Inventory in the Operation Theatre (OT) is one of the most crucial parts of a surgical procedure. Without appropriate equipment and inventory like medical supplies, it is impossible to carry out any procedure in the operation room. In fact, the entire surgical procedure is an aggregation and combination of the efficiency of surgeons, their teams and the right inventory in the OT.
From high-tech beds to advanced equipment, there are so many things that make for a well-equipped OT. Even a trivial defect in the equipment, or lack of right devices, could lead to disastrous, sometimes fatal, consequences.
A surgeon is somewhat like a fighter pilot -- for both, a small mistake can lead to a huge penalty, even leading to loss of a life. In the aviation profession, procedural knowledge developed over years is extensively externalised and verbalised into clearly structured instruction manuals, formulated over declarative knowledge, and is based on technical and scientific aeronautical data. Thus, throughout the training, pilots learn to master the knowledge, proceeding from simple to routine to unexpected scenarios. Similarly, the right kind of inventory in the operating room can equip a surgeon and empower him to ensure improved patient outcomes.
Inventory in OT is not a one-time investment, but it needs to be updated regularly to meet the advancing surgical technology and requirements. Major challenges include a diversity of the procedures that are carried out inside an OT and the variety of inventory to meet the wide-ranging requirements, and to ensure their safety and efficacy.
While some specialised operation rooms like cath-labs, where diagnostic and treatment procedures like an angiogram, angiography and angioplasty pertaining to cardiovascular diseases, are carried out, may appear to have a regular set of equipment, they too have their issues. Catching up with evolving technology, not just in terms of the innovations in devices but also the equipment that can support them, is one of the most important challenges that such specialised OTs face.
Similarly, OT specified for an orthopaedic procedure, heart surgeries, cancer surgeries etc., also need to have very precise and updated devices and a set inventory to carry out the highly complicated surgical procedures.
In these cases, a bilateral conversation between the surgeons and the experts designing and evolving the OT inventory help deliver better results. The exchange of knowledge, from the theoretical perspective, at the design level and from the perspective of the surgeon can help overcome the practical challenges linked with inventories in the OT. Physician specifications and experiences while using a certain type of surgical instrument helps bring further improvements in it.
However, at the same time, to control rising healthcare costs, it is also important to have inventory-optimised model, a system which could ensure optimum supply of inventory and a regulated addition of advanced equipment and procedures. While ensuring the precise inventory that is key to the smooth functioning of the surgical procedures, waste could be reduced significantly by improving the planning and coordination of materials and information.
To strike a balance between optimum inventory in the OT and excess, we need to plug the gaps in data analysis, which helps assess the requirements based on past experience and not merely on past practices, like ‘more is better’, or ‘have it just in case’. We also need to have a framework where the doctors could exchange their ideas and requirements with a responsible intermediate body and not directly with the suppliers. This is important to relieve doctors of the unnecessary burdens of decision-making, eliminate preferences, check the cost, and bring in better technologies.
So, having an inventory-optimised model is like ensuring just the right amount and the right kind of inventory in the OT, and at the same time their controlled and continued technological enhancement, that too without burdening the hospital infrastructure unreasonably.
Inventory in the OT being the backbone of the surgical procedure and evolution in surgical technologies indispensable to deliver world-class treatment, it is high time we had systems in place to ensure cost effective and well-equipped OTs across the country.
(The writer is Consultant Cardiologist, AIIMS, New Delhi).