Approaches to the rationalization of surgical instrument trays: scoping review and research agenda

• Published in: BMC health services research Vol. 21; no. 1; pp. 163 - 15
• Main Authors: dos Santos, Bruno Miranda, Fogliatto, Flavio Sanson, Zani, Carolina Melecardi, Peres, Fernanda Araujo Pimentel
• Format: Journal Article
• Language: English
• Published: London BioMed Central 20.02.2021; BioMed Central Ltd; BMC
• Subjects: Cost control; Health Administration; Health care industry; Health Informatics; Health services; Healthcare needs and demand; Humans; Literature reviews; Management; Medicine; Medicine & Public Health; Nursing Research; Processes improvement; Public Health; Rationalization; Research Article; Scoping review; Sterilization; Surgical apparatus & instruments; Surgical equipment and supplies; Surgical Instruments; Surgical tray rationalization; Surgical trays; Brazil; Surgical instruments; Scoping review; Processes improvement; Surgical tray rationalization; Surgical trays
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-021-06142-8

Background Surgical Tray Rationalization (STR) consists of a systematic reduction in the number of surgical instruments to perform specific procedures without compromising patient safety while reducing losses in the sterilization and assembly of trays. STR is one example of initiatives to improve process performance that have been widely reported in industrial settings but only recently have gained popularity in healthcare organizations. Methods We conduct a scoping review of the literature to identify and map available evidence on surgical tray management. Five methodological stages are implemented and reported; they are: identifying research questions, identifying relevant studies, study selection, charting the data, and collating, summarizing and reporting the results. Results We reviewed forty-eight articles on STR, which were grouped according to their main proposed approaches: expert analysis, lean practices, and mathematical programming. We identify the most frequently used techniques within each approach and point to their potential contributions to operational and economic dimensions of STR. We also consolidate our findings, proposing a roadmap to STR with four generic steps (prepare, rationalize, implement, and consolidate) and recommended associated techniques. Conclusions To the best of our knowledge, ours is the first study that reviews and systematizes the existing literature on the subject of STR. Our study closes with the proposition of future research directions, which are presented as nine research questions associated with the four generic steps proposed in the STR roadmap.