The SLIM Study: Economic, Energy, and Waste Savings Through Lowering of Instrumentation Mass in Total Hip Arthroplasty

Description

In this presentation, Andrew Adamczyk, an adult reconstruction fellow at the University of Ottawa, discusses the SLIM Study, focusing on the increasing rates of total hip arthroplasty surgeries and the associated costs and waste. With over 60,000 procedures performed annually in Canada, the Ottawa Hospital alone conducts around 700 surgeries a year, predominantly using the direct anterior approach. The rising demand brings forth concerns about escalating waste production and energy consumption, necessitating a more efficient methodology.



The presentation emphasizes the application of lean methodology, originally developed by Toyota, to optimize resources, improve patient care, and enhance operational efficiency within the hospital setting. Adamczyk describes the process of conducting a prospective, multi-surgeon, randomized controlled trial comparing standard procedures against the newly designed SLIM setup. Observation points were established, including patient characteristics, energy and economic costs, and waste measures related to surgical setups.



Survey results indicated dissatisfaction among nursing staff regarding the current surgical setup's inefficiency and environmental footprint. The standard setup was found to incur a processing cost of approximately $37.60 per instrument pan, which comprised multiple components leading to significant waste. In contrast, the SLIM setup reduced the number of main instrument pans from eight to two and demonstrated a considerable decrease in associated waste and energy consumption.



While surgical time and patient outcomes such as blood loss were unaffected, the SLIM method revealed a notable reduction in processing costs and energy demands per operation cycle. The presentation concludes that adopting the SLIM setup not only enhances efficiency but also aligns with contemporary environmental sustainability standards, suggesting potential widespread application of such assessments across global healthcare systems to improve both economic and ecological aspects of surgical procedures.

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