Surgical Cost Awareness Program: Impact of a Novel, Real-Time Cost Awareness Intervention on Operating Room Expense in Thoracoscopic Lobectomy

INTRODUCTION: For surgical patients, operating room expense is a significant driver of overall hospitalization cost. Surgical teams often lack awareness of the cost associated with surgical supplies, which may lead to unnecessary expenditure. The purpose of this study was to evaluate whether a surgical cost awareness program (SCUP) would reduce operating room cost. METHODS: The Surgical IQ software displays the type and cost of disposable instruments used in real time during operation and generates postoperative cost reports. A prospective pre-post controlled trial of thoracoscopic lobectomy procedures performed by 7 surgeons at a single academic center was conducted. Control and intervention groups consisted of consecutive cases from February 2, 2021, to June 23, 2021, and from June 28, 2021, to December 22, 2021, respectively. The primary outcome was mean per case surgical disposables cost. RESULTS: A total of 322 thoracoscopic lobectomies were evaluated throughout the study period (control: n = 164; intervention: n = 158). Baseline patient and tumor characteristics were comparable between groups. Mean disposables cost per case was $3,320.73 ±,$814.83 in the control group compared with $2,567.64 ± $594.59 in the intervention group, representing a mean cost reduction of $753.08 (95% CI, $622.29 to $883.87; p < 0.001). All surgeons experienced a reduction in disposables cost after the intervention. Intraoperative and postoperative outcomes did not differ between the cohorts (Table). Table. - Cost Use Measures and Surgical Outcomes Variable Control group (N = 164) Intervention group (N = 158) p Value Disposables cost (CAD$), mean (SD) 3,320.73 (±814.83) 2,567.64 (±594.59) <0.001 Operative time (minutes), mean (SD) 112 (±45) 114 (±44) 0.704 Conversion from thoracoscopy to thoracotomy, n (%) 7 (4.3%) 5 (3.2%) 0.819 Transfusion <24 hours after operation, n (%) 8 (4.9%) 4 (2.5%) 0.414 Reoperation, n (%) 6 (3.7%) 4 (2.5%) 0.794 Chest tube duration (days), median (IQR) 4 (3-6) 3 (2-6) 0.348 Hospital length of stay (days), median (IQR) 5 (3-7) 4 (3-6) 0.537 Postoperative complication, n (%) 47 (28.7%) 41 (25.6%) 0.540 Readmission <60 days after operation, n (%) 13 (7.9%) 6 (3.8%) 0.621 CONCLUSION: Providing real-time educational feedback to surgical teams significantly reduced cost associated with surgical supplies without compromising surgical outcomes for lobectomy. Integrating the novel Surgical IQ software across other procedural settings may generate data insight with the potential for significant cost savings.