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Improving perioperative management of surgical sets for trauma surgeries: the 4S approach

BACKGROUND: The perioperative management of the surgical instruments and implants that comprise sets for trauma surgeries has been identified as a complex and resource-intensive activity due to non-standardized inventories, redundant surgical instruments and unnecessary sterilization cycles. The 4S...

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Autores principales: Ribes-Iborra, Julio, Segarra, Borja, Cortés-Tronch, Victor, Quintana, Javier, Galvain, Thibaut, Muehlendyck, Christian, Escalona, Elena, Battaglia, Suzanne, Navarrete-Dualde, Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9615625/
https://www.ncbi.nlm.nih.gov/pubmed/36307812
http://dx.doi.org/10.1186/s12913-022-08671-2
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author Ribes-Iborra, Julio
Segarra, Borja
Cortés-Tronch, Victor
Quintana, Javier
Galvain, Thibaut
Muehlendyck, Christian
Escalona, Elena
Battaglia, Suzanne
Navarrete-Dualde, Jorge
author_facet Ribes-Iborra, Julio
Segarra, Borja
Cortés-Tronch, Victor
Quintana, Javier
Galvain, Thibaut
Muehlendyck, Christian
Escalona, Elena
Battaglia, Suzanne
Navarrete-Dualde, Jorge
author_sort Ribes-Iborra, Julio
collection PubMed
description BACKGROUND: The perioperative management of the surgical instruments and implants that comprise sets for trauma surgeries has been identified as a complex and resource-intensive activity due to non-standardized inventories, redundant surgical instruments and unnecessary sterilization cycles. The 4S Intelligent Trauma Care program aims to improve perioperative management and thereby reduce environmental impact by utilizing standardized inventories, a sterile implant portfolio, a barcode that enables a digital safety certification, and a digitized restocking service. OBJECTIVE: The objective of this study was to investigate the impact of the introduction of the 4S program for the management of surgical sets in open reduction internal fixation (ORIF) trauma surgeries. METHODS: This was a single-center, quality improvement study of ORIF trauma surgeries, comparing the current practice (30 procedures) to the procedure following the introduction of the 4S program (30 procedures). The primary outcome was the proportion of procedures requiring only one sterilization cycle. Secondary outcomes were the number of sterilization cycles per procedure, set processing time across departments, total set processing costs, number of missing or damaged implants, number of cleaning cycles per procedure, time taken to assemble containers for sterilization, number of containers entering the autoclave per procedure, environmental impact, number of baskets entering the cleaning machine per procedure, and staff satisfaction. RESULTS: Introduction of the 4S program resulted in a reduction in the mean number of sterilization cycles required from 2.1 to 1.0 (p < 0.001). In the current practice, only 30.0% of procedure sets were sterilized within one cycle, compared to 100.0% following introduction of the 4S program (p < 0.001). A reduction in the mean set processing time of 24.1% in the OR and 35.3% in the sterilization department was observed. Mean set processing costs for the current practice were €81.23, compared to €50.30 following introduction of the 4S program. Furthermore, following the introduction of the 4S program, procedures were associated with significant reductions in water and electricity usage, and increased staff satisfaction. CONCLUSIONS: This quality improvement study demonstrates the substantial time and cost savings, positive environmental impact and staff satisfaction that could be achieved by streamlining surgical set management through the 4S program. To our knowledge, this is the first study of this type and our findings may be instructive to other hospitals and surgical specialties.
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spelling pubmed-96156252022-10-28 Improving perioperative management of surgical sets for trauma surgeries: the 4S approach Ribes-Iborra, Julio Segarra, Borja Cortés-Tronch, Victor Quintana, Javier Galvain, Thibaut Muehlendyck, Christian Escalona, Elena Battaglia, Suzanne Navarrete-Dualde, Jorge BMC Health Serv Res Research BACKGROUND: The perioperative management of the surgical instruments and implants that comprise sets for trauma surgeries has been identified as a complex and resource-intensive activity due to non-standardized inventories, redundant surgical instruments and unnecessary sterilization cycles. The 4S Intelligent Trauma Care program aims to improve perioperative management and thereby reduce environmental impact by utilizing standardized inventories, a sterile implant portfolio, a barcode that enables a digital safety certification, and a digitized restocking service. OBJECTIVE: The objective of this study was to investigate the impact of the introduction of the 4S program for the management of surgical sets in open reduction internal fixation (ORIF) trauma surgeries. METHODS: This was a single-center, quality improvement study of ORIF trauma surgeries, comparing the current practice (30 procedures) to the procedure following the introduction of the 4S program (30 procedures). The primary outcome was the proportion of procedures requiring only one sterilization cycle. Secondary outcomes were the number of sterilization cycles per procedure, set processing time across departments, total set processing costs, number of missing or damaged implants, number of cleaning cycles per procedure, time taken to assemble containers for sterilization, number of containers entering the autoclave per procedure, environmental impact, number of baskets entering the cleaning machine per procedure, and staff satisfaction. RESULTS: Introduction of the 4S program resulted in a reduction in the mean number of sterilization cycles required from 2.1 to 1.0 (p < 0.001). In the current practice, only 30.0% of procedure sets were sterilized within one cycle, compared to 100.0% following introduction of the 4S program (p < 0.001). A reduction in the mean set processing time of 24.1% in the OR and 35.3% in the sterilization department was observed. Mean set processing costs for the current practice were €81.23, compared to €50.30 following introduction of the 4S program. Furthermore, following the introduction of the 4S program, procedures were associated with significant reductions in water and electricity usage, and increased staff satisfaction. CONCLUSIONS: This quality improvement study demonstrates the substantial time and cost savings, positive environmental impact and staff satisfaction that could be achieved by streamlining surgical set management through the 4S program. To our knowledge, this is the first study of this type and our findings may be instructive to other hospitals and surgical specialties. BioMed Central 2022-10-28 /pmc/articles/PMC9615625/ /pubmed/36307812 http://dx.doi.org/10.1186/s12913-022-08671-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Ribes-Iborra, Julio
Segarra, Borja
Cortés-Tronch, Victor
Quintana, Javier
Galvain, Thibaut
Muehlendyck, Christian
Escalona, Elena
Battaglia, Suzanne
Navarrete-Dualde, Jorge
Improving perioperative management of surgical sets for trauma surgeries: the 4S approach
title Improving perioperative management of surgical sets for trauma surgeries: the 4S approach
title_full Improving perioperative management of surgical sets for trauma surgeries: the 4S approach
title_fullStr Improving perioperative management of surgical sets for trauma surgeries: the 4S approach
title_full_unstemmed Improving perioperative management of surgical sets for trauma surgeries: the 4S approach
title_short Improving perioperative management of surgical sets for trauma surgeries: the 4S approach
title_sort improving perioperative management of surgical sets for trauma surgeries: the 4s approach
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9615625/
https://www.ncbi.nlm.nih.gov/pubmed/36307812
http://dx.doi.org/10.1186/s12913-022-08671-2
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