Surgical tray reduction for cost saving in pediatric surgical cases: A qualitative systematic review

Background: Standardization of surgical instrument trays and doctor preference cards (DPC) are known to reduce the cost of adult surgical cases. The practice in pediatric surgery may be more complex owing to a wide range of patient age, leading to difficulty with practice implementation and loss of potential financial savings, which underscore the importance of the review of this topic. Methods: A systematic review of pediatric surgical tray standardization and cost-effectiveness was performed. Original and review articles from 2000 to 2018 were extracted from MEDLINE (via PubMed), Embase, Cinahl, Cochrane, and an electronic search through Scopus. After screening by inclusion and exclusion criteria, articles were selected and reviewed. Results: Five articles were included. On average, discontinuation of disposable instruments and standardization of equipment resulted in a removal of 40%-70% of surgical instruments per set. This yielded a cost savings of 20% (an average US $200), with no intraoperative complications or perceived safety issues. Conclusions: Standardization of operating room (OR) doctor preference cards (DPC) and surgical instrument trays in pediatric surgical cases result in lower operative supply costs without impacting OR time or safety. (c) 2020 Elsevier Inc. All rights reserved.