Lack of a general knowledge as to the average amounts of supplies necessary for each department for a given time.
Unwise purchasing and ignorant or careless handling.
(Employing people who “do not know how” is also a frequent source of waste.)
First Steps
It has been well said that the first step toward thrift is taking account of the items. A proper system of accounting for the daily supplies sent to each department will go a long way toward checking extravagance. This system of accounting secures facts about the consumption of supplies, that are absolutely necessary for the detection of extravagance or waste, and it should be adhered to as an important part of the work of every department. The surgical department is one which needs special supervision. While perhaps it would not technically come under the head of housekeeping, it often is in charge of the hospital housekeeper, and in considering the sources of waste it cannot be well omitted. In measures for the prevention of waste, the departments of a hospital should be a unit. Only thus can the problem be handled successfully. Referring to the excessive use of surgical supplies, Dr. John W. Brannan, president of the board of trustees of Bellevue and allied hospitals, New York, in an open letter to Charities has said:
Surgical Department
“I wish to lay especial stress upon the possibility of effecting a very material saving in the use of surgical appliances and expensive drugs in all the hospitals. In order to accomplish this it is necessary to have the goodwill and co-operation and constant thought, not only of the superintendent and his staff, but also of the surgeons and physicians, both attending and house. If the visiting physicians and surgeons were to exercise the same consideration in the use of surgical dressings and expensive drugs as they do in their private practice among people of moderate means, and exact the same of the house staff; there would be, in my opinion, a marked reduction in the amount of the supply account.
“The following is an example of what can be done in the way of saving in surgical supplies: The attention of the visiting surgeon of one of the divisions of Bellevue Hospital was called about a month ago to the large consumption of gauze in his wards, some 2,100 yards having been used in the previous week. He at once made an investigation, with the result that the next week the amount of gauze consumed was only 1,100 yards, and during the week following that only 610 yards, although the service continued just as active and the patients were cared for fully as well as before.”
The author of “The Commissariat” stated that in the hospitals of London, where the surgical department is diligently supervised, it has been found possible to effect an annual saving amounting to five pounds for each bed, and that without in any way lowering the standard of nursing or treatment.
Utilizing Hospital Waste