Annals of surgical oncology · 2026
Implementation of Green Changes Can Result in Shortened Turnover and Decreased Surgical Waste in Breast Cancer Operations.
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Mehta Dhruvi, Robinson Dominique, Komenaka Maya, Welch Jack, Hsu Chiu-Hsieh, Keane Charles A, WintonLi Lisa M, Komenaka Ian K, Davis John
Аннотация
BACKGROUND: The operating room accounts for the bulk of costs and use of resources in healthcare. This study was performed to demonstrate that changes can be easily implemented and result in improved turnover time.
PATIENTS AND METHODS: This study was performed at three hospitals and one ambulatory surgery center (ASC) from 1 January 2025 to 31 December 2025. A total of 300 operations were included in the study; 150 operations at the ASC and 150 operations at the hospitals. All opened disposable items and reusable equipment were documented. The weight of the waste bags and laundry bags were recorded for each case.
RESULTS: The study included 300 operations. In the initial 150 operations, only 18% and 28% of instruments were used at the hospitals and ASCs, respectively. The average weight of the waste produced from hospitals was 14.1-15.7 lbs and 8.03 lbs at ASCs. The cost of the unused items per case were US$183.78 to US$280.58 at hospitals and US$52.35 at ASCs. Following the initial operations, mini-trays with 17 instruments were created at one hospital and ASC. With the downsized trays, the surgeons used 14/18 (78%) of the instruments. The weight of waste produced at the hospital decreased from 14.1 lbs to 11.8 lbs (p < 0.01). The turnover time decreased by 29% (from 36 min to 27 min).
CONCLUSIONS: Trays with fewer instruments can be created quickly at hospitals and ASCs. These changes result in improved turnover time and significantly less waste of valuable resources.
PATIENTS AND METHODS: This study was performed at three hospitals and one ambulatory surgery center (ASC) from 1 January 2025 to 31 December 2025. A total of 300 operations were included in the study; 150 operations at the ASC and 150 operations at the hospitals. All opened disposable items and reusable equipment were documented. The weight of the waste bags and laundry bags were recorded for each case.
RESULTS: The study included 300 operations. In the initial 150 operations, only 18% and 28% of instruments were used at the hospitals and ASCs, respectively. The average weight of the waste produced from hospitals was 14.1-15.7 lbs and 8.03 lbs at ASCs. The cost of the unused items per case were US$183.78 to US$280.58 at hospitals and US$52.35 at ASCs. Following the initial operations, mini-trays with 17 instruments were created at one hospital and ASC. With the downsized trays, the surgeons used 14/18 (78%) of the instruments. The weight of waste produced at the hospital decreased from 14.1 lbs to 11.8 lbs (p < 0.01). The turnover time decreased by 29% (from 36 min to 27 min).
CONCLUSIONS: Trays with fewer instruments can be created quickly at hospitals and ASCs. These changes result in improved turnover time and significantly less waste of valuable resources.