Letters & Emails

By: Zzz Zzz

Published: 10/10/2007

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Making the Case for Bundling


Making the Case for Bundling
Re: "Should You Bundle Your Cataract Supplies?" (March, page 80). Dr. Richard Lee makes some excellent points in support of product bundling for cataract procedures. There are several others worthy of mention that build an even stronger case for bundling.

For most facilities, the cost per procedure is a more important number than the cost of individual supplies. Typically, a supplier that has a wide breadth of products can provide most of the disposables for that procedure at a bundled price that is lower when compared with individually priced items. Both the facility and the suppliers benefit by consolidating all products into a procedural bundle.

What many facilities fail to consider is that "breaking the bundle" can lead to increased indirect costs to the facility. Dr. Lee mentions the costs associated with accounts payable, shipping and receiving and inventory management. Other hidden costs are labor, facility overhead, waste disposal and OR time associated with handling stand-alone products. These costs are more difficult to measure than the cost of the products themselves and are therefore ignored most of the time.

Once an organization can analyze and assign a "total" cost to a procedure, it can negotiate reimbursement contracts using a factual database. There is a better way to achieve financial success and accurate procedural costing is a first step.

Barbara Ann Harmer, RN, BSN, MHA
Orlando, Fla.
[email protected]

For the Record

What I Saw at SAGES" (April, page 54) contained several errors about Baxter's Easy Prep System. We misspelled Tisseel and referred to the sealant as a topical hemostat when it is for hemostasis and tissue sealing in a variety of surgical applications. We erred when we said that the needles are contained in the Tisseel vials; the protected needles are contained within the Easy Prep system itself. We misspelled FloSeal and referred to it as a porcine-based product. FloSeal uses Bovine thrombin and a proprietary collagen gel matrix. Baxter, and not Angiotech, distributes CoSeal.

Do Warmer Patients Mean Better Outcomes?" (April, page 36) may have given the impression that the Bair Paws patient adjustable warming system is a therapeutic device designed to prevent hypothermia. It is neither. The Bair Paws system uses a warming gown to comfort patients before and after surgical procedures. Unlike its sister system, Bair Hugger therapy, the Bair Paws system is not indicated for therapy during surgical procedures.

The photo of the Biogel Super-Sensitive glove on page 48 of "Take the Infection Control Challenge" is courtesy of Regent Medical.

— We listed an incorrect telephone number for CTQ Solutions in "Product News" (May, page 100). The correct number is (877) 208-7605.

Keep Writing Those Articles, Dan
I'd like to thank Infection Prevention columnist Dan Mayworm for sharing his knowledge with me every issue. He helps to make a sometimes-overwhelming subject more understandable.

Lynn Foehrkolb, RN
Clinical Director
Columbia Urological Surgery Center
[email protected]

Does LMA equal GA?
Re: "7 Keys to Fast-Track Anesthesia" (March, page 52). While Dr. Larry Grossman acknowledges that laryngeal mask airways (LMAs) are tolerated at lighter levels of sedation, the article failed to mention that the mere insertion of an LMA transforms a sedation or Class B anesthetic into a Class C or general anesthetic, according to the AAAASF (a plastic surgeon-founded accreditation group).

The insanity of this AAAASF proposition means that in Florida, for instance, an anesthesiologist doing propofol-ketamine (PK), a non-triggering anesthetic technique, who needs an LMA is then required to have an anesthesia machine and dantrolene despite the fact that Dr. Rebecca Twersky has clearly stated in her ASA guide to safe office anesthesia that it is safe to give non-triggering anesthetic without an anesthesia machine (and by inference dantrolene).

Barry L. Friedberg, MD
Corona del Mar, Calif.
[email protected]