Data-Driven Surgical Tray Optimization to Improve Operating Room Efficiency

38 Pages Posted: 18 Jun 2021 Last revised: 28 Apr 2022

See all articles by Vinayak Deshpande

Vinayak Deshpande

University of North Carolina (UNC) at Chapel Hill - Operations Area

Nishanth Mundru

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School

Sandeep Rath

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School

Martyn Knowles

UNC Rex Hospital

David Rowe

Operative Flow LLC

Benjamin Wood

UNC Rex Hospital

Date Written: June 13, 2021

Abstract

Surgical procedures account for over 60% of the operating cost of a hospital. About 15% of these costs are those related to surgical instruments and supplies. Hospitals spend several million dollars a year on instrument sterilization, instrument tray assembly, and instrument repurchase costs. However, less than 20-30% of reusable instruments supplied to a surgery are used on average. Prior implementations of surgical tray rationalizations have typically been expert-driven. This is a labor-intensive effort, typically focused on a small set of trays. On the other hand, past mathematical programming model-based studies have typically tested models with simulated data because of the difficulty in obtaining actual instrument-level usage data. We obtained actual surgical instrument usage at a large multi-specialty hospital in partnership with OpFlow, a healthcare software company. We formulate a data-driven mathematical optimization model for surgical tray configuration and assignment with the goal of reducing costs of unused instruments, such as sterilization, instrument purchase, and tray assembly costs. We develop a solution methodology that scales to thousands of surgeries, thousands of instruments, and hundreds of surgical trays. We perform extensive out-of-sample testing of our solution. Our model-based approach identifies improvements in tray configuration and assignment, which would lead to a 54% reduction in unused instruments per surgery compared to current tray configuration used at this hospital. We also validated our model with an expert-recommended solution for a subset of trays. We find that our model-based solution leads to 20% lower overage and 21% lower underage than the expert-recommended solution. We estimate projected annual cost savings of 35% in instrument sterilization, tray assembly costs and instrument repurchase costs from using the recommendations of our model. Our analysis has quantified the value of collecting point-of-usage data to be at least $1.39 million per year from using the model-recommended solution at the hospital

Note:
Funding Information: No external funding was utilized for this research.

Conflict of Interests: Martyn Knowles. and Benjamin Wood are shareholders and owners of the technology (OpFlow; Operative Flow Technologies, Raleigh, NC) used for data collection. David Rowe is the CEO of Opflow. No competing interests for Sandeep Rath, Vinayak Deshpande, and Nishanth Mundru.

Ethical Approval: No patient identifying information was used. Only retrospective surgical instrument usage data was used for model analysis and development.

Keywords: data-driven optimization; healthcare operations; surgical tray rationalization

Suggested Citation

Deshpande, Vinayak and Mundru, Nishanth and Rath, Sandeep and Knowles, Martyn and Rowe, David and Wood, Benjamin, Data-Driven Surgical Tray Optimization to Improve Operating Room Efficiency (June 13, 2021). Available at SSRN: https://ssrn.com/abstract=3866226 or http://dx.doi.org/10.2139/ssrn.3866226

Vinayak Deshpande

University of North Carolina (UNC) at Chapel Hill - Operations Area ( email )

300 Kenan Center Drive
Chapel Hill, NC 27599
United States

Nishanth Mundru

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School

McColl Building
Chapel Hill, NC 27599-3490
United States

Sandeep Rath (Contact Author)

University of North Carolina (UNC) at Chapel Hill - Kenan-Flagler Business School ( email )

McColl Building
Chapel Hill, NC 27599-3490
United States

Martyn Knowles

UNC Rex Hospital ( email )

David Rowe

Operative Flow LLC ( email )

Benjamin Wood

UNC Rex Hospital ( email )

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