Last word
Supply standardization is often at or near the top of a materials manager’s priority list. There are several benefits of standardization both financially and clinically, which include:
- Increased efficiency in the storeroom by reducing the SKUs of like items.
- Improved ordering methods by reducing active SKUs in the item master file.
- Increased opportunity for better pricing due to increased volume of a particular manufacturer’s product.
In addition to the financial benefits of standardization, is the reduced variability of supplies within the clinical setting.
By reducing the number of like items in a given supply category, variation in patient outcomes may be decreased. For example, if an organization identifies an increase in urinary tract infections among patients, the greater the variety in types of Foley catheters in use, the greater the challenge is to identify the cause of the catheter-related problems.
There are obvious prime targets for standardization that include sharps safety products, orthopedic implants and personal protective equipment. Sharps safety products are important because of the vast amount of evaluation and education that is required. OSHA requires evaluation and input into the selection of such safety devices by front-line workers. While this process guarantees front-line workers their first choice of products, it also ensures that the evaluation is not done in an administrative vacuum.
Orthopedic implants also tend to be the focus of most hospitals. If efforts in this area are lax, the proliferation of nonstandard implant items is more likely to occur. This can have a negative impact on the operating room staff, the sterile processing staff, financial performance and potentially a patient.
Ideally, a standardized item has been through an analysis. In some instances, it’s the result of simple trial and error. In others, a more in-depth review has been done; but in any event, pragmatic clinical information should guide such decisions. Physician preference items may be a nemesis among procurement options; however, these are very important items in the continuum of quality patient care that our organizations provide.
There will be times when physician preference or specific clinical need requires nonstandard items, therefore, a well managed balancing act between general product standardization and specific clinical effectiveness is crucial. This includes establishing a protocol for using a nonstandard product, managing inventory and providing education for clinical and materials staff.
The timeline for implementing a standardization plan should occur in the following sequence: negotiations, information/gathering, evaluation/trials, inventory/ conversion and education/in-service. Depending on the scope of the project, it could take from two months to one year to complete.
Information gathering requires presentations by sales representatives, review of various subscription databases such as ECRI or MD Buyline and help from local, regional or national associations or e-mail listservs. Information should be gathered and presented to a cross-functional team that includes clinicians, materials and/or financial members. Evaluation or trials should result in a decision by the cross-functional team. Limiting the evaluations to a specific area whenever possible will allow for tighter controls and better observation of outcomes.
Negotiations should occur prior to and throughout the evaluation period. Identification of all consumable-related items, items to be replaced, and contract information should be addressed during this time.
Inventory/conversion can be the hidden dagger to cost containment. Converting high-ticket items such as endomechanical devices can have a big financial impact if the old inventory is not managed out of the organization. Start thinking about this early in the process.
Last, and most important, is educating staff on new devices. If staff is having issues using any product, there may be significant costs financially as well as in the quality of care being delivered.
We must recognize that we affect the quality of care that clinicians in our organizations deliver to patients.
Jeff Wagner is an assistant vice president with MidMichigan Health, Midland.
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