that is straightforward to implement in other hospitals. This optimisation aims to enhance patient safety and sustainability and to improve working conditions and reduce costs. We identified actual instrument usage (IU) in the operating room (OR) and obtained expert recommendations (ERs). Data from both methods were combined in a computer model (CM) to adjust the SITs. The performance of the adjusted SITs was assessed over a year. IU of three different SITs was collected during 16 procedures (mean = 28.4%, SD = 6.4%). Combining IU and ERs resulted in a 36.7% reduction in instruments and a 31.3% weight reduction. These measures contribute to reducing the carbon footprint and enhancing sustainability. During the evaluation of the new SIT contents (n = 7 procedures), mean IU increased from 28.4% (SD = 6.4%) to 46.5% (SD = 11.0%), with no missing instruments during surgery. A one-year follow-up showed no need for further alterations. Combining both methods yields better results than using them individually, efficiently reducing unnecessary items in SITs without compromising patient safety.

Keywords: surgical instrument tray optimisation; sustainability; OR efficiency; computer model; instrument reduction; resource use; patient safety (search for similar items in EconPapers)
JEL-codes: O13 Q Q0 Q2 Q3 Q5 Q56 (search for similar items in EconPapers)
Date: 2024
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