title: Comparing surgical trays with redundant instruments with trays with reduced instruments: a cost analysis.
abstract: BACKGROUND
  When prearranged standard surgical trays contain instruments that are repeatedly unused, the redundancy can result in unnecessary health care costs. Our objective was to estimate potential savings by performing an economic evaluation comparing the cost of surgical trays with redundant instruments with surgical trays with reduced instruments ("reduced trays").
  
  
  METHODS
  We performed a cost-analysis from the hospital perspective over a 1-year period. Using a mathematical model, we compared the direct costs of trays containing redundant instruments to reduced trays for 5 otolaryngology procedures. We incorporated data from several sources including local hospital data on surgical volume, the number of instruments on redundant and reduced trays, wages of personnel and time required to pack instruments. From the literature, we incorporated instrument depreciation costs and the time required to decontaminate an instrument. We performed 1-way sensitivity analyses on all variables, including surgical volume. Costs were estimated in 2013 Canadian dollars.
  
  
  RESULTS
  The cost of redundant trays was $21 806 and the cost of reduced trays was $8803, for a 1-year cost saving of $13 003. In sensitivity analyses, cost savings ranged from $3262 to $21 395, based on the surgical volume at the institution. Variation in surgical volume resulted in a wider range of estimates, with a minimum of $3253 for low-volume to a maximum of $52 012 for high-volume institutions.
  
  
  CONCLUSIONS
  Our study suggests moderate savings may be achieved by reducing surgical tray redundancy and, if applied to other surgical specialties, may result in savings to Canadian health care systems.
authors.affiliation: Department of Anesthesia and Perioperative Medicine (John-Baptiste, Martin); Department of Epidemiology and Biostatistics (John-Baptiste, Martin); Department of Otolaryngology-Head and Neck Surgery (Sowerby, Rotenberg), Interfaculty Program in Public Health (JOhn-Baptiste), Schulich School of Medicine and Dentistry, Western University; and Center for Medical Evidence, Decision Integrity, Clinical Impact (John-Baptiste, Martin), University of Toronto (Chin), Mount Sinai Hospital, Toronto, Ont.
authors.forename: A
authors.initials: A
authors.lastname: John-Baptiste
authors.affiliation: Department of Anesthesia and Perioperative Medicine (John-Baptiste, Martin); Department of Epidemiology and Biostatistics (John-Baptiste, Martin); Department of Otolaryngology-Head and Neck Surgery (Sowerby, Rotenberg), Interfaculty Program in Public Health (JOhn-Baptiste), Schulich School of Medicine and Dentistry, Western University; and Center for Medical Evidence, Decision Integrity, Clinical Impact (John-Baptiste, Martin), University of Toronto (Chin), Mount Sinai Hospital, Toronto, Ont.
authors.forename: L J
authors.initials: LJ
authors.lastname: Sowerby
authors.affiliation: Department of Anesthesia and Perioperative Medicine (John-Baptiste, Martin); Department of Epidemiology and Biostatistics (John-Baptiste, Martin); Department of Otolaryngology-Head and Neck Surgery (Sowerby, Rotenberg), Interfaculty Program in Public Health (JOhn-Baptiste), Schulich School of Medicine and Dentistry, Western University; and Center for Medical Evidence, Decision Integrity, Clinical Impact (John-Baptiste, Martin), University of Toronto (Chin), Mount Sinai Hospital, Toronto, Ont.
authors.forename: C J
authors.initials: CJ
authors.lastname: Chin
authors.affiliation: Department of Anesthesia and Perioperative Medicine (John-Baptiste, Martin); Department of Epidemiology and Biostatistics (John-Baptiste, Martin); Department of Otolaryngology-Head and Neck Surgery (Sowerby, Rotenberg), Interfaculty Program in Public Health (JOhn-Baptiste), Schulich School of Medicine and Dentistry, Western University; and Center for Medical Evidence, Decision Integrity, Clinical Impact (John-Baptiste, Martin), University of Toronto (Chin), Mount Sinai Hospital, Toronto, Ont.
authors.forename: J
authors.initials: J
authors.lastname: Martin
authors.affiliation: Department of Anesthesia and Perioperative Medicine (John-Baptiste, Martin); Department of Epidemiology and Biostatistics (John-Baptiste, Martin); Department of Otolaryngology-Head and Neck Surgery (Sowerby, Rotenberg), Interfaculty Program in Public Health (JOhn-Baptiste), Schulich School of Medicine and Dentistry, Western University; and Center for Medical Evidence, Decision Integrity, Clinical Impact (John-Baptiste, Martin), University of Toronto (Chin), Mount Sinai Hospital, Toronto, Ont.
authors.forename: B W
authors.initials: BW
authors.lastname: Rotenberg