Surgical Case Carts Categories of Supplies
Surgical Case Cart items Always used: items that will be used with a high degree of
probability for use on the particular case, i.e. drapes, prep kit, anesthesia tubing, gowns, basic instrument set, are usually very predictable.
Routine Surgical Case Cart supplies: required in varying quantities by virtually all cases.
For example, the number of lap sponges, 4x4’s, needles, and sutures often vary from case to case of the same procedure.
Surgical Case Cart Specialty items: that might be needed for that particular case. For
example, arterial grafts, orthopedic implants, and intraocular lenses are items for which the surgeon generally cannot specify exactly which item will be used prior to the case. There are also instruments or supplies that might be needed only if the case turns out to be more complicated than expected, i.e. an arthroscopic procedure which turns out to require an open incision.
Surgical Case Cart “supply categorizing is a critical step towards optimizing your results.
This categorization of materials may seem ‘simple-minded’ but hospitals frequently have difficulty optimizing inventory levels and minimizing handling costs because they are not dealing with [handling] supplies differently. There is a high probability that each category requires a different supply mechanism.
Example of how Surgical Case Cart categories might be applied.
Surgical Case Cart items Always used: Case Carts would be used for those items that can be
predicted accurately.
Routine Surgical Case Cart supplies: Stocked in a Cart in OR rooms for routine items used in
varying quantities. This Cart would be restocked daily.
Surgical Case Cart Specialty items: Stocked in OR on “Specialty” cart for items that might be
used for procedures in a particular specialty.
Items that just might be used are stocked on the Surgical Case Cart.
This results in the return [on the Case Carts] of many items that were not used.
This results in significant double handling of items picked for the case and then restocked.
The same excessive double handling results when the routine items are stocked on the Case Carts in quantities sufficient to meet the needs of most cases. Stocking at this level means that on many cases, not all of the routine items will be used.
Appropriate Surgical Case Cart stocking is a delicate balance. It can only be achieved with careful planning and good information. For example, an item should generally not be stocked on a Surgical Case Cart unless it is used for at least 50% of cases. ( a facility must Qualify this % )
A good information system would track the usage of each item on the Surgical Case Carts for each
procedure type so that the percentage of times each item is used could be determined.
With proper planning, a Surgical Case Cart usage rate of about 90% can be achieved for items
stocked on case Surgical Case Carts. Good backup systems must be in place to supply the items not
stocked on Surgical Case Carts.
Surgical Case Carts Categories of Supplies
Surgical Case Carts Phased-in Implementation Plan
If possible, find a way to begin the surgical case cart implementation slowly.
Set up an implementation task force must include both the CS and the OR.
Prepare “Functional Program” [flow chart with functions].
Select a Specialty Service to Begin the the surgical case cart implementation.
Review and optimimize the Surgeon Preference Cards for that Specialty Service
Develop a list of items to be placed in Surgical Case Carts by CS for that Specialty Service.
Enter the Surgeon Preference Cards in Computer for that Specialty Service.
Order the initial inventory of necessary Surgical Case Cart supplies for that Specialty Service.
Train CS Staff.
Evaluate the need for a ‘Surgical Case Cart System specialist’.
During the initial phase provide a Backup Surgical Case Cart for that Specialty Service.
Implement deployment of the Surgical Case Carts for that Specialty Service.
Evaluate the Surgical Case Cart inventory levels and methods of operation.
Repeat for Other Services.
Surgical Case Carts Phased-in Implementation Plan
Surgical Case Cart Implementation:
Surgical Case Carts will Impact your Management Staff.
Surgical Case Cart Stock Level Agreement.
There will be two primary differences of opinion driving how the Surgery and Central Supply Management Staff will implement and manage the Surgical Case Cart System: may want anything that could possibly be used on the Surgical Case Cart, may want only the items that will be used on the Surgical Case Cart.The Surgery and Central Supply Management Staff must reach a common understanding and goal for WHAT supplies will be delivered by the Surgical Case Carts.
Surgical Case Cart Re-handling.
Items picked for the Surgical Case Cart that are not used must be re-handled to return to stock it.Returning items to stock expends as much labor cost as picking the item originally. Minimizing the re-handling of stock items can deliver a significant reduction in labor costs.
Surgical Case Cart ‘unofficial’ Supply Level Increases. The OR Staff will frequently find ways to increase the levels of supply based on the demands of the Surgeons. This is particularly true with the level of Instruments in Instrument Sets and the number of Specialty Instrument Sets. Supply levels tend to increase easier than they will decrease. OR’s are generally not well organized to manage supply inventories and the management of the inventories is typically not within the primary skill set of the OR Staff. The OR-CS Management Team should have efficient methods to monitor actual usage levels with which they will be able to establish and maintain optimal inventory levels. There should be no reason to ‘double-check’the Surgical Case Cart.
When the Surgical Case Cart arrives in the OR the OR personnel may not trust that Central
Processing has picked the Surgical Case Cart inventory properly. This will result in double-checking after the Surgical Case Cart arrives in the OR. If double-checking occurs, methods should be developed and implemented to reduce this behavior. Double checking is costly and can significantly reduce the cost savings available from a Surgical Case Cart System.
Surgical Case Carts will Impact your Management Staff.