Picking apart surgical pick lists - Reducing variation to decrease surgical costs

Am J Surg. 2018 Jan;215(1):19-22. doi: 10.1016/j.amjsurg.2017.06.024. Epub 2017 Jun 29.


Background: Average costs associated with common procedures can vary by surgeon without a corresponding variation in outcome or case complexity.

Methods: De-identified cost and equipment utilization data were collected from our hospital for elective laparoscopic cholecystectomy performed by 17 different surgeons over a 6-month period. A group of surgeons used this data to design a standardized equipment pick list that became optional (not mandated) for laparoscopic cholecystectomy. Cost and consumable surgical supply utilization data were collected for six months prior to and following the creation of the standardized pick-list.

Results: 280 elective laparoscopic cholecystectomies were performed during the study interval. In the 6 months after standardized pick list creation, the cost of disposable supplies utilized per case decreased by 32%.

Conclusions: Surgical cost savings can be achieved with standardized procedure pick lists and attention to the cost of consumable surgical supplies.

Keywords: Cholecystectomy; Cost; Quality initiatives; Standardized equipment.

MeSH terms

  • Cholecystectomy, Laparoscopic / economics*
  • Cholecystectomy, Laparoscopic / instrumentation
  • Cholecystectomy, Laparoscopic / standards
  • Cholecystectomy, Laparoscopic / statistics & numerical data
  • Cost Savings / statistics & numerical data*
  • Disposable Equipment / economics*
  • Disposable Equipment / standards
  • Disposable Equipment / statistics & numerical data
  • Elective Surgical Procedures / economics*
  • Elective Surgical Procedures / instrumentation
  • Elective Surgical Procedures / standards
  • Elective Surgical Procedures / statistics & numerical data
  • Guideline Adherence / economics*
  • Guideline Adherence / statistics & numerical data
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / economics*
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data
  • Retrospective Studies
  • Wisconsin