• Standardize implants.
Gundersen's orthopods were
using a variety of implants, so
they worked to narrow the
choices in order to qualify for a
reduced rate through a buying
group. "When new surgeons
come on board," says Ms. Wied,
"we tell them that we want them
to use these standards, even if
they hadn't before. There's been
no resistance."
• Examine your supply costs
item by item. Gundersen's sup-
ply costs were pretty low to
begin with, but there was one
outlier: cement costs. They were
using antibiotic cement, which
costs more than antibiotic-free cement. The total joint surgeons weren't
married to antibiotic cement, so Ms. Wied asked the purchasing depart-
ment to find an antibiotic-free cement. "We now add the antibiotic our-
selves," says Ms. Wied, "and that reduced our cost greatly."
• Do you really need to catheterize? Thanks to a push by the surgi-
cal nurses, Gundersen no longer inserts catheters into total joint
arthroplasty (TJA) patients. After reviewing research showing TJAs
don't need catheters post-operatively, nurses did a small study at the
hospital to test that finding. When they confirmed for themselves
what researchers had found, the nurses presented their findings to the
surgeons, who agreed. "That saves us $30 per case in insertion time
and supply costs," says Ms. Wied, "and did away with costs related to
1 0 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 8
• STOP THE BLEEDING Administering intravenous and topical
tranexamic acid is key to achieving "meticulous" hemostasis.
Pamela
Bevelhymer,
RN,
BSN,
CNOR