Projecting Cost Containment in the Operating Room Utilizing Incentivized Strategies to Reduce Healthcare Cost

Introduction: Streamlining healthcare in United States is of paramount concern while maintaining standards of quality and safety. Incentivizing change may be even more effective in driving such measures. At Nationwide Children's Hospital, we incentivize cost savings directly to the healthcare team member. In this project, we evaluated a simple substitution of a buretrol for Y-type tubing based on weight rather than age cutoffs. Methods: This was deemed a quality improvement project and therefore exempt from Institutional Review Board approval. We obtained costs of Y-type tubing versus buretrols. We interrogated the electronic medical record to quantify case volume in the main operating room according to age and weight. We calculated our costs to compare our current practice of using buretrol fo age <= 12 years and the planned practice of using buretrol for weight < 20 kg. Results: We identified 28,875 children ages 0-12 (60% weight <20kg) and 6,301 children ages 13-18 (0.1% weight <20kg) undergoing procedures in the main operating rooms over a 1-year period.. A unit cost savings of $4.40 substituting Y-type tubing for a buretrol was determined. Transitioning from age-based to weight-based criteria for buretrol use was determined to potentially save $51,260 over the period reviewed. Conclusions: Simple changes can impact efficiency and cost in healthcare. It is important to consider incentivizing such measures to help drive these changes. In the future, with more incentivized measures, hopefully we can successfully make an impact of efficiency and cost of healthcare in United States without compromising safety or quality.