From package to practice: standardizing surgical equipment to increase efficiency and access
7 affiliations
- 1WHO Collaboration Center for Emergency, Critical and Operative Care, Program in Global Surgery and Social Change, Harvard Medical School
- 2Department of General Surgery, New York University Langone
- 3WHO Collaboration Center for Emergency, Critical and Operative Care, Program for Global Surgery and Trauma, The George Institute for Global Health
- 4Department of Plastic and Oral Surgery, Boston Children's Hospital
- 5Former WHO Team Lead Medical Devices and In Vitro Diagnostics
- 6Department of Global Public Health, Karolinska Institutet
- 7Department of Surgery, Brigham and Women's Hospital
Abstract
Surgical conditions account for approximately one third of the global burden of disease. In 2025 at least 160 million additional operations per year were needed to meet this need, which is greatest in low- and middle-income countries (LMICs). Standardizing surgical packages is a key step toward improving operating room (OR) efficiency and expanding surgical care delivery across high-, middle-, and low-resource settings. Yet in low-resource settings, surgical equipment procurement often remains fragmented, non-standardized, and driven by facility-level ad-hoc processes rather than procedure-based planning. A universal standard could support high-quality surgical care that is both nationally scalable and internationally consistent. The World Health Organization's (WHO) service package delivery and implementation (SPDI) tool is a viable candidate for such standardization of surgical instrument sets as it already covers nearly all essential surgeries identified by existing normative frameworks, making it a strong foundation for universal surgical package standardization. National implementation of reduced, standardized surgical sets could extend demonstrated single-center efficiency gains by improving OR efficiency and increasing case volume, supporting case reproducibility and more consistent care, and making supply chains more reliable, cost-effective, and environmentally sustainable. Pre-defined packages lend themselves to rapid, cost-effective scale-up of supply chains, while minimized sets can also lower the carbon emissions associated with surgical care. Ministries of health, hospital networks, and practitioners at the facility level may consider the WHO's UHC Compendium as a foundation for expanding access to safe, high-quality surgical care.
Related
- Standardizing Rectal Suction Biopsy Preparation With a Dedicated Equipment Box: A Quality Improvement Project.
- Increase in Surgical Case Mix Index Across a Multi-Hospital System with Structured Limited Surgeon Chart Review
- Do non-steroidal anti-inflammatory medications or opioids increase the risk of nonunion after surgical and nonsurgical treatment of tibial shaft fractures?
- Study protocol for a randomized controlled multinational trial to analyze the effects of an app-based patient education textbook (Ready4OP App) to increase health literacy before major oncologic surgery and its potential effects on surgical outcomes in Slovenia, Spain, and Germany—the APERIO Trial
- A Pragmatic Study of Brief, Low-Effort Implementation Strategies to Increase Reporting of Evidence-Based Practice Use in a Community Mental Health Program Implementing Multiple EBPs
BibTeX
@article{dawood2026from,
title = {{From package to practice: standardizing surgical equipment to increase efficiency and access}},
author = {Nardeen B. Dawood and Priyansh Nathani and Gabriella Y. Hyman and Adriana Velazquez Berumen and Anita Gadgil and Nobhojit Roy and Nakul P. Raykar},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1957552},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1957552/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - From package to practice: standardizing surgical equipment to increase efficiency and access
AU - Nardeen B. Dawood
AU - Priyansh Nathani
AU - Gabriella Y. Hyman
AU - Adriana Velazquez Berumen
AU - Anita Gadgil
AU - Nobhojit Roy
AU - Nakul P. Raykar
PY - 2026
DA - 2026/10/14
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1957552
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1957552/full
AB - Surgical conditions account for approximately one third of the global burden of disease. In 2025 at least 160 million additional operations per year were needed to meet this need, which is greatest in low- and middle-income countries (LMICs). Standardizing surgical packages is a key step toward improving operating room (OR) efficiency and expanding surgical care delivery across high-, middle-, and low-resource settings. Yet in low-resource settings, surgical equipment procurement often remains fragmented, non-standardized, and driven by facility-level ad-hoc processes rather than procedure-based planning. A universal standard could support high-quality surgical care that is both nationally scalable and internationally consistent. The World Health Organization's (WHO) service package delivery and implementation (SPDI) tool is a viable candidate for such standardization of surgical instrument sets as it already covers nearly all essential surgeries identified by existing normative frameworks, making it a strong foundation for universal surgical package standardization. National implementation of reduced, standardized surgical sets could extend demonstrated single-center efficiency gains by improving OR efficiency and increasing case volume, supporting case reproducibility and more consistent care, and making supply chains more reliable, cost-effective, and environmentally sustainable. Pre-defined packages lend themselves to rapid, cost-effective scale-up of supply chains, while minimized sets can also lower the carbon emissions associated with surgical care. Ministries of health, hospital networks, and practitioners at the facility level may consider the WHO's UHC Compendium as a foundation for expanding access to safe, high-quality surgical care.
SN - 2296-2565
ER -