"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.