OasisLMS

This systematic review evaluates the use of time-driven activity-based costing (TDABC) and related costing approaches to identify opportunities for improving cost efficiency in plastic surgery. Across 17 studies, operating room time, staffing, and postoperative care emerged as major cost drivers, with potential savings identified through shorter operative and ICU utilization, enhanced recovery pathways, task reallocation, virtual care, and improved workflow design. TDABC provides detailed information about resource utilization that can support cost transparency and inform strategies for improving efficiency, with clinical outcomes and care quality evaluated alongside costs. However, implementation requires detailed data collection, staff engagement, appropriate infrastructure, and integration with electronic health records, while the predominance of academic and resource-intensive reconstructive settings in the existing literature limits generalizability to other plastic surgery practices.

Intended Audience

This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.

Learning Objectives

After viewing this course, the participant should be able to:

1. Describe the principles of time-driven activity-based costing and how it differs from traditional healthcare costing approaches.
2. Identify major cost drivers in plastic surgery, including operating room time, staffing, and postoperative care.
3. Evaluate strategies for improving cost efficiency through workflow optimization, task reallocation, and postoperative care redesign.
4. Explain how time-driven activity-based costing can support bundled payment models and value-based care in plastic surgery.
5. Recognize current limitations, implementation barriers, and opportunities for expanding time-driven activity-based costing in plastic surgery.

Emily L. Isch, MD; Gabrielle Kozlowski, BS; D. Mitchell Self, MD; Theodore E. Habarth-Morales, BS, 1LT, USAR; Sydney Somers, BS; Ahilan Sivaganesan, MD; David Kim, MD; Heather McMahon, MD; Andrew Newman, MD; Matthew Jenkins, MD

Editor-in-Chief

Jeffrey E. Janis, MD

Co-editors

Amanda Gosman, MD, FACS

Albert Losken, MD, FACS

Business editor

Edward M. Reece, MD, MS

Heather McMahon, MD

Emily L. Isch, MD

• Systems-based Practice
• Medical Knowledge
• Practice-based Learning and Improvement

Accreditation

The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation

The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMA PRA Category 1 Credit™: 1.0

Media: Journal Article

Release Date: 9/20/2026

Expiration Date: 9/20/2029*

Estimated time to complete this course: 1 hour

*Course access ends on course expiration date

Disclosure Policy

The American Society of Plastic Surgeons (ASPS) requires all instructors, planners, reviewers, managers and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. ASPS also requires faculty/authors to disclose when off-label/unapproved uses of product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable.

The following planners and faculty members have no relevant financial relationships or affiliations to disclose:

Gabrielle Kozlowski, BS

D. Mitchell Self, MD

Theodore E. Habarth-Morales, BS, 1LT, USAR

Sydney Somers, BS

Ahilan Sivaganesan, MD

David Kim, MD

Andrew Newman, MD

Matthew Jenkins, MD

Emily L. Isch, MD

Heather McMahon, MD

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Directly provided by the American Society of Plastic Surgeons® (ASPS®)

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-in to reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.