Surgical Tray Set Rationalization at an Elective Surgical Hub in England: Methodology, Feasibility, Implementation and Impact on Financial Costs and Carbon Emissions.

Abstract

We aimed to investigate the impact of rationalizing general surgery surgical tray sets at an elective surgical hub in England. This was an analysis of data collected prospectively for a clinical quality improvement project between 25th March and 20th June 2024. Baseline data on use of surgical instruments for four general surgery procedures were collected, and the items categorized as high, medium and low use. Meetings were then held with surgical and operational teams involved in delivering each procedure and a set of surgical instruments for each procedure agreed upon and a rationalized tray was formed. Data were collected for 39 rectal procedures, 42 open hernia repairs, 15 laparoscopic hernia repairs and 14 laparoscopic cholecystectomies. A tailored rectal procedure tray was formed with 16 items from the original 53 items small basic tray; the two trays used for open hernia repair were rationalized from 53 to 43 items (small basic tray) and 75 to 60 items (large basic tray). The same laparoscopic tray was used for hernia repairs and cholecystectomies and was rationalized from 55 to 45 items. Estimated base-case annual financial savings were £16,863 and carbon savings 42.6 kgCO₂e for these four procedures. Saving of up to £62,648 and 3612.9 kgCO₂e annually may be realized if rationalization avoids opening a second tray to obtain items not present for use on a single tray. Rationalization of surgical trays can reduce financial costs and carbon emissions. It may also yield co-benefits in terms of enhancing theater efficiency.