H. Curlin

Physician Engagement in Improving Operative Supply Chain Efficiency Through Review of Surgeon Preference Cards

STUDY OBJECTIVE To reduce operative costs involved in the purchase, packing, and transport of unnecessary supplies by improving the accuracy of surgeon preference cards. STUDY DESIGN Quality improvement study (Canadian Task Force classification II-3). SETTING Gynecologic surgery suite of an academic medical center. PARTICIPANTS Twenty-one specialized and generalist gynecologic surgeons. INTERVENTIONS The preference cards of up to the 5 most frequently performed procedures per surgeon were selected. A total of 81 cards were distributed to 21 surgeons for review. Changes to the cards were communicated to the operating room charge nurse and finalized. MEASUREMENTS AND MAIN RESULTS Fourteen surgeons returned a total of 48 reviewed cards, 39 of which had changes. A total of 109 disposable supplies were removed from these cards, at a total cost savings of

Sacral Schwannoma Mimicking a Myoma Uterus

767.67. The cost per card was reduced by

Predicting Pelvic Pain After Endometrial Ablation: Which Preoperative Patient Characteristics Are Associated?

16 on average for disposables alone. Three reusable instrument trays were also eliminated from the cards, resulting in savings of approximately

The Association between the Diagnosis of Adenomyosis by Pelvic Ultrasound Prior to Endometrial Ablation and the Subsequent Risk of Hysterectomy

925 in processing costs over a 3-month period. Twenty-two items were requested by surgeons to be available on request but were not routinely placed in the room at the start of each case, at a total cost of

Improving Operative Room Costs and Efficiency Through Review of Surgeon Preference Cards

6,293.54. The rate of return of unused instruments to storage decreased after our intervention, from 10.1 to 9.6 instruments per case. CONCLUSIONS Surgeon preference cards serve as the basis for economic decision making regarding the purchase, storing, packing, and transport of operative instruments and supplies. A one-time surgeon review of cards resulted in a decrease in the number of disposable and reusable instruments that must be stocked, transported, counted in the operating room, or returned, potentially translating into cost savings. Surgeon involvement in preference card management may reduce waste and provide ongoing cost savings.

Does the Uterine Cervix Become Abnormally Reinnervated After Subtotal Hysterectomy and What Is the Association With Future Trachelectomy

Retroperitoneal schwannoma. A 47-year-old gravida 2 para 2 woman presented for surgical management of a large multimyoma uterus. Transvaginal ultrasound revealed an 18-cm uterus with a 10-cm pedunculated ligamentous myoma and a 9-cm submucosal myoma (Fig. 1). Preoperative endometrial biopsy was benign. The patient underwent total laparoscopic hysterectomy, bilateral salpingectomy, and cystoscopy. Intraoperative findings were notable for a multimyoma uterus and a firm 10-cm