In the past decade, there has been major restructuring of the American health care system. And with that change has come the push for heightened efficiency for providers to remain competitive. Facilities now are faced with the challenge of increasing productivity while reducing costs. Although the demand for surgical services may be growing, the margins are not.
As expenses rise and payment declines, health care organizations are challenged to find innovative ways to improve services cost effectively without compromising quality of care.
A major barrier to profitability is the variance in how supplies are ordered and used. Supply cost reductions through standardizing product use and choices, contract compliance, rebate opportunities, inventory controls and redesigning your physical plant may provide strategies to control cost.
Organizations need to review each case from start to finish, control inventory management by adjusting par levels to needs, standardize products and eliminate obsolescent inventories.
You must carefully evaluate purchase practices that lock you into a long-term commitment. Initially, this provides cost savings but might force you into a higher cost for the long term.
One way to achieve quick cost savings is to review the contents of custom packs. Identify items that are not used regularly and eliminate them. Ask your vendor to help redesign the packs to lower costs. If your business is valued, they will gladly do so.
Individual physicians may prefer custom packs tailored to their needs. However, this is not practical if you have multiple packs that serve the same purpose.
Significant savings can be generated without compromising patient care and outcomes by implementing stricter standardization.
Inventory control is a key component, which presents many opportunities to reduce overstocking, expiration dates and carrying cost. When supplies are scattered throughout the OR and at times hidden from view, an inventory nightmare can occur. Standardizing OR supplies can prevent overstocking.
Controlling OR inventory involves a four-step plan: count the materials, estimate their value, reduce the value and implement controls. Automated inventory management can monitor inventory used, maintain perpetual inventory by tracking on-hand quantities, generate requisitions based on par levels and on-hand quantities, maintain multiple supply locations, track consignments, sustain site designations for supplies, organize pick lists based on inventory locations, provide supply and requisition reports, and interface with bar code readers.
Supplies tend to be kept in scattered locations throughout ORs rather than a central location in part due to limited space. As medicine becomes increasingly dependent on high-tech, complex medical instruments and supplies, the space required to store them continues to grow. Many surgical suites were built years before image-guided systems, case carts, ultrasound units and surgical carts crowded with an array of costly supplies. Although many OR suites have withstood the test of time, they may have no place to grow.
A direct connection to increased savings can be achieved by housing supplies and equipment in a central location. There will be opposition to centralizing supplies and some will argue that specific service line supplies cannot be relocated to a central storage area. This doesn’t have to be a barrier if cases are pulled correctly and you maintain critical specialty supplies close at hand. One area you may want to consider as a storage area is ORs that are no longer suitable for procedures.
If you do not have an available vacant OR to house supplies and equipment, consider bringing in a consultant to suggest space efficiency improvements. If hiring a consultant isn’t an option, approach this project creatively with a mind open to change.
It’s possible to tackle multiple challenges. Implementing inventory controls, centralizing supplies and equipment, and making better use of the space in your existing surgical suite are achievable goals. Each provides an opportunity to control cost and ultimately add significant dollars to your bottom line.
Ruth P. Shumaker, R.N., serves on the AORN national presidential safety commission and is a past president of AORN.
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