Many hospitals are getting serious about permanently eliminating costs from their organizations. Product selection can be one of the keys to achieving significant dollar savings, improving quality and assuring patient safety. An easy-to-implement five-step process can help your organization determine the right product for the right procedure at the right price. This new way to assess the supply chain emphasizes a partnership between materials staff, clinicians, physicians and executive leadership that encourages clinical input, including quality-based criteria and employs analytical processes that drive financial value for the organization.
The five-step approach
Using an example may help underscore the value of this approach. Let's say your organization is faced with reducing the high incidence of hospital-acquired pressure ulcers.
Step one: Assessing the problem
Making an appropriate decision involves assessing the current situation and conducting a root cause analysis to determine the underlying reason for the problem. Asking "how much," "who," "when" and "where" helps to quantify and qualify the clinical situation. Critical data points for the assessment of the pressure ulcer challenge include:
• Number of pressure ulcers this year compared to the number of cases in the past three to five years.
• Characteristics of patients who developed pressure ulcers and the average cost of treatment.
• When did the patient develop the pressure ulcer?
• Where was the patient treated and by whom?
A root cause analysis will help determine whether the situation calls for a product intervention.
Step two: Planning
This phase involves conducting research to establish a "best practice." Products used to address the problem should be researched to determine their effectiveness, ability to sustain results and safety with prolonged use. For the pressure ulcer example, research would be conducted on the product being considered as well as other products designed to decrease the occurrence of pressure ulcers. A literature review will determine the evidence and best practice recommendations for this situation.
Step three: The design
Designing the optimum solution involves several sequential events. Results from the planning stage should be compared to the desired outcome and a return on investment check conducted on all viable options. Options should then be put in priority order based on effectiveness, efficiency, difficulty to implement and cost. When an intervention is determined, conducting a controlled trial of the intervention with the identified patient population will help validate outcomes. If the desired outcomes are not achieved, a controlled trial should be conducted on the next highest priority intervention until the desired outcome is achieved.
Step four: Implementation
This phase occurs when the successful option becomes a standard of practice for the institution. Protocols, policies and/or procedures that include assessment data will need to be developed. Intervention-related staff education will need to be conducted and a three-month to one year post-implementation measurement period should be established.
Step five: Measure and sustain
This phase involves monitoring the intervention for achieving the desired outcomes and sustaining them over the long-term. Measurement results should be compared to the baseline data and the desired outcome goals. If measurement shows a negative result, the organization should return to step one or choose another viable option from step three. If the results are positive, the organization should create processes that sustain the gains, often this means measuring and reporting a combination of financial and clinical data. For hospitals to succeed in this new world of healthcare they must begin to address permanently eliminating costs from the system while improving quality and patient safety. Choosing the most appropriate product can help the organization reach its desired goals.
Ms. Tinker has more than 20 years of experience in healthcare. She is the national leader for VHA's Clinical Quality Value Analysis™ and provides expertise for supply chain non-salary cost reduction opportunities. She holds a bachelor's degree in health administration from Central Michigan University in Mount Pleasant, Mich., and is a licensed social worker.
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The five-step approach
Using an example may help underscore the value of this approach. Let's say your organization is faced with reducing the high incidence of hospital-acquired pressure ulcers.
Step one: Assessing the problem
Making an appropriate decision involves assessing the current situation and conducting a root cause analysis to determine the underlying reason for the problem. Asking "how much," "who," "when" and "where" helps to quantify and qualify the clinical situation. Critical data points for the assessment of the pressure ulcer challenge include:
• Number of pressure ulcers this year compared to the number of cases in the past three to five years.
• Characteristics of patients who developed pressure ulcers and the average cost of treatment.
• When did the patient develop the pressure ulcer?
• Where was the patient treated and by whom?
A root cause analysis will help determine whether the situation calls for a product intervention.
Step two: Planning
This phase involves conducting research to establish a "best practice." Products used to address the problem should be researched to determine their effectiveness, ability to sustain results and safety with prolonged use. For the pressure ulcer example, research would be conducted on the product being considered as well as other products designed to decrease the occurrence of pressure ulcers. A literature review will determine the evidence and best practice recommendations for this situation.
Step three: The design
Designing the optimum solution involves several sequential events. Results from the planning stage should be compared to the desired outcome and a return on investment check conducted on all viable options. Options should then be put in priority order based on effectiveness, efficiency, difficulty to implement and cost. When an intervention is determined, conducting a controlled trial of the intervention with the identified patient population will help validate outcomes. If the desired outcomes are not achieved, a controlled trial should be conducted on the next highest priority intervention until the desired outcome is achieved.
Step four: Implementation
This phase occurs when the successful option becomes a standard of practice for the institution. Protocols, policies and/or procedures that include assessment data will need to be developed. Intervention-related staff education will need to be conducted and a three-month to one year post-implementation measurement period should be established.
Step five: Measure and sustain
This phase involves monitoring the intervention for achieving the desired outcomes and sustaining them over the long-term. Measurement results should be compared to the baseline data and the desired outcome goals. If measurement shows a negative result, the organization should return to step one or choose another viable option from step three. If the results are positive, the organization should create processes that sustain the gains, often this means measuring and reporting a combination of financial and clinical data. For hospitals to succeed in this new world of healthcare they must begin to address permanently eliminating costs from the system while improving quality and patient safety. Choosing the most appropriate product can help the organization reach its desired goals.
Ms. Tinker has more than 20 years of experience in healthcare. She is the national leader for VHA's Clinical Quality Value Analysis™ and provides expertise for supply chain non-salary cost reduction opportunities. She holds a bachelor's degree in health administration from Central Michigan University in Mount Pleasant, Mich., and is a licensed social worker.
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