Evaluating the Impact of Surgeon Preference Card Age on Surgical Waste and Costs

Abstract

Background

Disposal of unused surgical items exacerbates the environmental footprint and costs of hospitals. Surgeon preference cards (SPCs), which specify equipment needed for surgeries, impact inventory control and wasted supplies. This study assessed the effect of SPC age on surgical waste and costs, and examined staff attitudes towards SPC systems.

Methods

A random selection of elective surgeries was observed in four operating theatres (March – October 2023) at a regional public hospital in New South Wales, Australia. Wasted items per procedure and the age of SPCs were recorded. Waste cost calculations were based on hospital records. An online survey measured perioperative nursing staff and surgeon attitudes. Data analysis involved simple linear regression, descriptive and summary statistics.

Results

Data from 35 of 1456 (2.4%) elective surgical procedures showed that 285 single use items were unused (median 2 per procedure, IQR 7). Each year the SPC aged, 1.6 additional items were wasted (95% CI 1.3-1.9, P < 0.01). The total waste from unused single-use items amounted to 22.4 kg (18.7 kg general waste, 1.9 kg sharps waste, and 1.9 kg recycled) and purchase price totalled $3543.07 AUD. Survey respondents (n = 36) expressed mixed opinions about the current SPC system, with concerns about waste, cost, and environmental consequences. They favoured an electronic system for its potential to enhance efficiency and patient safety but noted barriers such as resource constraints and costs.

Conclusion

Updating SPCs is an effective strategy to minimise surgical waste and costs. Hospitals using paper based SPCs should consider transitioning to electronic systems for better sustainability.