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This article was originally published on Healthcare Business Today.
A nurse’s number one priority is to care for patients, but many find much of their days spent on tasks outside of care delivery. Research shows how frontline clinicians spend an average of 17% of their workweek dealing with inventory issues, with 65% wanting to trade that time to be with their patients.
Manual healthcare supply chain management is a tremendous burden on nursing staff, taking significant time away from patient care, and increasing the risks for error, including missing supplies, use of expired/recalled supplies and incorrect/incomplete documentation.
Healthcare organizations have yielded a significant return on investment (ROI) from optimizing inventory management in clinical areas through a consolidated, integrated and automated point of use (POU) system.
By leveraging POU technology, health system administrators are relieving nurses of manual supply management burden, increasing job satisfaction while improving efficiency, reducing costs and risks, and most importantly, enabling nurses to spend more time with patients.
More than half (57%) of 400 hospital stakeholders surveyed — nurses, physicians, service line leaders and supply chain administrators — said they recalled a time when a physician did not have a product that was needed for a patient during a procedure.
When supplies are unavailable, nurses are forced to leave the patient’s bedside and search for them. In the perioperative space, this can mean leaving a patient on the operating room (OR) table.
In theory, a physician’s preference card should list everything required in terms of supplies for a procedure. When the card is inaccurate, the OR team does not receive the supplies it needs for a case. When this occurs, the nurse must leave the OR (and the patient) during the procedure to find and gather the missing “add-on” items.
“The number one priority among nurses is staying by the bedside to provide patient care,” said Betty Jo Rocchio, MS, RN, CRNA, CENP, Senior Vice President and Chief Nursing Officer at Mercy. “But before we put in the point of use solution, we were running at about 46% add-on supplies, meaning we were running out of the room 46% of the time to grab things that we needed.”
Mercy’s POU solution automates the tracking and documentation of supplies in the OR, including products that are used, those that are never opened and went unused, any products that were opened and unused, as well as add-on items. The health system uses this data to continuously update its preference cards, removing unused items and adding the missing ones. With greater preference card accuracy, Mercy’s add-on rate dropped by more than half to 20%.
And it is not only large health systems that are benefitting from this approach. At Concord Hospital, a 295-bed regional medical center in New Hampshire, the POU system has returned more than 5,800 hours in clinical time back to caregivers.
Before implementing a POU solution, circulating nurse Jessica Bader said there were times when her facility had to cancel surgeries when they realized they didn’t have the implants they needed.
“This impacts the patient, who made big changes in their life to be there for surgery, and any family members or friends with them who took time off to be there,” explained Bader. “This also messes up the OR team’s day by throwing off our whole schedule and potentially affects other patients who were scheduled for procedures later in the day.”
With an end-to-end supply chain management (SCM) solution that automates product tracking from point of receipt to the POU, Bader and her team gained the visibility to plan ahead.
“We could look at our surgery schedule, check inventory and make sure we had everything we needed for a case through the operating room supply chain system,” said Bader. “If we found something we didn’t have for an upcoming surgery, we had time to get it from the supplier. There was no more rush to overnight missing supplies, which with supply shortages might not even be possible.”
In today’s value-based care environment, healthcare organizations need to prove they are providing value to the patient — delivering high quality care in a cost-effective manner that improves long-term outcomes.
Before the POU solution, Rocchio says Mercy’s physicians didn’t have a way to know the cost of each item in a procedure or calculate the total cost of supplies per case. Today, with product cost data readily available in the SCM at the POU, nurses can scan an item and immediately find out its price tag.
“For example, we can now scan five different staplers in the OR to find out their prices at the physician’s request and they can decide which one to use,” said Rocchio. “And they walk out of the OR with kind of a grocery store receipt of what the total supply costs were for that case. It has been a game changer because it allows them to make the right decisions around value for the patient.”
Because the SCM and POU applications are integrated with the electronic health record (EHR), enterprise resource planning (ERP) and financial systems, a healthcare organization can seamlessly bring together real-time data and perform analytics to determine how supplies correlate to clinical and financial outcomes.
“Using that data set we can produce, even long-term, patient outcomes against costs for the products we use,” Rocchio explains. “That is highly valuable when you consider where the payment model is going in this country where we increasingly must account for costs and prove value. Looking at the data, we may determine it is beneficial to spend a little bit more money on an implant if we are getting better long-term outcome from it.”
“We are also able to take those data sets to our vendors and say this implant isn’t worth $400 more than the others, or it is worth more based on patient outcomes, so we want to buy more of them,” Rocchio added. “We can prove the money we are spending is providing the value that we want to deliver as a health system.”
Nearly one in four (24%) hospital staff members surveyed said they have seen or heard about expired or recalled equipment used on a patient.
To help prevent this from happening, healthcare organizations are using SCM technology to capture item-level details (e.g., lot and serial numbers, expiry dates) of products upon receipt, which can be accessed all the way through to the patient’s bedside through POU scanning.
“With the technology, an expired or recalled product won’t even make it to the patient’s room because the system will alert supply chain staff as they are scanning it to the case cart,” said Rocchio. “If supply chain doesn’t catch it for some reason, which is rare, the nurse will catch it when scanning the product at the bedside.”
Expired supplies not only threaten patient safety, but they also add to healthcare costs. With its POU solution, Munson Healthcare, a healthcare system consisting of nine hospitals serving 24 counties throughout Northern Michigan, reduced expired inventory costs by more than $250K per year.
“We are able to capture charges more efficiently and track inventory levels more accurately, both of which allow our clinical staff more time to focus on patient care,” said Flavius Toader, Director of Supply Chain for Munson Healthcare.
Because nurses are overworked, burned out and leaving the field, health systems and hospitals are pressured to do whatever they can to keep existing nursing staff and fill vacant positions.
A better work environment not only improves nursing satisfaction but can also improve patient outcomes. Penn Nursing’s Center for Health Outcomes & Policy Research (CHOPR) found better nursing work environments are associated with lower odds of negative nurse outcomes, poor safety or quality ratings and negative patient outcomes, but higher odds of patient satisfaction.
“Value doesn’t just come in the form of money, it comes in the form of co-worker satisfaction, that nurse satisfaction,” said Rocchio. “For us, that nurse efficiency is staying by the bedside for patient care. So that’s one of the things we looked at: reducing workload.”
With automated inventory tracking and POU data capture, nurses can focus on their number one priority — patients — knowing supplies are available and use is documented in the patient record.
The end goal for each healthcare organization is enterprise-wide inventory visibility and controI. Implementing a point of use solution has the potential to improve operational performance as well as staff productivity levels. With more data and technology capabilities, nurses have the tools and supplies to ensure they are providing the best patient care possible.