HA 695 Unit 8 leadership presentation example

$1.62 Million a Year, Opened and Thrown Away: A Leadership Presentation on Cutting Operating Room Supply Waste by a Third

Student Name

Health Care Administration, Herzing University

HA 695: Graduate Capstone Project

Instructor Name

March 5, 2026

Slide 1: $182 a Case, Opened and Never Used

October audit, 120 cases: $182 of disposables opened and discarded unused per case.

8,900 cases a year: about $1.62 million.

11.8% of everything we spend on disposables.

Speaker notes: Last October two of our nurse educators stood in our operating rooms for a month and wrote down each disposable item as it was opened, then checked at the end of the case which ones nobody touched. The answer was $182 a case thrown away unused. Across a year, that is about one point six million dollars. I want to be clear from the start: this is not carelessness. Our staff open what the card tells them to open, for good reasons, and the rest of this talk is about fixing the cards and the rules, not blaming people.

Slide 2: The Recommendation and the Ask

Reduce waste by one-third, to $121 a case, within six months.

Cost: $15,415 once, $22,572 a year. Expected net saving about $520,000 a year at full effect.

The ask: approve the costs, sponsor three information systems requests, and co-sign a message to surgeons.

Speaker notes: Here is what I am asking for, before any detail, so you can listen to the rest with the decision in mind. The program costs about fifteen thousand dollars to start and twenty-two and a half thousand a year to run. At full effect it should save about half a million dollars a year. I need three things from you: approval of those costs, your name on three requests that would otherwise wait in the information systems queue, and a letter, signed with the surgery chair, asking surgeons to sit down and review their cards.

Slide 3: The Baseline and the Gap

One bar chart: current waste per case, $182, beside the target, $121.

The gap, $61 per case, labeled beneath: about $543,000 a year.

Source line: October 2025 observation audit; target from published results.

Speaker notes: This is the only chart I will ask you to remember. The left bar is where we are, one hundred eighty-two dollars a case. The right bar is where the evidence says we can realistically get, one hundred twenty-one. The difference is sixty-one dollars a case, about five hundred forty-three thousand a year. The target is not a guess. In published studies, standardizing a preference card cut supply cost per case by about a fifth (Avansino et al., 2013), and monthly cost feedback to surgeons cut supply spending by about a tenth (Zygourakis et al., 2017).

Slide 4: Where the Waste Is

Orthopedics and spine: 62% of the waste.

Twelve surgeons: 61%.

Fifteen items: 58% of the dollars.

Speaker notes: The good news is that the waste is concentrated. Two services produce most of it. Twelve surgeons produce most of that. And fifteen expensive items, things like hemostatic agents and single-use energy handpieces, make up most of the dollars. That means we do not need to change every card in the hospital. We need about eighty good conversations and one short list of items.

Slide 5: What We Will Do, in Order

Months 1 to 3: review 80 cards with 12 surgeons; remove 214 inactive cards.

Month 3: costs shown on cards; private monthly scorecards to surgeons.

Month 4: 15 high-cost items held unopened until requested, tested in two rooms.

Month 5: extend the hold list only if no item took over two minutes to reach the field.

Speaker notes: The order matters. We start with the card reviews because they carry almost no risk and deliver savings fast. Only after that do we add cost information and the hold list. The hold list is the part staff worry about, because nobody wants to be the person who could not produce an item when the surgeon needed it. So we test it in two rooms first, time every retrieval, and exclude anything needed instantly in an emergency.

Slide 6: Cost, by Category

One-time, $15,415: card reviews and revisions $6,640; hold bins $2,700; training $2,475; cost display and scorecards $3,600.

Recurring, $22,572 a year: supply analyst time $17,472; annual card review $2,900; quarterly audits $2,200.

Net saving: about $288,000 in year one, about $520,000 a year after.

Speaker notes: These are the same categories as the business case you have received. The largest recurring cost is a part-time supply analyst to produce the scorecards and maintain the hold list. Year one saves less because the later stages start in month four. You will see the savings as smaller supply orders. Where an item is bought through a group purchasing contract, we buy fewer of them, though each one costs the same.

Slide 7: How You Will Know, and When We Stop

Months 3, 6 and 12: the October audit repeated exactly.

Every held-item retrieval timed; supply delays and safety events tracked monthly.

Rules set now: stop the hold list for any retrieval over two minutes when a patient needs the item; at month 6, adopt at $121 or less, adapt up to $150, scale back above $150.

Speaker notes: You will get a two-page report at three, six and twelve months. The rules for what happens next are written now, before any results, so nobody can move the goalposts later, including me. If the hold list ever slows care for a patient, it stops that day for that item. If at six months we have not reached a hundred fifty dollars a case, we keep the card cleanup and drop the rest.

Slide 8: The Ask, Again

Approve $15,415 one-time and $22,572 recurring.

Sponsor the three information systems requests.

Co-sign the invitation to orthopedic and spine surgeons with the chair of surgery.

Speaker notes: To close, the same three things. If you approve today, card reviews can start in two weeks and the first report reaches you in June. Thank you. I have a few reserve slides for the questions I expect.

Reserve Slide A: Why Not Card Cleanup Alone?

Card cleanup alone: about $288,000 a year.

Full program: about $520,000 a year, for under $20,000 more in recurring cost.

The sequence lets us stop at cleanup if the hold list is not safe.

Speaker notes: Card cleanup alone is a reasonable option and scored close in the comparison. It saves roughly half as much. The full program adds about two hundred thirty thousand a year in savings for under twenty thousand in extra cost, and because it is sequenced, choosing it does not commit us to the hold list if the test shows problems.

Reserve Slide B: What If Surgeons Do Not Take Part?

Scorecards are private and compare each surgeon with their own baseline.

The chair of surgery reviewed and supports the approach.

Most surgeons do not see supply costs today; showing them is the point.

Speaker notes: Surgeons here are mostly not our employees, so participation is voluntary. The chair of surgery reviewed the plan, and we removed an earlier idea of ranking surgeons publicly after he objected. Surveys have found that surgeons estimate the cost of common devices correctly only about a fifth of the time, even though most say cost should matter (Okike et al., 2014). Giving them their own numbers is how we expect to earn participation.

References

Avansino, J. R., Goldin, A. B., Risley, R., Waldhausen, J. H. T., & Sawin, R. S. (2013). Standardization of operative equipment reduces cost. Journal of Pediatric Surgery, 48(9), 1843-1849. https://doi.org/10.1016/j.jpedsurg.2012.11.045

Okike, K., O'Toole, R. V., Pollak, A. N., Bishop, J. A., McAndrew, C. M., Mehta, S., Cross, W. W., III, Garrigues, G. E., Harris, M. B., & Lebrun, C. T. (2014). Survey finds few orthopedic surgeons know the costs of the devices they implant. Health Affairs, 33(1), 103-109. https://doi.org/10.1377/hlthaff.2013.0453

Zygourakis, C. C., Valencia, V., Moriates, C., Boscardin, C. K., Catschegn, S., Rajkomar, A., Bozic, K. J., Soo Hoo, K., Goldberg, A. N., Pitts, L., Lawton, M. T., Dudley, R. A., & Gonzales, R. (2017). Association between surgeon scorecard use and operating room costs. JAMA Surgery, 152(3), 284-291. https://doi.org/10.1001/jamasurg.2016.4674