An estimated 50 million inpatient surgical procedures occur each year in the United States, at a cost of $175 billion. Given these striking numbers and the fact that over 40% of costs of the acute care episodes of surgical patients are related to the resource-intensive operating room, it comes as no surprise that the OR has become a locus of cost-containment initiatives for health systems. As a starting point, systems such as the University of California, San Francisco have experimented with deploying cost-transparency tools and financial incentives in the OR. University of Utah Health has gone one step further by bringing surgeons together to review spending data and develop standardized processes for addressing variation in OR supply costs.
How to Get Surgeons to Make Cost-Effective Decisions Without Jeopardizing Care
The University of Texas MD Anderson Cancer Center successfully employed a variety of “nudges” to get surgeons to consider costs when deciding which operating-room supplies to use. The behavioral economics techniques included a dashboard that showed the costs of the discretionary items (e.g., disposable implants, instruments, sutures) to be used in upcoming procedures; comparisons of the supply costs of each surgeon within individual departments; posters placed in dictation rooms and operating suites that displayed low-cost alternatives for common equipment such as staplers, sutures, and thermal cutting devices; and monthly reports that showed individual surgeons how their average costs compared with those of their peers and the overall department for a given type of procedure.