There is an unwritten pecking order in most CS departments when it comes to surgical trays. Facility owned trays and instruments are usually tracked and cared for as if they were made of gold (and at some of their replacement prices, it would seem that many of them are!). Loaner equipment is usually handled begrudgingly, with a growing awareness that effectively managing loaners is critical to surgical readiness. Perhaps lowest on the totem pole is consignment trays, which are rarely tracked and rarely talked about…. until there is a problem!

This article provides three best practices in managing the often overlooked area of consignment inventory management.

  1. Ensure all consignment trays are covered under a hospital contract. This sounds pretty simple. After all, what would a consignment tray be doing at a hospital if it wasn’t supposed to be there? In practice, non-contracted consignment inventory can accumulate for a variety of reasons. The way to meet this best practice is to have a process to check-in every consignment tray that is brought in. That way, managers will always know that 100% of the consignment inventory is approved for use at the facility. And, this prevents your department from becoming a rep’s warehouse for trays that won’t be used at your facility.


  1. Optimize consignment inventory levels. Too little surgical inventory can lead to ‘hair-on-fire’ scrambles to prepare surgical carts or even canceled/rescheduled cases. Too much inventory on hand takes up precious shelf and floor space and adds to the complexity of CS department operations. The key is to work with vendors and your hospital supply chain to make sure inventory levels are ‘just right’ for each piece of consigned equipment. With a check-in procedure in place (above), a check-out process needs to also be established to account for items taken out of the hospital by reps. With these two steps, appropriate inventory levels can be constantly monitored for optimal levels.


  1. Treat completed consignment trays as your own. Just as with owned and loaned trays, consignment trays need to be regularly inspected. If any tray shows signs of physical distress, signs of contamination or evidence of mishandling (stacking), the tray needs to be reprocessed. In addition to keeping these trays compliant with your facilities’ infection prevention guidelines for event related sterility, consignment trays that have been unused for an extended period should be evaluated for need. After all, if your facility hasn’t used a tray in 6-12 months, chances are that the tray should not be kept on-site.

While the various types of equipment (owned, loaned, consigned) can get confusing, it is critical that all trays are handled in a way that not only ensures patient safety, but also contributes to CS operational effectiveness.