Rationalization of Orthopaedic Surgical Instrument Trays: Three Years' Experience of a Practical Approach to Cut Down Unnecessary Costs.

Background This study aimed to rationalize the surgical instrument trays (SITs) used in some trauma and orthopedic (T&O) procedures to reduce unnecessary costs. Methods SITs for several T&O procedures at our trust were assessed to judge the utility of each instrument. SITs for hip, knee, and shoulder arthroscopy, dynamic hip screw (DHS), rotator cuff repair, shoulder stabilization, total shoulder arthroplasty (TSR), and proximal humerus fracture fixation were reviewed. Infrequently used and irrelevant instruments were removed to minimize the number of used trays for each procedure. A qualitative survey was conducted following SIT rationalization to assess the practicality and suitability of these changes. Results The number of SITs was rationalized from four to two for DHS, three to one for hip, knee, and shoulder arthroscopy, five to two for rotator cuff repair and shoulder stabilization, three to one for TSR, and proximal humerus fracture fixation. Based on the local database figures for these procedures, the estimated number of used trays reduced from 2,785 to 1.015 (36.4%) trays per year. Based on the sterilization cost of £35 per tray, annual savings amounted to about £61,950. Qualitative analysis of theatre staff feedback showed increased time efficiency and a positive feeling of practicality. Conclusion The critical appraisal of the departmental operating practice is an effective tool to achieve cost-efficient practice. The rationalization of SITs for orthopedic procedures can result in significant savings by reducing sterilization costs alone.