Lean and Green Hand Office-Based Hand Surgery: Does it Work?

Introduction: United States healthcare spending continues to increase every year with projected spending of $5.3 trillion for 2025. This spending represents 19.6% of the GDP. The United States also leads the world in waste production with the healthcare industry being the second largest producer of waste nationally. Implementing new strategies and techniques in the operating room can help reduce the cost and waste produced. Adopting a more Lean and Green approach to hand surgery can help to reduce waste and costs without compromising patient safety and satisfaction.

Methods: A retrospective chart review of one surgeon's office-based cases was done. 437 cases performed over a 12-month period were reviewed. Study items included: infections, secondary procedures, patient satisfaction, and cost and waste savings seen with Lean and Green surgical packs. The patients were asked the following questions: how does the procedure compare to a dental visit, would you recommend to a friend or family member, and would you do office-based surgery again?

Results: The superficial infection rate was 3.9% with no deep infections. The secondary procedure rate was 0.2% Using Lean and Green surgical packs, there were cost savings of $4,650 and a decrease in waste of 2,211 lbs (1.1 tons). Patient satisfaction with the procedure was high: 99% of patients rated the surgical experience as the same or better than visiting the dentist, 99% would recommend to a friend or family member, and 99% would do office-based surgery again.

Conclusion: Wide-Awake local anesthesia office-based hand surgery is safe, cost effective with high patient satisfaction. By adding Lean and Green surgical packs, we saw both cost savings and a decrease in garbage associated with those cases. The combination of Lean and Green surgery with Wide-Awake office surgery is effective and will continue to be important in the future of healthcare delivery.