Repacking Items: A Look at the Difference Between Supply Cost and the Cost of Time/Labor.
By Todd Hillman
The potential to reduce cost in a simulation or skills lab of any health care discipline is often critical or highly desired. In my lab, it was something frequently talked about, but never acted on for a variety of reasons. In my experience, I determined it usually came down to a lack of knowledge and time.
Here are a few things I have learned that allowed me to start re-packing at my center.
Disclaimer: I am not promoting any specific brand or company. This is what I have found and used.
The very first reason I looked at re-packing items was from a cost perspective. I want the learners to have the most realistic experience they can, regardless of it being a skill or an SE. When the learner is using an item that would be sterile in the hospital (or any other medical setting). Making the experience as realistic as possible is incredibly important, but not always a possibility because of the budget. As a public state university, I am restricted to our state contracts, requiring most items to be purchased from a small selection of vendors. This can be both detrimental and beneficial, making some things very affordable and others more expensive.
Currently, we use two different types of packaging to re-pack supplies. The first is an Instrument Sterilization Dust Cover Pouch from Medline. The pouches are available in several sizes. These work well and can be used to hold sterilized equipment if you can sterilize it. These tend to be slightly more expensive because they are intended for sterile supplies. Typically they are better for larger items rather than smaller, but will still work. The second type is utilizing a thermal sealer paired with 2.0 mil poly tubing. This system is more expensive for the initial setup, but the price per package is significantly less. Our setup utilizes a 12-inch sealer from Uline with several different sizes of tubing rolls. Also, we insert our own custom "not sterile - not for patient use" labels in with the items we re-pack.
Here are some differences in our cost for a couple of items we re-pack: Purchasing a standard sterile 10 mL Normal Saline filled syringe can be between .26 cents and $1.00. A prefilled 10 mL "packaged as sterile" distilled water syringe is usually $1.00. Our cost to re-pack as a "sterile" syringe filled with distilled water is .0012 cents; if the syringe cap needs replaced it is .2412 cents. The pricing does not factor in time/labor. My university produces distilled water for the biology department; this allows me to obtain it at no cost. Another item is a Foley catheter kit. We use kits that are non-sterile - not for human use, but are packaged as sterile, this type of kit lowers our cost as we don't need sterile supplies. Our students use a new kit to learn and practice the skill on task trainers. The students also get a new kit when they perform their skill check off. The first kit is given to the students as they often check out task trainers and practice on their own time, we don't require the kits to be returned, but most students do. We work with faculty during the skill check off so we can reclaim the kit without it being damaged. Our price from the vendor is $8.78 per kit. These are the items that get replaced: extended cuff exam gloves (I've found this makes the glove easier for students to put on after it's folded into the sterile sleeve), alcohol swab sticks (to avoid Betadine contact with task trainers), lubricant, the fenestrated drape, the towel that is wrapped around the outside of the kit, and refill the pre-filled syringe. The contents of the kit are cleaned and wiped down with PDI disinfectant wipes before we re-pack them. These supplies are $1.20 per kit.
Now I will address time and labor. I think it's common that simulation centers don't have available staff to manage to repack supplies, or it is simply easier to order new. The wage of an employee directly influences the cost of repacking; this could be a reason that would deter a center from repacking. Repacking supplies is a relatively new process at my facility, so far we determined it takes roughly 4.5 hours of labor to re-pack 36 Foley catheter kits correctly. As our staff gains experience, we should become more efficient. My price to purchase 36 kits from a vendor is $316.08, my price for 36 re-packed kits is $43.20 before labor is considered. The amount of money we save by utilizing and reusing supplies can be very significant, but it is at the expense of valuable time. We are fortunate enough to have career path interns and student employees that are not paid from our simulation/skills lab budget. These student employees have a wage of $9 per hour. If we did pay their salary from our budget, it would make the cost $82 for the 36 kits. I gave these examples because it provides an idea of the money that can be saved by taking advantage of used supplies. These savings might allow a center to purchase new equipment, hire a dedicated supply employee, etc.
I know everywhere is a little different with supplies and inventory. For those that already repack supplies, awesome, I imagine I could learn a lot from you. For those that have not thought about repacking supplies, or did not know where to start, I hope this information is helpful. I know that our center is going to be expanding and refining our repacking process.