The cost of a retained surgical item, commonly called RSI, is significant. The greatest potential cost, of course, is human life. Even when that most unfortunate result doesn't occur, these so-called “never events” — which actually happen 39 times a week in the U.S.1 — cost facilities and patients prolonged care, unnecessary or unreimbursed medical expenses, penalties and lawsuits that often come with large settlements.
For hospitals, health systems and other provider organizations across the country, RSIs are a costly problem, with retained surgical sponges being responsible for 69 percent2 of these incidents. The question is: are the executives leading these organizations fully prepared and taking action to avoid the most common RSI, a retained surgical sponge?
New research indicates the answer is “no.” In a recent survey of 291 healthcare professionals conducted by Modern Healthcare Custom Media, 85 percent of professionals report that their institutions are proactively avoiding these events through prevention and process.3 Yet, merely 16 percent3 use the only clinically proven 100-percent sensitive and specific detection technology—radio frequency (RF detection)—to detect retained surgical sponges, which occur approximately 27 times each week4 in the United States.
Leading the charge to end retained surgical sponge events, Dr. Glenn Ault, Associate Professor of Surgery at the University of Southern California Department of Surgery, has adopted RF technology (Medtronic's Situate™ Detection System) throughout his institution. Over about five years, the technology detected 11 “near missed” sponges that were about to be retained, out of 2,051 procedures.18 According to Dr. Ault, since implementing RF technology, LAC+USC Medical Center has had a 100-percent clear rate of no retained surgical sponges.18
“Current industry-standard protocols are labor intensive while leaving significant opportunity for retained surgical sponges to go undetected,” said Ault.5 “The industry has to do better to keep patients safe, which in turn will lessen provider costs as they reduce the risk for readmissions and additional procedures.”
The most commonly used process is pre- and post-procedure counting, which is ineffective an estimated one time out of every 64 procedures.6 In fact, it is estimated that 88 percent of RSIs occur when sponge counts are identified as correct.7 Basic human error and emergency situations greatly impact the accuracy and ability to count.18
If there is a miscount, most institutions then rely on X-ray technology, which is only effective 67 percent8 of the time in detecting retained sponges. This fact surprised 40 percent of C-suite executives surveyed.3 Surprisingly, 54 percent of respondents falsely believe that X-ray has a 75 percent or greater effective rate in locating a retained surgical sponge.3 Additionally, while only 19 percent of respondents trust X-ray “very much” to locate a retained surgical sponge when a procedure doesn't allow for counting, 57 percent are relying on it.3
The executives surveyed may think counting or X-ray is a proactive process, but these measures are not completely effective.4,6 RF technology offered by Medtronic Situate™ is proven 100% sensitive and specific9 in detecting retained sponges, even in the most special cases and in patients with a high BMI, up to 82.15 It works by using RF-tagged sponges and a scanner to allow for quick, effective resolution of miscounts.8
“In our industry, it's near impossible to actually find a technology that is 100 percent effective so it's a mystery why every institution isn't using it,” continued Ault. “Change of procedure and protocol is difficult for any organization, but the improved patient outcomes and cost savings greatly outweigh any implementation education that is necessary.”
The potential savings are significant. The annual cost of retained surgical sponge prevention technology is about $191,35210 compared to less effective methods of prevention that cost more than $450,00011, not considering the costs of X-ray use and OR time.
Indeed, the cost and quality outcomes of RF technology are impressive. But the most valuable part of a technology like this is more accurate prevention of adverse events, which may make for safer and healthier patient experiences.
For more information on Medtronic Situate™ and these survey results, visit medtronicsolutions.medtronic.com/situate.