Operating rooms contribute approximately 50% of hospital waste and are more energy-intensive than other hospital areas.
Now, a new study suggests that giving surgeons immediate feedback on the cost of an operation could help to slash healthcare costs.
The research, published in the Journal of the American College of Surgeons, suggests that surgical scorecards, a novel tool designed to provide direct feedback to surgeons about the costs associated with procedures, have emerged as a promising approach to significantly reduce healthcare costs without compromising clinical outcomes.
The study, led by Dr Wesley Dixon, an internal medicine resident physician at Brigham and Women’s Hospital in Boston, Massachusetts, highlights the potential of surgical scorecards in addressing the exorbitant expenses associated with healthcare in the US.
The scorecard is typically delivered to surgeons via an email receipt, report card or informational session.
It summarises the cost of various components involved in surgical procedures, including surgical items, staffing, and the time used.
Surgeons can also compare their costs to those of their colleagues and similar operations.
Dr Dixon said: ‘The reality is that healthcare in the United States is exorbitantly expensive, and despite this increased spending, Americans don’t have better health outcomes than our high-income country neighbours. Our results show that scorecard implementation is one of many different methods that can be used to lower healthcare costs, particularly operating room costs, which comprise a significant proportion of healthcare spending. Different cost-saving interventions can reduce overall US healthcare spending without compromising patient care.’
To arrive at their findings, the researchers conducted a comprehensive scoping review, analysing data from 21 studies published between 2011 and 2022.
These studies spanned eight subspecialties and 30 different procedures. Key cost elements, such as ‘surgical supplies’, ‘implants’, ‘wasted supplies’ and ‘operative time’, were identified and analysed.
The key findings of the study include:
- Of 30 total scorecard interventions measured across the 21 studies, 53% showed surgical procedure cost reductions between 5% and 20%.
- In 11 studies, cost reduction was attributed to the reduced use of specific high-cost items. These savings resulted from using less expensive alternatives or wasting fewer supplies that were opened but unused during the operation.
The most common surgical subspecialties included in the review were orthopaedic and general surgery. Various procedures were analysed, with adult and paediatric laparoscopic appendectomy being the most common.
One significant knowledge gap identified in the study was the need for more research connecting surgical scorecards to environmental or emissions data related to the operating room.
Dr Dixon emphasised that incorporating carbon-related data into data-driven feedback mechanisms could make hospitals more energy-efficient and environmentally friendly.
It’s important to note that a limitation of the study is that a large part of scorecard use nationwide is implemented as part of quality improvement initiatives, and those results are only sometimes published.
As a result, the study’s findings may need to be more representative of the true impact of surgical scorecards.
