By Elizabeth Shoaf, Vizient Consulting Director
As hospitals and health systems work to manage costs while maintaining care quality, surgical tray standardization remains an untapped opportunity for many organizations. Over time, the number of instruments on a surgical tray grows as preferences shift and new surgeons join the team.
The use of some instruments also may be simultaneously declining with these changes. The combination of these factors results in unnecessary costs to purchase, process and manage instruments.
It's important to understand the principles of tray management and how to properly configure them to equip staff with the minimum instruments required to perform the highest number of procedures within a specialty.
Multiple tray standardization initiatives conducted recently by Vizient reveal many ways to evaluate and streamline instruments and provide additional value, including saving staff time preparing and maintaining the trays, reducing sterilization and purchasing expenses, and providing lighter trays that are safer to handle and transport.
Vizient tray management engagements employ a proven methodology to ensure success. The stages in Vizient's process include assessing the current state, designing new trays based on the organization's unique needs, deploying the new trays and continuously sustaining and maintaining the results.
Step 1: Assessment
In the assessment stage, people working together on the project typically explore four considerations, beginning with defining which instruments should be included to ensure consistency in data and decision-making. For example: an instrument "held by the surgeon" at least 50% of the time.
Step 2: Evaluate quantities used
Next, the quantities of each instrument used are evaluated. Observation and data collection are required to document the actual number and name of instruments used in each operation from induction through closure. Team members also must assess and define the trays, instruments, procedures and surgeons they will include in the initiative. The team can then observe surgeons and procedures where a specific tray is listed on a surgeon's preference cards.
Step 3: Determine how many trays to hold in inventory
The team should closely evaluate how many trays of each type should be held in inventory. Utilization records of immediate use, sterilization and projected procedural volumes might indicate the need for a larger quantity of a specific instrument tray.
A multidisciplinary team evaluates all of the information and data to design and deploy the tray standardization initiative, with goals of cost containment and performance improvement.
Step 4: Sustain
While evidence-based innovations are abundant in healthcare, many disseminate slowly or never gain traction. This makes the fourth step, sustain, critically important.
To create sustainable change, Vizient's approach to surgical tray standardization incorporates a multi-disciplinary team, constant innovation and adaptation of tray configurations, a defined timeline and partnerships with key stakeholders.
A diverse and engaged team draws on differing experiences, knowledge and expertise to accomplish a unified goal as it allows for the pursuit of opportunities to maintain long-term outcomes. Engaging stakeholders throughout the process helps ensure success and creates a sense of shared ownership.
About the author
Elizabeth Shoaf, RN, DNP, is an innovative, solutions-driven healthcare professional who blends creativity and practical clinical expertise. She brings more than 20 years of experience in healthcare rooted in clinical practice, having served as a registered nurse transitioning to business operations. Her areas of expertise and professional skills include quality and safety management, throughput improvement and staff development. Prior to joining Vizient, she spent 10 years at Wake Forest Baptist Medical Center.