With surgical supplies among the highest expenses in the
hospital inventory, accurate instrument tracking becomes key. Lost instruments
can cost a 500-bed hospital an average of over $200,000 per year.
Instrumentation issues are among the ten most frequent causes of O.R. delays.
These delays, due to incorrectly assembled or unavailable instrument sets, cost
an average of $1,000 per hour.
There are an assortment of instrument tracking systems on the
market to solve a variety of problems: tracking the movement of instruments;
measuring which instruments in a set are actually used; measuring usage history
of instruments and flagging them when service is due; automating set assembly to
ensure 100% accurate tray assembly; plus maintaining historical sterilizer load
details.
Instrument tracking may also prove useful in defending
against lawsuits regarding hospital-acquired infections because facilities will
have the documentation in place to trace instruments to specific patient
procedures.
Often systems are designed with flexibility in mind, and can
be used for tracking surgical instruments alone, or for tracking mobile patient
medical equipment.
A common method of tracking involves bar codes on trays and
individual instruments, with items being scanned with handheld, radio frequency
or wireless scanners before each new procedure or movement. For example, items
can be scanned before and after being placed in the washer. Other new technology
involves RFID (Radio Frequency Identification), in which a small tag stores a
unique code together with information that the user may specify. RFID technology
has been shown to have a 5% productivity enhancement over bar coding.
One area where automated instrument tracking can be
particularly helpful is in tray assembly. When the tray is scanned into the prep
area, a "pick list" may be printed, which tells staff members how many
instruments are needed by type of instrument, whether any of the instruments
were missing from the tray before, which items are being repaired and how many
times an instrument has been used since the last repair.
In the sterilization area, the automated system will alert
operators of sterilizing errors, or deviations in the sterilization process. The
system also captures employee data regarding who worked on which trays, and how
long it took him to complete the task. New tracking technologies can alleviate
questions regarding the length of time a tray has been waiting to be cleaned. If
a tray is needed sooner than normal processing would take, a message can be sent
to decontamination personnel regarding the time of the next case. Storage can
also be simplified with the system showing the correct shelf for the item to be
placed.
Reporting capabilities with most systems are abundant, with
literally hundreds of available reports that chronicle nearly every aspect of
instrument usage. There is an integrated tracking/training/testing system which
educates employees and provides unlimited competency testing that can lead to
certification in sterile processing. Such systems can be useful in decreasing
the learning curve of surgical instrument processors by providing training on
tray assembly and other procedures.
While some systems may initially be expensive investments,
often the time to recover costs is minimal in relation to increased productivity
and error reduction. One instrument tracking company boasts a 40% reduction in
instrument replacement costs, plus a 40 to 50% reduction in tray assembly time
with their instrument tracking package. In addition, some systems allow more
accurate billing records and the capture of charges that may have been
previously lost.
The first instrument
makers were armorers, followed by cutlers and silversmiths until finally
surgical instrument making became a profession in the 18th century. The world’s
oldest surgical instrument manufacturer in the world is The Pilling Company,
which had its origins in 1814 with Jacob Stockman in Philadelphia who made and
sold fraternal emblems and jewelry. Stockman’s skills were frequently sought by
surgeons in devising surgical instruments. George Pilling became Stockman’s
apprentice, rose to partnership and now owns Pilling Surgical which is credited
with the first antitoxin syringe and the Bowles stethoscope. 
ns of physicians. During the
industrial revolution, instruments were assembled in mass quantities for sale.
Early in the twentieth century, American surgeons began purchasing most of their
instruments from Europe. When an instrument was damaged or needed sharpening,
the doctor had to either throw it away or ship it back to Europe for repairs,
which could take from a few months to a few years.
Today, there are more than
10,000 hand-held surgical instrument patterns that basically perform one of
seven functions: to cut or incise, to retract, to grasp/hold/occlude, to dilate
or probe, to cannulated or drain, to aspirate/inject/infuse, to suture or ligate.
What follows is a guide to surgical instrument suppliers and the types of
surgical instruments they provide.