$45,950 in unused supplies. "We took the preference out of preference
cards," says Mr. Warman. "It's a procedure card." This got other sur-
geons' competitive juices flowing. "They were all jumping on board,
wanting to compete with each other to see who could get the lowest
cost with the best patient outcomes," says Mr. Warman.
They also removed harmonic scalpels from the laparoscopic chole-
cystectomy preference (make that procedure) card and replaced it
with a J-hook. "There's no need to use a harmonic on an elective lap
chole," says Mr. Warman.
2. Conserve water. The staff nurse who came up with a water conser-
vation idea won a gold medal for creativity. It's not uncommon for a
scrub tech or a surgeon to kickplate the water on and let it run for the
2 to 3 minutes they're washing their hands, says Dr. Johnson. Do the
math: 2 to 3 people scrubbing per case, 275 cases per day. That's 3
hours of running water. That's a lot of liters down the drain. Lehigh
replaced the kickplates with sensors at all of its scrub sinks. Across
the network, Dr. Johnson expects to save $728,000 to $950,000 in
water bills.
3. Reserve CHG wipes. Lehigh used to use a $5 pack of CHG wipes
on every patient, but they stopped using them for cases with smaller
incisions. "For a carpal tunnel, do you really need to wipe over their
body?" asks Mr. Warman.
6 4 • 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
"We have a saying: No margin, no mission.
Surgery is a business. Businesses can't flourish
without money. Cash is king in the OR."
— Hope Johnson, DNP, MBA, RN, CNOR, NEA-BC
