Clinical supply waste is a significant, and growing, financial and environmental challenge in healthcare. A report from Johns Hopkins University1 identifies an estimated $15 million worth of unused surgical supplies are discarded every year and research from the University of California-San Francisco2 found 2,000 tons of waste comes from operating rooms (ORs) daily. The heightened use of disposable items has greatly contributed to the increase in waste. Single-use or disposable surgical supplies such as scalpels, sterile gloves, gowns and drapes, sealants and Surgifoam® may add up to hundreds of dollars of waste per case.
Just how much waste is generated by our hospitals?
Let us consider one common procedure in North America, primary total knee replacement surgery. Western University in London, Ontario3, published a report showing that primary knee replacement surgery produces an average of 13.3 kg or 29.3 pounds of waste.
To add some perspective, let’s add in surgical volumes. 65,581 primary knee replacements were performed in Canada based on data from the “2017-2018 Canadian Joint Replacement Registry Annual Report” published by the Canadian Institute for Health Information4. The “2018 Annual Report” published by the American Joint Replacement Registry reported 650,674 primary knee replacement procedures were performed throughout the U.S. in 20175. If we extrapolate the average waste weight/primary knee replacement surgery from the Western University study, then we are producing 872,227 kg or 1,921,523 pounds of waste in Canada and 8,653,964 kg or 19,064,748 pounds of waste in the U.S. This is a staggering amount of landfill waste!
The bundling of surgical supplies in custom packs relies heavily on disposable items and is an attractive approach to shorten OR turnover. However, this common practice exacerbates the problem because the custom pack may contain ”just-in-case” items and the actual usage of such items is not monitored. A similar situation exists with physician preference cards (PPCs). PPCs are very fluid due to changes in technology and practice yet hospitals struggle with their maintenance, specifically from a supply chain perspective. The result is more waste when new products are added, but obsolete and/or superfluous products remain on the card, bloating inventory quantities and carrying costs.
These numbers clearly show that hospital waste management represents a significant environmental and social obligation. Hospitals must implement programs to reduce overall waste while finding cost-effective treatment and disposal methods of their non-regulated and regulated medical waste.
How can hospital supply chains reduce waste by ensuring the right amounts of products are available at the right time?
The good news is that there are specialized supply chain solutions to help hospitals reduce surgical waste. Below are recommendations to consider for your healthcare facility.
- Improve inventory management. Without solid supply chain processes, you run the risk of having too much inventory, not having enough or lacking the right kind of inventory. Visibility and control are paramount to operating more effectively and reducing waste due to loss and expiration. With proven supply chain management methodologies, you can gain visibility and increased accuracy of supplies and enable redistribution of inventories when possible.
- Implement demand planning coupled with just-in-time replenishment.Forecasting is attainable in the healthcare setting thanks in part to the abundance of technology solutions at use in most facilities including point of use, automatic identification and data capture technologies. This data provides the foundation for forecasting programs that “right size” your inventory and can minimize stockouts and inventory shortages. The visibility gains enable you to maintain optimal stocking levels and build trust with the clinicians, which in turn will reduce their fear-based practice of hoarding and hiding supplies. Combined, best supply chain practices will reduce the amount of expired or misplaced product.
- Maintain and manage custom packs and physician preference cards electronically. Electronic surgical case management solutions help create a better understanding of what is needed, what was used, what was returned and what was wasted. The collected data can be used to ensure the supplies are both up-to-date and compliant with procedural requirements.
- Use advanced analytics to monitor preference cards. When you manage custom packs and physician preference cards electronically with clinically integrated supply chain solutions, you then have access to effective, data-driven oversight. This makes it easier to provide high quality supply chain services to your clinical partners. Specific results include: reducing variation across service lines, supply optimization recommendations and contributes to accurate and current preference cards. You are also able to track the actual cost to deliver procedures — an important metric to support initiatives around standardization and cost rationalization.
The key is to implement solutions that are easy-to-use, complement clinical workflows and do not distract from the primary objective of the clinicians — the delivery of excellent patient care.
- Global Public Health Impact of Recovered Supplies from Operating Rooms: A Critical Analysis with National Implications. World Journal of Surgery. January 2015, Volume 39, Issue 1, pp 29-35.
- Operating Room Waste: Disposable Supply Utilization in Neurosurgical Procedures. Journal of Neurosurgery. February 2017, Volume 126.
- Surgical Waste Audit of 5 Total Knee Arthroplasties. Canadian Journal of Surgery. April 2013, Volume 56, Issue 2, pp 97-102.
- Hip and Knee Replacements in Canada, 2017-2018, Canadian Joint Replacement Registry Annual Report. Canadian Institute for Health Information. June 20, 2019.
- Annual Report. American Joint Replacement Registry. 2018.