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Surgeon Scorecards Lower Supply Costs

News  |  By Jennifer Thew RN  
   March 20, 2017

Surgeons who received monthly cost feedback in the form of scorecards combined with a financial incentive lowered their surgical supply costs by 6.5%.

How much is that retractor in the window? Many surgeons don't know. But those who do have demonstrated lower surgical supply costs without negative effects on outcomes, according to findings in a study published in JAMA Surgery.

The OR Surgical Cost Reduction project, a single-health system, multi-hospital, multi-departmental prospective controlled study, found that surgeons provided with cost feedback scorecards lowered their surgical supply costs by 6.5%.

Those who did not receive the scorecards showed an 7.4% increase in surgical supply costs.

What Hospitals Waste

From January 1 to December 31, 2015, each surgeon in the intervention group received standardized monthly scorecards showing the median surgical supply direct cost for each procedure type they performed in the prior month compared with his or her baseline costs which were calculated from data from July 1, 2012, to November 30, 2014.

The scorecard also compared the individual surgeon's costs with the baseline costs of all the institution's surgeons performing the same procedure.

Incented to Reduce Costs
The surgeons in the control group did not receive the monthly scorecard. All surgical departments were eligible for a financial incentive if they met a 5% cost reduction goal.

In the intervention group, the median surgical supply direct costs per case decreased 6.5% from $1,398 in 2014 to $1307 in 2015 which added up to a savings of $836,147 during the year-long study.

In the control group, the median surgical supply direct cost increased 7.4% from $712 in 2014 to $765 in 2015.

After researchers controlled for surgeon, department, patient demographics, and clinical indicators, the intervention group showed a 9.95% decrease in surgical supply costs over the year.

Patient Outcomes
Patient outcomes—30-day readmission, 30-day mortality, and discharge status—were equivalent or improved after the intervention, and surgeons who received scorecards reported higher levels of cost awareness on compared to the control group.

Attending surgeons in orthopedic surgery, head and neck surgery, and neuro surgery made up the group receiving the scorecards. Those in the control group were cardiothoracic, general, vascular, pediatric, obstetrics/gynecology, ophthalmology, and urology surgeons.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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