Process Mapping as a Key Tool in Identifying Waste in Dermatologic Procedures to Improve Cost-Effectiveness and Sustainability: An Interventional Case Study.

Background: Dermatologic procedures use many consumable items, resulting in significant financial and environmental costs.

Objective: To demonstrate process mapping's utility in identifying and reducing consumable waste generated during dermatologic excisions.

Materials and methods: Process mapping was used to identify and quantify consumable wastes generated by 20 excisions at a dermatologic surgery clinic. The results were discussed among researchers, clinical support staff, and clinicians to develop waste mitigation interventions. 20 additional excisions were mapped after implementation of these interventions to quantify reduction of consumable waste and associated financial savings.

Results: Preintervention, the average total cost of consumables per excision was $48.02. The average cost of wasted consumables was $21.69 (45%). Process mapping identified unused items, such as cotton-tipped applicators, and partially used items, including iodine, lidocaine, and gauze. Interdisciplinary discussion of results revealed limitations to waste mitigation such as standard packaging sizes, existing supply chains, hospital and state policies, and workflow efficiency tradeoffs. Waste mitigation strategies included removal of unused products (e.g., cotton-tipped applicators and extra blades), alternative formulations (e.g., betadine swab vs bottles), and smaller packaging sizes. Postintervention, the waste cost per case decreased by 16.9% to $18.01.

Conclusion: Process mapping is an effective tool to identify consumable waste in dermatologic surgeries and results in significant cost savings.