[Development of a cost-satisfaction indicator for monitoring implantable medical devices on loan and in permanent storage]

The implantable medical devices (IMDs) in the operating rooms of our hospital are managed through permanent deposits. Recently, a shift in supplier practices seems to limit the opening of permanent deposits in favor of iterative loans. Their increasing number appears to complicate the flow of IMDs. The aim of this study was to estimate the costs associated with these circuits while considering the satisfaction of the key stakeholders involved. The flows of deposits and loans in the orthopedic operating room were analyzed retrospectively over the course of a year. In parallel, a prospective assessment was made of the hours dedicated to managing both permanent and temporary deposits by the preparers and operating room managers. A satisfaction survey was conducted for all stakeholders: preparers, managers, pharmacists, surgeons, nurses, and suppliers. The cost per unit of IMD managed through permanent deposit is €1.89, compared to €2.66 for loans. The overall satisfaction for deposit management is 81%, compared to 55% for the same implant managed through loans (P<0.001). Furthermore, an implant in loan proves to be 68% more expensive for the hospital when the unit cost is weighted by satisfaction (€4.84 vs. €2.33). Managing IMDs through loans is thus more costly for the hospital. This difference becomes even more pronounced when professional satisfaction is factored into all the roles involved in the IMD flows. This study focuses specifically on aspects of IMD management on the ground (renewals, labeling, expired items, and returns). No similar studies were found in literature. The reliance on loans is increasingly burdensome for stakeholders, generating stress and sometimes demotivating work due to a lack of recognition.