There’s a book called “The Power of Positive Deviance” that shows how unlikely situations can lead to innovations. The concept is simple - when there is an outlier in a difficult situation who is doing WELL, there is power in knowing why.
At Dallas Children’s we used to give the EMLA cup to the unit using the most EMLA. At the time, more topical anesthetic signified the best care for vascular access pain management. A recent literature review shows now BUZZY is the second most effective venipuncture pain reliever next to Ametop. (EMLA didn’t even make the list, and LMX isn’t FDA cleared for needle procedures so it hasn’t been studied much). It’s also the fastest, working on contact.
The secret is, Buzzy is an order of magnitude LESS EXPENSIVE, too. Buzzy is 0.25/3 minute procedure, or 0.12 for an injection. Since each Buzzy is guaranteed to last through 3 battery changes (but often more), the cost per poke is $0.04.
So if you’re hearing that budgets are tight, ask your pharmacist which wards have the lowest topical anesthetic spend. LMX is bundled so it’s a financial loss for the hospital. EMLA takes an hour so it’s a productivity loss. So which department is winning?
Chances are, the least costly areas are using Buzzy. Often we find Buzzy is taken on by a champion in one department (the “positive deviation” succeeding in spite of the odds), but not another. When Buzzy is used, more patients have pain relief because no one has to wait.
BUDGET HACK
How much per patient could the pharmacy save if the unit switched to Buzzy? Buy half that many Buzzy units for Child Life and nursing there, watch a training video, and see what happens.
