Streamlining variability in hospital charges for standard thyroidectomy: Developing a strategy to decrease waste.
Surgery
; 156(6): 1441-9; discussion 1449, 2014 Dec.
Article
em En
| MEDLINE
| ID: mdl-25456929
ABSTRACT
BACKGROUND:
We assessed the efficiency, consistency, and appropriateness of perioperative processes for standard (total) thyroidectomy and devised a valuable strategy to decrease variability and waste.METHODS:
Our multidisciplinary team evaluated <23-hour stay standard thyroidectomy performed by 3 surgical endocrinologists. We used the nominal group technique, process flowcharts, and root cause analysis to evaluate 6 perioperative processes. Anticipated decreases in costs, charges, and resources from improvements were calculated.RESULTS:
Median total charge for standard thyroidectomy was $27,363 (n = 80; $48,727 variation). Perioperative coordination between surgery and anesthesia clinics could eliminate unnecessary testing (potential decrease in charges of $1,505). Nonoperating room time was less in the outpatient operating room (43 vs 52 minutes; P < .001). Consistent scheduling could decrease charges by $585.49 per case. By decreasing 20% of nondisposable instruments on the surgical tray, we could decrease sterile processing costs by $13.30 per case. Modification of postoperative orders could decrease charges by $643 per patient. Overall, this comprehensive analysis identified an anticipated decrease in cost/charge of >$200,000 annually.CONCLUSION:
Perioperative process analyses revealed wide variability for a single, presumed uniform procedure. Systematic assessment helped to identify opportunities to improve efficiency, decrease unnecessary waste and procedures/instrument usage, and focus on patient-centered, quality care. This multidisciplinary strategy could substantially decrease costs/charges for common operative procedures.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tireoidectomia
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Redução de Custos
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Custos Hospitalares
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Preços Hospitalares
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Assistência Perioperatória
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Prevalence_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article