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Hospital Play #1 – Reducing Disposables Waste in the OR

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    June 13, 2018

    Our research and experience in the OR at more than 18 institutions shows that a surgical team’s knowledge of the procedure performed is one of the most robust predictors of waste and inefficiency in the operating room. [3] The informational gap is a huge problem – it accounts for billions of dollars of waste each year and requires serious attention, particularly in the estimated $2B annual opportunity of opened-but-unused disposable supplies in the United States.[2] We specifically designed ExplORer to address this informational gap and inform surgical teams on what supplies are needed, which should be opened and ready (and when), and which should be held in reserve.

    With a cloud-based digital workflow system like ExplORer, teamwork can be enhanced by motivating nurses, techs, and surgeons to focus maximizing surgical efficiency together.  This collaboration happens three ways:

    1. First, in hospitals, greater procedural knowledge (particularly of surgical steps, instruments, and supplies) utilized through steps is required to eliminate unintentionally wasteful behavior. With the help of ExplORer, team members can acquire procedural knowledge before the day of surgery, or if necessary, real-time during a case. Providing this information in an easy-to-use, readily available format eliminates unintentional opening of supplies and distracting departures form the OR to hunt for supplies that team members realize are needed for the procedure once it’s begun.
    2. Second, by mapping detailed instrument utilization based on the surgical procedure  to be performed, ExplORer provides the “lean” context necessary to review instrument and supply needs critically.  This helps to identify procedural variances between surgeons and differences in supplies needed based on the surgeon being supported.
    3. Third, ExplORer can be used during or at the end of procedures to track supply use, identify opened and unused items, determine items that enter the OR that are not on the preference card, and finally, determine items that are used in contingencies.

    The fundamental problem is informational. Surgeons might know what tools they want, but rarely have insight into their preference cards. Nurses know that preference cards are often inaccurate. Knowledge about surgeon preferences and “if-then” scenarios reside in the minds of nurses and techs who have worked extensively with that surgeon, but this information is not easily shared individually or collectively across the OR staff, especially during a procedure. The most troubling factor is the very document that’s supposed to help with these problems, the surgical preference card, is not designed to support surgical teams live in the case.

    In an early study of ExplORer’s digital intraoperative workflow management solution applied in laparoscopic cholecystectomies, disposable waste was reduced by more than 95%. With ExplORer available in the sterile field, the team was able to eliminate the guesswork from room preparation and intraoperative supply management. Circulators and scrub nurses frequently comment: “Having ExplORer in the OR allows me to know exactly what instruments and supplies we will use, and have confidence the room is set up right.”

    Such collaboration is exciting but also reflects the results of a focused team effort.  This effort is sustainable with technological support like ExplORer.

    If you and your colleagues are working to reduce disposable waste in your OR, we’d like to help. To learn more about ExplORer Surgical, and how we might help, please contact us at and visit us online here.

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