Cost containment is more important than ever in healthcare, and perioperative services often are scrutinized because they can consume more than 30% of hospital budgets. Procurement, processing, and use of sterile surgical items are a big portion of that budget, and those often have been recognized as areas of inefficiency.
A study in the January 2022 issue of The Joint Commission Journal on Quality Patient Safety—“Inventory Optimization in the Perioperative Care Department Using Kotter’s Change Model,” by Jay Toor, MD, MBA, and colleagues—used an established change model to effectively implement inventory optimization (IO), driving improvements across inventory, efficiency, and satisfaction metrics.*
“With millions of procedures performed annually in North America, significant labor and inventory cost could be saved with minimal adverse effects on patient care by improving efficiency in instrument reprocessing,” the study authors wrote.
QI Model Used
The researchers optimized inventory across four high-volume surgical services while using the steps in Kotter’s Change Model (KCM):
- Create a coalition
- Create vision for change
- Establish urgency
- Communicate the vision
- Empower broad-based action
- Generate short-term wins
- Consolidate gains
- Anchor change
The study authors contended that the KCM process has been increasingly applied to the healthcare setting to facilitate the implementation of quality improvement (QI) interventions.
“The purpose of this QI project was to implement the IO using KCM, overcome organizational barriers to change, and measure key outcome metrics related to surgical inventory and corresponding clinician satisfaction,” the study authors wrote. “We hypothesized that KCM would be an effective method of implementing the IO.”
The results of the study were:
- Total inventory was reduced by 37.7%, with an average tray size reduction of 18%
- Total reprocessing time savings of 1,333 hours annually and labor costs of $39,995 annually
- Depreciation cost savings totaled $64,320 annually
- Case cancellation rates resulting from instrument-related errors decreased from 3.9% to 0.2%
- Staff completely satisfied with inventory improved from 1.7% preoptimization to 80% postoptimization
“This was the first study to show the success of applying KCM to facilitate change in the perioperative setting with respect to surgical inventory,” the study authors concluded.
“We have outlined the important organizational obstacles faced when making changes to surgical inventory. The same KCM protocol can be followed for optimization processes for disposable versus reusable surgical device purchasing or perioperative scheduling.”
The article’s accompanying editorial, by James Farrelly, MD, MHS, credited the timely study as proving “that not only can surgical staff enlist the proper buy-in and dedication needed to increase perioperative efficiency, they also are capable of organizing a standardized change process to implement the improvements in a manner that is reproducible and relatively predictable.”
Read the study.
The thoughts and opinions expressed in this column are solely those of Dr. Jacobs and do not necessarily reflect those of The Joint Commission or the American College of Surgeons.
*Toor J, Jin Tong D, Koyle M, Abbas A, et al. Inventory optimization in the perioperative care department using Kotter’s Change Model. Jt Comm J Qual Patient Saf. 48(1):5-11.