Recent studies show that about 30% of U.S. healthcare spending—part of a huge $3.6 trillion yearly healthcare budget—is wasted, mostly during surgeries. One big problem in hospitals is the differences and lack of uniformity in surgeons’ preference cards (PPCs). PPCs are papers or digital files listing the surgical tools and supplies a surgeon wants for specific procedures.
Since each surgeon customizes their cards based on personal habits without much coordination, hospitals end up needing to stock more items. This causes higher costs, longer surgeries, and safety issues for patients.
This article looks at ways hospitals can encourage surgeons to improve PPC planning and cost control. It focuses on involving doctors, setting standard processes, and using new tools like artificial intelligence (AI) and workflow automation.
Operating rooms are important to both the money and medical work of hospitals. They usually make up more than half the hospital’s revenue but also over a quarter of expenses. Research from Michigan State and Rutgers Universities shows that different surgeon PPCs add 5 to 10 extra minutes to each surgery. Though this seems small, over time it adds big costs because of wages, longer anesthesia, and possible surgery problems.
Surgeons often personalize their preference cards based on what they trust. This causes differences and means hospitals must keep many extra items ready. This hurts how well the supply chain works in the operating room.
Anand Nair, a professor in operations and supply chain management, said that healthcare often puts surgeon choices above efforts to make PPCs uniform. This creates a tough situation where trying to standardize faces resistance from surgeons’ habits, leading to last-minute changes and extra costs.
A study called “The Impact of Planning and Communication on Unplanned Costs in Surgical Episodes of Care,” in the Journal of Operations Management, found hospitals could save about $1,800 per surgery by reducing variation in PPCs. Over a year, this could mean about $28 million saved for hospitals that improve planning and communication with surgical teams.
To deal with rising costs, many U.S. healthcare systems use physician incentive programs. These programs aim to improve cost control, care quality, and efficiency. Doctors get paid partly based on how well they meet goals in patient care, safety, operations, and finances. The pay usually has a fixed part for joining committees and a bonus for reaching certain targets.
Baptist Health, a system with nine hospitals, shows how this works. Their Co-Management Physician Incentive program focused on emergency department (ED) efficiency. They looked at things like how many patients left without being seen (LWBS), how fast patients saw a doctor, and sign-up rates. In five months, they cut LWBS by 33%, adding almost $4 million in revenue.
This success came from governance systems that involved doctors across facilities and encouraged teamwork among different departments, reducing usual operational separations.
These incentives get physicians involved in decision-making where they can see how their actions affect hospital results. Jody Prather, Chief Strategy and Marketing Officer at Baptist Health, said involving doctors helps improve patient care and operations faster. While the example focused on the emergency department, similar ideas could work in surgical services, where surgeon-led programs might promote PPC standardization and improvement.
To fix problems caused by different PPCs, hospitals should use clear methods that include surgeons in planning, track unexpected costs, and reward good cost control. Here are some ideas from research and practice for hospital leaders and IT managers:
Surgeons may not always know how their PPC choices affect hospital spending. Hospitals can use systems to show surgeons data about unplanned costs and differences in their PPCs. For example, telling surgeons that last-minute changes lead to longer surgeries or higher supply costs makes them more responsible. Feedback that is easy to understand helps surgeons see the effect of their choices on costs.
Hospitals can create programs that reward surgeons who help standardize PPCs or lower unplanned costs. These might include sharing financial savings with surgeons when supply waste goes down or time is saved. Traditional gainsharing pays doctors based on cost improvements compared to past results, often tied to quality measures. Over time, these incentives can change to meet new goals in value-based care.
Last-minute changes and PPC differences often happen because of poor communication among surgical teams. Better coordination between surgeons, nurses, techs, and purchasing staff can help make pre-surgery planning more accurate. Holding regular meetings with different team members to agree on PPC content can cut down unexpected requests and make sure the right instruments are ready and stocked.
