Surgical Instrument Tray Optimization Process at a University Hospital: A Comprehensive Overview

Authors

Rubak P., Christensen A-E., Granlie M., Bundgaard K.

Original article

Surgery Open Science 21 (2024): 60-65.

https://doi.org/10.1016/j.sopen.2024.09.007

Introduction

Healthcare costs are rising worldwide, with operating rooms (ORs) representing a significant expense due to extensive use of surgical instruments and supplies. At Aarhus University Hospital, Denmark’s largest university hospital, a hospital-wide initiative was launched to address inefficiencies caused by overloaded surgical instrument trays - many containing unused or worn instruments.

Aim

The study aimed to streamline open-surgery instrument management by:

• Reducing the number of instruments and tray types
• Consolidating or separating trays according to surgical needs
• Introducing modular trays for specific procedures
• Standardizing commonly used instruments across specialties

Summary of Methods and Key Findings

Using an interdisciplinary workshop approach,1,340 instrument trays across 74 ORs and 12 specialties were evaluated. Redundant instruments were removed, trays were merged or split, and specialty-specific modules were created.

• Tray types fell from 258 to 215 (17% reduction, p = 0.01)
• Average instruments per tray decreased from 30 to 24 (18% reduction, p = 0.0002)
• Total instruments dropped from 43,073 to 36,687 (16% reduction, p < 0.0001)

Specialties showed variable results: plastic surgery achieved a 42% instrument reduction per tray, while obstetrics and gynecology cut tray types by 33%.

Conclusions

This structured optimization reduced surgical instrument complexity and total instrument counts, potentially lowering costs, improving OR efficiency, and enhancing patient safety. The authors recommend total instrument count as a more meaningful metric than instruments per tray and call for further research on effects in central sterile processing and overall OR scheduling.