Configuring Surgical Instrument Trays to Reduce Costs
31 Pages Posted: 16 Nov 2014 Last revised: 23 Sep 2015
Date Written: August 31, 2015
Most hospitals in the US provide and manage durable surgical instruments used in operating rooms. Instruments are customarily stored and delivered to operating rooms as trays (kits). The advantages of organizing instruments into custom trays have been discussed elsewhere. They include: reliability in providing the needed instrument, speed of delivery in an emergency situation, and tighter control over the inventory. Hospital materials managers and surgeons appear to weigh differently the various attributes of different tray configurations. Surgeons prefer trays with the minimum number of unneeded instruments, while materials managers want to limit the cost of inventory and the variety of trays. We propose a mathematical programming formulation to decide on the composition of trays to minimize the relevant costs. We show that the optimal configuration depends not only on physician instrument preferences but also on the actual operating rooms’ schedules. This implies that changing surgery schedules can have significant impact on how trays should be configured. Using real-world data we demonstrate that optimizing trays can result in significant cost savings for the hospital and increase surgeons’ satisfaction, based on the reduction of the “unneeded instruments.” We describe a column-generation algorithm and a heuristic algorithm for finding a low-cost trays configuration given surgeons’ preferences and surgical schedules. Our numerical experiments suggests that currently hospital materials managers overestimate the cost of tray variety and underestimate the cost of re-processing the extra instruments in a tray.
Keywords: Operating room efficiency, optimal surgical tray composition
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