Hospitals do better when surgeons have formal roles in decision-making about supplies. This lets them review and approve standard PPC templates together, instead of each surgeon making their own version. Multi-level governance groups at system, regional, and local levels help align surgeon choices with hospital priorities.
Hospitals should remember that changing PPCs may cause a short rise in unplanned costs. After making about six PPC changes, these costs usually go down as teams learn and workflows improve. Offering continuous education and support for surgeons and staff during this time helps new PPC systems work more smoothly.
New technology like artificial intelligence (AI) and workflow automation offers useful tools for hospitals to improve PPC planning and control costs better. These tools can help reduce the differences and inefficiencies of current manual and separate processes.
AI can study past data about PPCs, surgeries, inventory, and supply use to find patterns and predict the best stock levels. Using machine learning, hospitals can adjust supplies ahead of time. This helps avoid having too many or too few items because of surgeon preferences. These predictions lower unplanned costs by making sure surgeons have what they need before surgery.
Connecting AI with hospital systems allows PPCs to update automatically as surgeon needs and supply stocks change. The system can point out errors or duplicates in surgeon preferences and suggest efficient, standard sets. Surgeons can review and approve these suggestions, helping the team agree on PPC standards.
Workflow automation tools improve communication in surgical teams. Automated alerts and real-time updates about surgery schedules, equipment, and supplies reduce last-minute changes. Messaging linked with AI can warn the team of supply problems before they happen.
AI dashboards keep checking unplanned costs from PPC changes and surgery delays. They give detailed reports for each surgeon and procedure. This information helps hospital leaders and surgical teams change behaviors and focus on cost management.
Hospitals in the U.S. work in a complex mix of fee-for-service and value-based care. They also face growing pressure from payers to control costs without lowering quality. The strategies here fit well by involving surgeons directly instead of only applying top-down supply limits.
Medical leaders and hospital owners play key roles in creating systems that balance surgeon freedom with hospital rules. Because surgical care in the U.S. is very specialized, hospitals with many locations or high surgery volumes benefit from incentive programs made for their groups of surgeons.
IT managers are important for this work. Using technology like AI supply management and automation needs strong links to electronic health records (EHRs), operating room tools, and purchasing software. IT teams working closely with clinicians make sure the tech fits real hospital work and cost goals.
Hospitals that use clear strategies combining doctor incentives, open cost tracking, and technology improvements can lower waste, control operating room costs, and improve patient care. When surgeons take part in PPC planning and cost control, hospitals grow stronger financially and improve quality in a tough healthcare setting.
Hospitals face significant waste in operating room costs, with research indicating they could save an average of $1,800 per surgery by addressing unplanned costs, amounting to nearly $28 million annually.
Physician preference is prioritized over standardization due to surgeons tailoring their preference cards (PPCs) based on personal experiences, leading to variability in inventory and inefficiencies.
Lack of standardization results in multiple PPCs for the same procedure, causing inefficiencies, unplanned costs, and potentially endangering patients due to time lost during searching for supplies.
Unplanned costs can increase surgery duration, raising staffing costs and posing risks to patient safety, particularly due to complications related to anesthesia.
Effective communication among surgical team members facilitates anticipating needs and reduces unplanned costs, highlighting the importance of open dialogue during procedures.
Hospitals are encouraged to implement systems that facilitate tracking unplanned costs, enabling learning opportunities that can enhance planning and operational efficiency.
Hospitals can incentivize surgeons by increasing visibility on unplanned costs, allowing greater control over supplies, and rewarding reductions in these costs.
Initial changes to the PPC may increase unplanned costs, but learning and efficiency improvements occur after multiple revisions, leading to a decline in costs after about six changes.
Operating rooms represent both high revenue sources and significant expenses for hospitals, accounting for over 50% of revenues and more than 25% of expenses.
Hospitals should streamline and standardize processes while actively involving surgeons in system improvements to create effective, collaborative solutions for managing medical supplies.
Simbo is using AI agents to automate all phone related workflows. Connect now to know more.
Schedule AI Agents Demo Now© Since 2019, Simbo AI.
