Cost Awareness Among Operating Room Providers and Staff
Adee J. Heiman, M.D.1, Deepa Bhat, M.D.1, Vilok Desai, M.S.2, Joseph A. Ricci, M.D.3.
1Albany Medical Center, Albany, NY, USA, 2Albany Medical College, Albany, NY, USA, 3Montefiore Medical Center, Bronx, NY, USA.
BACKGROUND: Operating rooms, together with labor and delivery suites, comprise approximately 70% of the total waste accumulated by hospitals. Packs of suture, sterile gowns, and gloves are frequently opened and never used. This not only leads to huge amounts of waste, which negatively impacts the environment, but also leads to increased costs for the hospital and patient. The aim of this study is to evaluate the perceived versus actual costs of commonly used items in the operating room at a high-volume academic medical center.
METHODS: Anonymous paper surveys were distributed to defined healthcare personnel, which include operating room nurses, surgical technicians, attending anesthesiology staff, certified registered nurse anesthetists, attending surgery staff (general surgery, orthopedic surgery, plastic surgery, vascular surgery, urologic surgery, neurosurgery), anesthesiology residents, and surgery residents. The survey consists of a questionnaire asking the participant to estimate the costs of ten commonly used operating room (OR) items. These costs were then compared against actual costs to evaluate the accuracy of participants’ estimates.
RESULTS: A total of 167 surveys were collected. Cost estimates of all 10 items varied widely. Overall, only 16.4% of overall estimates were accurate (within 50% of actual purchasing price). The majority of item costs were overestimated. There were no statistically significant differences in accuracy between groups (p = 0.2, Chi-squared). There was no correlation between years at current position and number of accurate responses (R2 = 0.003).
CONCLUSIONS: While the lack of cost awareness among surgery residents and attendings of multiple specialties has been well-documented in the literature, there is very little focus on cost awareness among anesthesia providers and ancillary OR staff. While these individuals play a more minor role in selection of specialized equipment, they play a major role in the selection and utilization of low-cost items, such as sponges and sterile garments, which are the focus of this study. Our study shows no significant difference in cost awareness among surgeons, anesthesia providers, and ancillary OR staff. By addressing the knowledge deficit, we hope to globally educate physicians, as well as OR staff, on actual costs of materials in the operating room and subsequently reduce waste/costs for our healthcare system.
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