SCRUBS AND SUITS Consider the clinical benefits and financial impact of proposals to build the case for approval.

Your facility is facing increased competition for smaller pieces of the surgical revenue pie, so it's never been more important to invest in supplies, devices and technology that help the bottom line as much as they improve patient care. Here's how to get value-analysis committees to sign off on purchases of cost-effective products you want and need.

1Seek varying viewpoints
You need a well-rounded approach to decision-making and insights into how the proposed product would impact your entire facility, from cost of ordering to patient care to reprocessing and restocking. The only way you'll drill down to those details is by bringing together clinical and financial decision-makers for frank discussions about the potential benefits and drawbacks of adding the item. In my experience, limiting the committee's membership to approximately a dozen representatives from multiple service lines provides the perspectives you need without getting bogged down by too many voices in the room.

As a general rule, include members from medsurg and critical care nursing, the operating room, the director of finance or a financial analyst and the materials manager. Invite other staff members to participate, as needed. For example, if the product up for consideration is intended for use in sterile processing, ask a knowledgeable representative from that department to join the discussion.

2Use the time wisely
Include only physicians or staff members who can make contributions to the discussions — no listeners allowed — and make sure you start the meetings on time and run them efficiently. Like a contestant on Shark Tank, physicians who request new products should have the pitch down cold and the numbers firmed up before presenting to the committee. We ask individuals who are making requests to complete a 2-page form that contains the clinical, business and patient care reasons for adding the items. Committee members review the form beforehand, so they have a basic understanding of the product before meeting to review its clinical usefulness and financial benefits.

3Look beyond cost
It's essential to assess the entire package when deciding if a new supply or technology is right for your facility. Requests made for new items must be backed with clinical data from manufacturers or peer-reviewed journals that prove how the addition improves patient care. Does it decrease patient discomfort, get patients back to their normal lifestyles faster and lower the risk of infection? Will it decrease length of stay, nausea, post-op pain or time to ambulation? Can it reduce the time patients spend under anesthesia? That's always a great selling point. You also need to consider its usability and if it improves patient safety and helps protect members of your OR team.

Our surgeons made the case to add bupivacaine liposome injectable suspension to their pain control regimens during large abdominal cases, spine surgeries and total joint replacements. It's expensive — $285 per vial — but when we considered the improvements it's made to patients' post-op comfort, how much it improved their ability to mobilize soon after surgery and decreased post-op length of stay, and that surgeons were prescribing fewer post-op narcotics when the injections were used, adding the drug to our offerings was a clinical no-brainer. In addition, surgeons' reputations improved in the eyes of patients who will fill out satisfaction surveys that impact a portion of our hospital's reimbursements. That's the type of downstream benefit you need to consider.

4Engage physicians
Ask surgeons who want to add a piece of equipment to discuss their reasons for doing so during 5-minute presentations in front of the value-analysis committee. Listen to what they say is best for patients and weigh that against your efforts to standardize what's used in your ORs and keep purchases in line financially.

We recently studied the financial and clinical considerations of adding robotic colon surgery to our health system. Some of our general surgeons showed how the platform decreased their patients' length of stay, discomfort, blood loss and use of post-op pain medications. We included those clinical factors in our justification for adding the technology.

Make sure physicians consider the standardization, cost and clinical outcomes associated with the equipment they want to add. We recently engaged physicians and surgical managers to change our skin prep purchasing practices to reduce the number of agents we use across the health system from 29 to 7. Driving that standardization across several hospitals reduced costs associated with writing purchase orders, keeping stock on shelves and having product go unused in procedure packs. That one initiative saved our health system around $200,000 a year.

5Keep analyzing
Don't stop analyzing deals once new pieces of equipment have been approved. Check back with the surgical team 6 months or a year after the purchase for outcomes data and end-user feedback to see how the additions have panned out. It's never too late to make adjustments to equipment you've added, and you can use the data and insights to guide further purchasing decisions. The job of a value-analysis committee is never done. There are always new purchases to consider and past purchases to learn from. OSM