背景:在急诊科(ED),有预先组装的扁桃体出血托盘,用于治疗扁桃体切除术后出血和扁桃体周围脓肿。使用后,托盘被送到医疗器械再处理(MDR)部门进行净化,灭菌,和重组,所有这些都给医院和环境带来了巨大的成本。
目的:该项目的目标是在1年内将扁桃体出血盘上不必要的器械减少30%,并报告相关成本和二氧化碳(CO2)排放量的节省。
方法:这个质量改进项目是根据医疗保健改进研究所的改进模型制定的。对ED和耳鼻咽喉头颈外科工作人员和居民进行了调查,以确定扁桃体出血托盘上的哪些仪器被定期使用。根据结果,开发了一个新的托盘,并使用MDR数据和现有的CO2排放计算与旧托盘进行了比较。
结果:托盘优化导致每年每个托盘的总成本从1092.63美元降低到330.21美元,将每个托盘的处理时间从12分钟减少到6-8分钟,新旧托盘的二氧化碳排放量从每年6.11千克减少到2.85千克,分别。总的来说,新的托盘包含一半数量的仪器,组装需要一半的时间,减少50%的二氧化碳排放量,并将在10年内为医院节省约10万美元。
结论:医疗成本和环境可持续性是集体责任。手术和手术托盘的优化是一个简单的,有效,和可扩展的生态行动形式。
BACKGROUND: In the emergency department (ED), there are pre-assembled tonsillar hemorrhage trays for management of post-tonsillectomy hemorrhage and peritonsillar abscess. After use, the tray is sent to the medical device reprocessing (MDR) department for decontamination, sterilization, and re-organization, all at a significant cost to the hospital and environment.
OBJECTIVE: The goal of this project was to reduce unnecessary instruments on the tonsil hemorrhage tray by 30% by 1 year and report on the associated cost and carbon dioxide (CO2) emissions savings.
METHODS: This quality improvement project was framed according to the Institute for Healthcare Improvement\'s Model for Improvement. ED and Otolaryngology-Head & Neck Surgery staff and residents were surveyed to determine which instruments on the tonsil hemorrhage trays were used regularly. Based on results, a new tray was developed and compared to the old tray using MDR data and existing CO2 emissions calculations.
RESULTS: Tray optimization resulted in a total cost reduction from $1092.63 to $330.21 per tray per year, decreased processing time from 12 to 6-8 minutes per tray, and decreased CO2 emissions from 6.11 to 2.85 kg per year for the old versus new tray, respectively. Overall, the new tray contains half the number of instruments, takes half the time to assemble, produces 50% less CO2 emissions, and will save the hospital approximately $100,000 over 10 years.
CONCLUSIONS: Healthcare costs and environmental sustainability are collective responsibilities. Surgical and procedure tray optimization is a simple, effective, and scalable form of eco-action.