he'll be replacing the left knee of a 5-foot-2 woman. "Using that informa-
tion, your materials manager can work with your vendor to create 2 cus-
tomized trays that include instrumentation and cutting templates in a
size range suitable for smaller adults and only for the left knee," says Dr.
Berend. "This tweak alone can dramatically cut the number of trays
used in each case, since many standard systems automatically come
with a large range of sizes and instruments used for both the right and
left knee."
Lawrence J. Parrish, MBA, administrator and COO of the Illinois
Sports Medicine and Orthopedic Surgery Center, says his center has
taken a similar approach. When his surgeons started doing outpatient
total joints, the center's leadership looked at the large, generic trays
the docs were using in their hospital cases and worked to streamline
them. "We met with the surgeons and implant reps to go over the tray
lists and refine them, specifically targeting the soft-tissue trays," he
says. "If any specialty trays are needed, they're brought in for that par-
ticular case by the vendor's reps."
By simplifying the system, not only are you making storage and pro-
cessing easier, you're also boosting efficiency for staff and surgeons.
"As a surgeon, these procedures should eventually become routine,"
says Dr. Raab. "You should be able to cut down on the things that are
unnecessary and slowing you down."
Dr. Berend notes that it also means you can take on one-off special
cases. "I recently worked on a case where the patient had a femoral
nail in place. That meant I needed handheld navigation for the proce-
dure, which isn't something that's routinely kept on the shelf at the
surgery center," he explains. "Our materials manager coordinated this
request with our vendor, who was then able to ensure I had the
equipment I needed without placing an additional burden on the cen-
ter's inventory."
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