Supply management doesn't have to be a bore or a chore. Here at the Eastland Medical Plaza Surgicenter in Bloomington, Ill., we've implemented creative concepts to manage and streamline our supply purchasing and par-level control. From consolidating paperwork to a par-level lottery, here are 10 tips for a simpler, more effective (even enjoyable) inventory control system.

1 Create specialty heads.
We've designated five highly organized and responsible members of our team as specialty heads, each in charge of managing the supply needs of various specialties within our department. The specialty heads are either scrub techs or RNs; we've assigned one to each of the following: orthopedics, general/GYN, ENT, urology/plastics and ophthalmology. Each head is responsible for ordering supplies, maintaining par levels, talking with surgeons about special supply needs, calling vendors with specific questions about how an instrument or piece of equipment works and updating surgeons' preference cards. They act as an extension of, and report to, our materials manager.

2 Play the lottery.
Our materials manager came up with a fair and creative way to spot-check the work of the specialty heads. Each month she places index cards, one for each group, in a small box, and mixes them up. She then blindly pulls a card and reviews the selected specialty for appropriate par levels and inventory rotation. Each area can be reviewed multiple times, depending on the draw. We've found that the lottery is an effective and impartial way to keep the specialty heads on their toes, because the review is treated as an informative session as opposed to a punitive meeting to dread.

3 Use the middleman.
Whenever possible, our materials manager orders supplies through a distributor. A local distributor can quickly fill an order as needed, can deliver as many times during the week as you'd like and knows where and how to stack the supplies we order (unlike FedEx or UPS). We order from our distributor on Tuesdays and Thursdays; every specialty head knows supply requests must be on the materials manager's desk by 11 a.m. for us to include their request in the order.

4 Streamline requests.
Our materials manager streamlined the requisition form our staff needs to complete for supplies our distributor doesn't provide. The form is bright gold so it easily stands out when placed in the materials manger's mailbox; she knows a supply is needed, and makes sure the request is promptly addressed. Specialty heads write their names, the vendor's name, the type and quantity of supply they need and circle a delivery preference (standard or overnight). They then sign the form and turn it in to our materials manager. Documenting when an item is needed has organized our entire ordering process, allowing supplies to be more often shipped for second-day delivery instead of the more expensive overnight shipment.

5 Label shelves.
Our materials manager affixes prices to the shelves of high-use supplies, a simple practice that makes everyone aware of cost containment when pulling items for a case. Staff are apt to say, "Do we really need this, or can we use a similar item and attain the same goal?" I'll grab a cheaper pair of sterile gloves if I'm serving as the second scrub nurse or prepping the patient, saving the top-of-the-line gloves for more complicated procedures.

We bought battery-operated label makers for $17.99 each for the materials manager, specialty heads and me. They're inexpensive and good for making clear, easy-to-read price tags. The materials manager keeps track of unit pricing, and re-labels our supply area every three months to six months.

6 Verify vendors.
We established a vendor policy. The specialty head must pre-approve special items a rep brings in for a case. We also verify patient's insurance information before the procedure to determine if there is a special charge for the item. During the case, the rep must have the circulating nurse co-sign the invoice to verify its use; we won't pay otherwise.

7 Cart the mail.
Each of our five specialty heads is assigned a simple wire cart with baskets; the mobile carts sit in the hall and serve as mailboxes. The materials manager knows where to drop off special orders or mail, and everything is in a central location. One of the mesh baskets, attached to the very bottom of the cart, serves as a depot for loaner instruments. Our orthopedic surgeons are constantly trialing new equipment, and we've had trouble locating sets when reps dropped them off or arrived to pick them up after the case. Now, everyone knows exactly where to look for incoming or outgoing instruments.

8 Consolidate paperwork.
Our materials manager merged four forms - our requisition sheet, inventory count sheet, par-level sheet and pricing list - onto one form. Staff can now order, spot check inventory, re-establish par levels and compare pricing in one glance. The document contains a list of inventory items along its left margin and columns for the item's facility supply code; the number of items in a unit and how each unit is ordered (single units or by the case) a description of the product; the vendor that supplies the item; the supply's unit price; and the par level we want to maintain.

When checking on micro-tubing units, for instance, our specialty heads know that new orders of tubing come in 60-unit cases, the same quantity we've set as our par level. By easily seeing that one order will get us to our par level, specialty heads know they can deplete the number of micro-tubing units before they place an order. The inventory sheet pulls everything together and keeps our staff on task when trying to manage appropriate par levels.

9 Get throw-outs thrown in.
We always expect disposable supplies - things like arthroscopy pumps and ENT shaver consoles - to be provided at no cost. Most vendors are on board with this concept. If your rep refuses to throw in disposables, tell him you don't have an exclusive contract with his company and that you'll look elsewhere.

10 Foster communication.
We extensively remodeled our center and ended up merging the offices of our materials manager and accounts payable clerk. They now work side by side, know each other's responsibilities and can match invoicing and packing lists with pricing through a very streamlined process. The close proximity allows constant communication between these two key links in the supply management chain; listening to each other's phone conversations even alerts them to ordering or invoice problems as they happen.

A penny earned
Organizing and improving supply management is important, but so is keeping your staff abreast of the streamlining and money-saving ideas. Every time we save even a little, we record the savings on an ongoing list of accomplishments. We report these cost containment measures to our managing board quarterly. The idea is simple, but the reporting generates ideas and makes our employees feel good about the steps they take to save our center money. What's more, it motivates management, staff and physicians to continue to be positive agents for change.