Not every hospital executive has insight into everything that happens in their ORs, but what transpires there can often make or break a hospital's reputation and bottom line.
A retained surgical sponge, which happens approximately 27 times each week* in the U.S., for example, not only results in negative press coverage and extra scrutiny from regulatory bodies due to compromised patient safety, it also often comes with legal defense costs, malpractice settlements, reimbursement loss and state penalties.8 The lack of awareness around highly effective technology and processes that can help prevent these “never events” is causing providers to risk both patient safety and financial savings.
In a recent survey of 291 healthcare professionals conducted by Modern Healthcare Custom Media, more than half of the respondents believe a retained surgical sponge incident happens as often as once in every 200 procedures,3 and 44 percent acknowledge they have experienced an event in their organization in the past three years.3 Yet, 55 percent stated they were unsure how much these incidents cost their organization.3
It is estimated that a retained surgical sponge event can cost an institution more than $450,000,12 due to legal defense, settlements and reimbursement losses. This does not include the cost of using OR time and X-ray to rule out the presence of retained surgical sponges, which is estimated to be $219,056 annually.13 Interestingly, 49 percent of survey respondents were unsure how much their organization spends on X-ray annually to detect a possible retained surgical item.3
The most popular method being used for retained surgical sponge prevention is pre- and post-procedure counting of instruments and sponges.3 Fifty-seven percent of survey respondents report using X-ray, as well.3 Additionally, 31 percent of those surveyed combine using pre- and post-surgical counting and X-rays as a fail-safe,3 which has significant flaws:
- It's not always possible. In emergent events from gunshot wounds to heart attacks, there is rarely time or opportunity to stop and get an accurate count.18
- Humans make mistakes. Someone can count wrong. A miscount occurs once in every 64 procedures.14 For a hospital with a 10,000-surgery volume annually, that leads to 52 hours of wasted OR time reconciling miscounts.15 Human error leads to additional protocols, typically X-ray.
- Using X-ray to detect RSIs is effective only 67 percent of the time.16 Oftentimes it's not just that the X-ray doesn't pick it up, it's that the radiologist isn't aware of what may have been retained.
RF technology is far more accurate—at 100 percent sensitivity and specificity17—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 body scanner to allow for quick, effective resolution of miscounts,8 saving hours of wasted time, possible second surgeries and a host of other negative consequences related to a retained sponge event.8 The annual cost of implementing retained surgical sponge RF technology is about $191,352, far outweighing the costs of a retained surgical item event.8
“Hospital administrators and executives are currently investing in technologies that are not 100 percent effective, which still leaves them vulnerable to a very common event that can have a disastrous impact on an organization,” said Dr. Lawrence Lottenberg, Director of Trauma Research and Education at St. Mary's Medical Center in West Palm Beach, Fla.19 “Retained surgical items, particularly retained sponges, actually happen often and proactive measures must be taken in order to save patient lives, while relieving unnecessary financial burdens on organizations and the healthcare industry as a whole.”
There is also a disconnect around provider executives' perceptions of preventing these adverse events. In the survey, 85 percent said they consider their organizations to proactively approach adverse events through prevention and processes,3 with 12 percent saying their organizations are reactive.3 Yet, only 16 percent are using RF detection technology.3
RF technology comes at a crucial time, as payers are capping and bundling payments, requiring providers to take on the financial risk for clinical outcomes. A technology that is proven 100% sensitive and specific for detection of retained surgical sponges should undoubtedly be considered.
For more information on Medtronic Situate™ and these survey results, visit