Smart Ways to Save Money

Financial Management

By: Cherokee Gonzalez

Published: 10/7/2020

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Pinching pennies and saving big dollars can add up to significant profits.


Increasing case volumes is the obvious way to infuse your facility with additional revenue. Looking at ways to improve efficiencies, limit waste and make smart purchasing decisions are also important factors that ultimately contribute to running a fiscally sound facility. Your choices surrounding case scheduling, investments in capital equipment and supply buys must always be made with an eye on the bottom line because reducing expenses is another effective way to pad profits.

Time well spent

Filling out your daily surgical schedule based on estimates of how long procedures last instead of actual case times leads to a cascade of problems, including paying staff to stand around in empty ORs waiting for the next case to start.

The first way to address this issue is to realize that case times shouldn't be defined as the time that elapses between when incisions are made and when they're closed. Patients have to be positioned, prepped and anesthetized before surgery and woken up and moved to recovery afterward. If your historic scheduled case times are recorded using start-to-end times, meaning only the length of the procedure itself, I recommend adding at least 10 minutes to that time to reflect the more accurate in-room/out-room time.

Consider investing in a software package to evaluate your historic case time data and use that information to schedule cases based on how long they typically last, not how long you think they last. Take the additional time to break down the data by procedure and long-term averages. Doing so is helpful if surgeons question the recorded case times and point to an extenuating circumstance with a single procedure. Having procedure-grouped data lets you show that a certain procedure routinely takes longer than the time for which it was scheduled, and helps you make the case for adjusting the surgical schedule to improve overall efficiencies. You couldn't make your case nearly as well if you were still scheduling your cases with a written ledger. There's no substitute for being able to present hard data derived from scheduling software to ensure case times are accurate, and staffing and supply resources are properly allocated.

Costly components

FLUID WASTE Collection systems can help prevent slips and falls and potential infections, which are costly to treat and bring expensive workers comp claims with them.

Implants are a big-ticket item. You should always review how much your facility will earn for surgeries involving implants and know exactly how much implants cost to make sure the procedures are cost effective before they're added to your schedule. Negotiating implant carve outs with insurers will help maximize the profits of costly procedures.

It's best to be in consistent communication with implant manufacturers to stay on top of which implants, especially those used in orthopedic cases, are available and how much they cost. That knowledge puts you in good position to share the true cost of expensive implants with surgeons and ask if they could use a less expensive option that is every bit as effective.

Finding out if a more affordable implant option is available before meeting with surgeons is key to making this strategy work. Some surgeons simply aren't aware of how much their implants cost, the other ancillary supplies required to support the implant or the facility reimbursement.

Liquid income

We used to collect fluid waste in lined canisters, added chemicals to solidify the contents and then dropped the liners in bins of red bag waste. The additional weight of the solidified liquid added to the expense of regulated waste disposal, which is often calculated by the pound, so we switched to mobile collection systems that wheel into each OR. Once the procedure is completed, staff push the units to a docking station, which automatically suctions the contents into the sewer system. In-wall disposal units that automatically flush individual fluid collection canisters are also available and take up less space.

Disposable, absorbent floor mats are a cost-effective option for keeping OR floors dry, particularly during orthopedic procedures in which surgeons must stand in a place that mobile collection systems can't reach. The mats also minimize slip-and-fall risks. You'll also devote less staff time to cleaning up fluid from OR floors, a factor that could allow you to fill your schedule with more revenue-producing cases.

Picking and choosing

ALL THINGS CONSIDERED No decision is too small — such as removing unneeded supplies from a procedure pack — if it saves money.

All-in-one supply kits for specific types of surgeries were designed with efficiencies in mind. They include often-used supplies such as syringes, medication labels, surgical sponges, suction tubing and mayo stand covers — and allow you to spend less time preparing for the next day's cases. Procedure packs save significant time and expense because you don't have to collect individual items when pulling supplies for cases and vendors charge less money for pre-packaged supplies. We throw procedure packs for the next day's cases into laundry baskets for easy access during room turnovers.

Inefficiencies and waste creep in, however, when you don't monitor the items included in packs. You must constantly evaluate what contents of packs are used on a consistent basis and what items often get thrown out at the end of procedures. For example, if you typically used two suction tubings in a procedure and now routinely use one, contact the pack's vendor to make the adjustment. Plan ahead if you're going to downsize or change the items included in your packs because it can take vendors six to 12 weeks to implement the change.

Packs shouldn't contain extra "just-in-case" items. Jettisoning those is a really good way to save money. If you need an extra item during a case, you can always pull it from your regular supply inventory, which is much less expensive than throwing out extra items in packs during every procedure. If some surgeons use a cautery pencil and some don't, leave it out of a procedure pack. It often costs less to grab an item a particular surgeon wants than it is to order customized packs based on each surgeon's preference card and procedure. OSM

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