Dartmouth Hitchcock realizes 600k in annual cost savings with instrument reduction program
In May, Practice Greenhealth awarded Dartmouth-Hitchcock Medical Center (DHMC) the national "Greening the OR" award, recognizing them as the number one hospital in the U.S. for the team's work in reducing annual case-cart instrument kits, resulting in a net savings of almost $1.5 million.
In addition, for the second year in a row, Dartmouth-Hitchcock (D-H) was awarded Practice Greenhealth's "Top 25 Environmental Excellence" award, putting us in the top tier of hospitals leading the industry with innovation in sustainability.
"As a member of the D-H team, I'm very proud to see us get this award. I'm proud that we are in the top 25 this year, and then to be named number one – it's pretty amazing," Daniel Herrick, the Master Black belt sponsor of this project, says. "The project is a perfect example of all the work that was done in the OR with the surgeons, nurses, surgical techs and the people in the central sterile area. That's where all the work was done on the grassroots level. We should all be proud and share in this outstanding achievement."
Using data-driven industrial processes—in this case the Rapid Process Improvement Workshop (RPIW) methodology—D-H is doing more than cutting costs: it is training a new group of cross-disciplinary leadership teams who will propel health care into a new era of accountability and better patient care.
Overall, the team was able to reduce annual supplies purchases by $858,759, remove 485,489 instruments/91,753 pounds of instruments from the processing cycle, saving an estimated $606,861 annually, which resulted in the net savings of almost $1.5 million.
Reducing supply purchases and improving the processing cycle, this 18-month project, which wrapped in February of this year, found wide variances in prices for individual instruments that performed the same function, and which surgeons in OB-GYN and general surgery were returning about a third of unused surgical trays to Surgical Services.
Herrick says that project managers Heather Hardy and Alicia Titzmann, both Greenbelts, working with a team of surgical techs and nurses, set up review sessions with surgeons, laying out instruments used in the OR and facilitated discussions about the variations in the instruments and supplies used during surgery.
"We would talk about why there was variation, and we identified instruments that were no longer used so that we could pull them out and no longer order them," Herrick says. "For implementation, the project managers coordinated with the OR nursing team to change the preference cards for the providers and then with the central sterile team to re-organize the instruments. This coordination and communication was integral to the success of this work."
Herrick says that from a process improvement standpoint, when you can identify and reduce variation, "many things improve."