Next to personnel costs, medical supplies are a surgery center's biggest expense. But unlike the month-to-month consistency of payroll, your staff can significantly influence what is ordered, what is opened for a case and what you need to keep on hand in your supply room. When your surgical techs, OR nurses and surgeons are involved in managing inventory, they become part of the solution in reducing and controlling your facility's use of medical supplies. Here are six ways to do just that.
1. Post signage.
Placing small labels with supply unit prices and par levels on shelves next to each item in stock is a great way to educate your staff. This setup will constantly remind employees of supply costs each time they pull cases. In that same vein, put the actual price of supplies on your preference cards or pick lists. The more your staff see the price of an item, the more ingrained in their consciousness it will be.
2. Use staff meetings.
Hold inventory education sessions regularly. I recommend addressing a supply topic as part of your monthly staff meetings. Pick one item and discuss its cost, what par levels you've set and how its availability is affected by the company's delivery schedule and freight charges.
3. Play games.
A popular and fun method of education is to borrow a page from The Price is Right. Set up a bulletin board in a prominent area of your facility - in the staff lounge or on the back of an OR door - and display one item a week. Have your staff submit written guesses as to how much the supply costs. The employee closest to the actual price wins a gift certificate to a restaurant or a CD.
4. Include the surgeons.
Schedule time with each of your surgeons to review preference cards. Show them the unit pricing before offering a comparable product that will reduce the costs of the case (this is where having pricing information in your supply system is essential). Also tell surgeons that not every item has to be opened for a case. Reassure them that your staff will have required supplies available in the OR, but they won't open items until they're absolutely needed.
I worked with a surgeon who took great pride in trying to reduce the items on his preference card. He wanted to see his cards every six months, and he'd work hard to reduce the cost and number of items he used. Unfortunately, he was an exception. I've also worked with a surgeon who simply wrote "arthroscopy stuff" on his knee surgery preference cards. So how can you educate a doc who doesn't pay attention to the supplies he goes through? Use cost-per-case data to get his attention, and to play the surgeons off each other. Trust me, what you offer as a friendly competition to drive down case costs will produce plenty of peer pressure for the physician who performs the most expensive surgeries.
Teaching Staff Some Basics of Inventory Management
The more employees are aware of the factors that go into inventory management, the better. Their knowing the correct item pricing is the one thing that will benefit your facility's inventory control the most. That should be a non-negotiable element of your center's policy because the correct price listing is essential for proper case costing. Each time you place an order for an item, verify that the pricing is correct. Make the correction immediately in your supply records if there's been a change; putting it off usually means you won't make the adjustment. If the pricing change is way out of line - say a 50-percent increase - call your company's rep or ask to speak to a manager; there may have been a mistake the clerk handling the order can't address.
Once you establish par levels, a good way to track supply usage is to train your staff to write the date on a box when they open it. As the supply level drops, checking the date will tell you how long it takes to reach the reorder level. If you opened a box of suture in January and it doesn't empty until August, you won't need to order more than one box to replace the used suture. In this case, you can keep the minimum par level low because it takes a while for you to use the product.
When ordering supplies that you use often, learn the schedules of your supply deliveries. Do they deliver daily? Once a week? Twice a week? Knowing this will tell you how many supplies you need to keep on hand and will help avoid drop ship orders. By monitoring the OR schedule a few days in advance for special supplies you'll need for scheduled cases, you can limit expensive overnight services, relying instead on less costly ground or two-day air shipping.
- Ann Geier, RN, MSN, CNOR
5. Review procedure packs.
Each item in a pack should be used for every case, or else it should be a separate item that's not included in the pack. It can take up to 10 weeks to change a procedure pack, so be diligent in keeping up with any changes in a surgeon's usage. Make your surgical techs responsible for monitoring packs.
6. Uncover secret stashes.
Clinical staffs - especially nurses - are notorious for hoarding supplies. When walking through your center, perform spot checks on cabinets, closets and lockers. I've even heard of an administrator who found supplies tucked inside the paneled ceiling of a staff locker room. Once you find a hiding spot, constantly monitor the location to ensure the secret stash is not replenished. Educating your staff on proper inventory management skills will give them confidence in the par levels you set and make them feel like there is less of a need to keep a private stock of supplies.
Money already spent.
Inventory is money already spent, before - and regardless of - use. Picture stacks of money lining the shelves of your supply room. Your goal is to keep those stacks as low as possible while still having what you need on hand for the day's cases. The onus doesn't rest solely on the shoulders of your materials manager. Supply costs are the one expense an entire staff can, and should, help control.