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Spine Surgeons Waste Millions On Opened, Unused Implant Devices

Joe Cantlupe, for HealthLeaders Media, November 10, 2011

"If a screw was placed in a patient, and removed, as long as it wasn't destroyed or significantly compromised, it can go back in the bin (and be reused). If not, I think that's a significant definition of waste," he says. "Our consensus of waste was reached by asking the people who did the work: the nurses and surgeons and clinical advisors."

In their study, researchers recorded spine procedures and incidents of intra-operative waste over a 25-month period, from October 2007 to November 2009. Although it may be hard to believe, researchers say their study represented the first extensive review of waste-related spending in spine surgery.

After reviewing wasteful actions of surgeons, Beth Israel Deaconess staff decided to make changes to improve their use of implant materials. Those steps led to significant reductions of waste, says McGuire.

Besides initiating the Lean system, and cataloging their use of implant materials, they also challenged each other, saying, "This is your waste. This is your partner's waste."

They compiled lists of who had been wasting more instruments than others, and shared that information with one another.

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1 comments on "Spine Surgeons Waste Millions On Opened, Unused Implant Devices"


Apurv Gupta (11/10/2011 at 5:07 PM)
Really enjoyed reading this article, which reveals a highly successful deployment of a "performance improvement project". A similar "performance improvement" approach can work in improving quality, mitigating risk, and improving patient safety. Just to make the elements clear to all leaders, I'm posting my blog on this topic below. The article identifies the following "performance improvement tactics" that should be integral components of all improvement projects: ** Examined how much they used and spent (review and monitor data) ** Questioned why each device was being being used (ask why five times) ** Studied reasons for wastage (undertake root cause analysis) ** Asked surgeons, operating room personnel, industry representatives, and nurses to help them identify waste (seek multi-disciplinary input) ** Compiled lists of who had been wasting more instruments than others (create profiles) ** Shared lists [of waste generators] with each other (create report cards) ** Awareness campaign (educate) ** Physician leadership prompted change (get support from leadership) The key behavioral drivers that project leader, Dr. Kevin McGuire, Chief of Orthopedic Surgery, identified are "physicians are competitive in nature" and "no one wants to be an outlier". Understanding these drivers is key to understanding some of the performance improvement tools and how to deploy them effectively.