Table 2 Layers, categories and criteria in the MEAT VBP Framework applied to surgical gloves

Costs

Product

Purchasing

1. Price of purchasing / renting product / solution

The net price, inclusive of any discounts or rebates, paid for the volume of gloves purchased.

Number of units purchased (n) x Price per unit ($) x Discount (%).

2. Delivery and installation

Any additional costs for delivery or collection of gloves and installing them in place.

Any extra costs charged for delivery.

Any expenses incurred during collection and/or installation.

3. Conversion: staff training for new product

Training and support costs required to convert to a new type of glove.

Any direct vendor training costs.

Indirect costs: Staff wages ($/h) x Training duration (h).

4. Compatibility: upgrades to systems / infrastructure

Costs of any changes to infrastructure or systems.

All costs arising from changes to infrastructure or systems.

Storage

5. Storage room / infrastructure

All costs arising from storing surgical gloves.

Any fee for vendor-managed inventory ($/year).

Storage capacity required (m³) x Cost of storage capacity ($/m³/year).

6. Replacement at end of shelf life

Costs arising from replacing unused gloves at the end of their shelf life.

Number of units unused at end of shelf life (n) x Purchase price ($).

Disposal

7. Disposal / de- commissioning

Costs of disposing of surgical gloves.

Weight of surgical gloves used (kg/year) x Disposal cost ($/kg).

Any extra costs charged for collection, if applicable.

Care delivery

Operating / healthcare delivery

8. Medical staff time using device

Any change gloves cause in the amount of time staff spend delivering healthcare.

Estimated additional or saved time per staff member per procedure (h) x Wages of each staff member ($/h) x Number of procedures (n).

9. Infrastructure usage

Any change gloves cause in the utilisation of fixed assets – eg, operating rooms.

Estimated number of operating room ‘tear downs’ avoided (n) x [Average cost of a contaminated equipment disposed of ($) + Cost of sterilising reusable items ($) + OR overhead costs while idle ($)]

10. Unplanned usage: failure rate

Cost of additional gloves used.

Estimated number of units failing (units / year) x Cost per unit ($).

Patient benefits

1. Reduction of risk of Surgical Site Infection (SSI)

Estimated reduction of the costs, both direct and indirect, of treating Surgical Site Infections (SSIs).

Estimated number of SSIs avoided (n) x Average additional cost incurred to treat a SSI ($).

2. Reduction of risk of allergic or anaphylactic reactions

Estimated reduction of costs, both direct and indirect, of treating allergic or anaphylactic reactions.

Estimated number of allergic or anaphylactic reactions avoided (n) x Average additional cost incurred to treat a reaction ($).

Healthcare professional benefits

3. Reduction of risk of occupational exposure to blood-borne pathogens

Estimated reduction of costs, direct and indirect, arising from occupational exposure to blood-borne pathogens.

Estimated number of occupational exposures avoided (n) x [Average additional cost incurred to treat an exposure ($) + Average cost of associated sick pay ($) + Average cost of associated locum cover ($)].

4. Reduction of risk of allergic or anaphylactic reactions

Estimated reduction of costs, direct and indirect, arising from occupational exposure to latex.

Estimated number of allergic or reactions avoided (n) x [Average cost incurred to treat a reaction ($) + Average cost of associated sick pay ($) + Average cost of associated locum cover ($)].

5. Ease-of-use / handling and functionality

Impact of gloves on surgeon dexterity and tactile sensitivity.

Surgical team satisfaction.

Impact on productivity and/or performance.

Standardised tests.

Healthcare provider and healthcare system benefits

6. Training and access to education

Availability and provision of CPD / CME activities to surgical staff.

Training hours required (h).

Contract compliance rate.

7. Strategic fit for provider and support of strategy

Estimated reduction of costs or increase in revenue achieved by strategic projects in which switching to safer surgical gloves plays a significant role.

Estimated costs saved ($) + estimated additional revenues ($).

8. Reduction of medico-legal claims

Estimated reduction of costs arising from defending and/or settling medical-legal claims.

Estimated number of medico-legal claims avoided (n) x Average amount of settlement or damages and associated legal costs ($).