Purpose: To create a protocol for providing real-time operating room (OR) cost feedback to surgeons. We hypothesize that this protocol will reduce costs in a responsible way without sacrificing quality of care.
Methods: All OR costs were obtained and recorded for robot-assisted partial nephrectomy and laparoscopic donor nephrectomy. Before the beginning of this project, costs pertaining to the 20 most recent cases were analyzed. Items were identified from previous cases as modifiable for replacement or omission. Timely feedback of total OR costs and cost of each item used was provided to the surgeon after each case, and costs were analyzed.
Results: A cost analysis of the robot-assisted partial nephrectomy before the washout period indicates expenditures of 5243.04percase.Tenrecommendedmodifiableitemswerefoundtohaveanaveragepercasecostof1229.33 representing 23.4% of the total cost. A postwashout period cost analysis found the total OR cost decreased by 899.67(17.23530.05 with 457.54attributedtomodifiableitems.Afterthewashoutperiod,modifiableitemscostswerereducedby289.73 (8.0%). No complications occurred in the donor nephrectomy cases while one postoperative complication occurred in the partial nephrectomy group.
Conclusion: Providing surgeons with feedback related to OR costs may lead to a change in surgeon behavior and decreased overall costs. Further studies are needed to show equivalence in patient outcomes