An Efficiency Model for Decreasing Operative Room Turnover Time for Total Joint Arthroplasties

Objectives: Despite an increased demand for total joint arthroplasty (TJA), rising health-care costs and bundling of payments by payers have shifted the focus to improving operating room (OR) efficiency. This study aimed to assess the efficacy of an efficiency model that optimized instrument trays o n decreasing OR turnover time (TOT) and the benefits made possible by this improved efficiency.Methods: All primary TJA procedures performed by a single fellowship-trained surgeon from January ۲۰۲۲ to August ۲۰۲۳ were reviewed. The surgeon partnered with Zimmer Biomet to condense the total knee and total hip arthroplasty instrument trays from seven to three trays each. Patient in OR time and patient out of OR times were collected and used to calculate TOT. Mean TOTs pre-efficiency model implementation (January – October ۲۰۲۲) and post-efficiency model implementation (March – August ۲۰۲۳) were compared. Annual cost savings were calculated based on an average cost per one minute of OR time of ۴۷.۹۹ and an average cost for the Sterile Processing Department (SPD) to process a single TJA tray of ۷۹.۴۱.Results: Following implementation of the efficiency model, the average OR TOT significantly decreased by ۱۹ minutes (P < ۰.۰۰۰۱), a greater than ۴۴% reduction in TOT. At this surgeon’s current case volume, conservatively estimated at ۲۸۰ primary TJA cases per year, annual savings in OR and SPD processing costs were ۱۶۹,۵۹۷ and ۸۸,۹۳۹, respectively. Moreover, this led to increased case volume per operative day.Conclusion: A small-scale intervention such as optimizing instrument trays for TJA is a valuable and sustainable solution to improve efficiency in the OR by decreasing OR TOT, thereby generating considerable cost-savings and opportunity to increase surgical volume. Level of evidence: III

کلیدواژه ها:

Efficiency ، instrument tray ، Total hip arthroplasty ، Total knee arthroplasty ، turnover time