OBJECTIVES: To estimate the provider budget impact of using a pre-sterilized, single-use Distal Radius Sterile Kit (DRSK) versus re-usable instruments for wrist fracture surgery.

METHODS: An Excel-based budget impact model was developed to estimate the cost consequence from the perspective of the provider of using DRSK. A comprehensive literature review was performed to understand various components of resource utilization and costs for a wrist fracture surgery and to estimate various input elements. Moreover, an ethnography study was performed at three hospitals and one ambulatory surgery center to observe timing, procedure steps, and incidence of delays associated with preparing and sterilizing distal radius instrument trays. Qualitative interviews with staff were also conducted to identify the root causes of these delays. Labor costs from each facility were evaluated to calculate the economic impact of procedure delays. The average values across all sites were used as default values in the model. The model calculates the budget impact of DRSK compared to re-usable instruments on a per procedure or annum basis.

RESULTS: Average labor times of 55 and 14 minutes were observed for the sterilization and surgical scrub technicians per procedure, respectively. Non-sterilization labor time was an average of 13 minutes. Average autoclave time for sterilization was 251 minutes. Procedure delays occurred at an average frequency of 5.67%. and lasted 2.95 hours. Common delays included late delivery of surgical trays, returning trays due to instrumentation issues (e.g. compromised sterility), waiting for new set to arrive and missing instruments. DRSK was estimated to save on average $406 per procedure. The estimated savings per procedure increased as the frequency or length of procedural delay increased.

CONCLUSIONS: DRSK may result in substantial cost savings to various types of providers.