24 - Lightening the Load: OR Pack Optimization for Less Waste, More Savings

Description: Description of Team
This interdisciplinary project was led by an OR nurse leader in collaboration with perioperative nurses, scrub techs, surgeons specializing in orthopedic hand procedures, and supply chain representatives. The team also partnered with the surgical pack vendor to customize and implement changes.

Preparation and Planning
The team identified excessive waste in OR setups for hand surgeries due to the use of generalized extremity packs. A review of historical supply usage data and direct observations confirmed that many items in these packs were consistently unused. A goal was set to reduce clinical waste and supply cost without compromising patient safety or workflow. Planning involved stakeholder engagement, approval processes, and coordination with the vendor to create a procedure-specific hand pack.

Assessment
The team conducted a baseline assessment by weighing waste generated from existing extremity packs used in hand cases. Cost data were collected based on the value of unused and discarded supplies. The project PICOT question guided the evaluation: In the operating room setup for orthopedic hand surgeries (P), does a new optimized hand pack (I), compared to the standard extremity pack (C), reduce waste and cost (O) over a one-month period (T)?

Implementation
A Plan-Do-Study-Act (PDSA) model guided implementation:
Plan: Identify non-essential items and engage the vendor for pack redesign.
Do: Finalize and roll out the new optimized hand pack after team education and approval.
Study: Measure and compare waste weight and cost pre- and post-intervention.
Act: Integrate the new pack into preference cards for hand procedures and establish annual reviews.

Outcome
Post-implementation data showed a significant reduction in waste weight and cost. Fewer unused items were disposed of, and the T-test revealed statistically significant savings. Staff feedback highlighted improved pack relevance and streamlined workflow. The project achieved its goals without impacting surgical efficiency or outcomes.

Implications for Perioperative Nursing
This project highlights the importance of perioperative nurses in driving sustainable, cost-effective practice improvements. By analyzing actual use patterns and involving end users, OR nurses can drive meaningful changes that reduce environmental impact, improve supply chain efficiency, and enhance intraoperative workflow. The optimized hand pack initiative can serve as a model for similar efforts in other surgical specialties.