Lean Management of High Cost Supply Items

Lean Management of

High Cost Supply Items

Marisa Bartemes

Product Specialist

Speaker Profile

• Marisa Bartemes, Product Specialist, ERP Solutions

• McKesson tenure – 15 Years

– 30 years healthcare IT

– Product Management

– Account Executive and Account Management

– Project Manager

– IT Director

7/8/2013 2

Lean Management of High Cost Supply Items

• Learning Objectives

• Market Drivers

• Point of Use Supply

– Overview

– Integration Workflow

• Client Perspective – Rush Health Systems

– Profile

– Lean Pre- and Post-Assessments

– Lean Next Steps

• Questions

7/8/2013 3

Agenda

Learning Objectives

• Apply specific principles to improving management of

high-cost supply items

• Understand the benefits of extending point of use

management to specialty areas

7/8/2013 4


Market Drivers

•Rising costs and decline in reimbursements

•Reducing supply spend

•Improving revenue

•Improving productivity

•Needing control and stabilization of inventory

•Lacking available supplies for clinicians

•Reducing supply spend

7/8/2013 5


Market Drivers – Where Inventory Resides

• 14% Main Storeroom

• Extremely automated with significant visibility, accuracy and efficiency

• 25% Pharmacy

• 61% OR/Specialty Areas

• Prominently manual with duplicative and disjointed processes

7/8/2013 6


Storeroom

Pharma Specialty

For an organization with

$10 million in inventory

$6.1 million is manually

managed

7/8/2013 8


Point of Use Supply Overview

7/8/2013 9

• No Change

Pre-Admit in HIS

•No Change in SM

•SM sends case info to POU, record created

Case Schedule in Surgical Manager

•SM sends Requisition to Supply Location (SCM/SM) and POU for supplies based on Resource Map

Print Pick Ticket

•Supplies picked based on SM pick list

•Supplies picked based on POU pick list.

Case Pick


OR Integration Workflow

7/8/2013 10

•No Change

Case Initiation SM

• Select Patient Case

Patient Selected in POU •Items Picked for Case

will display

• Scan Add on Items

•Implants – Scan lot/serial/Expiration

• Add Non Catalog items

Usage

• Patient Usage Information flows to SM

Usage Integration

• Patient Return Information flows to SM

Return Integration

OR Integration Workflow


7/8/2013 11

• Interface MMIS to POU

• Send items to Cardiology

Supply Item Details

•No Change

Cardiology Case Initiation

• Scan Items

•Implants – Add lot/serial/Expiration

Usage

• Patient Usage Information flows to POU

Usage Integration

• Patient Return Information flows to POU

Return Integration


Cardiology Integration Workflow

• Learning Objectives

• Market Drivers

• Point of Use Supply

– Overview

– Integration Workflow

• Client Perspective – Rush Health Systems

– Profile

– Lean Pre- and Post-Assessments

– Lean Next Steps

• Questions

7/8/2013 12

Agenda

Lean Management

of High-Cost Supply Items

Speaker Profile

Angela Jensen, CSPDS Central Supply/Sterile Processing Department Supervisor

Rush Foundation - 21 years

Materials Management – 12 years

Labor & Delivery OB/ORT

CBSPD Certified since 2002

National Supervisor Representative with CBSPD Board of

Directors – Second term

CE and Ethics committee member

Rush Health Systems

Integrated health system comprised of hospitals,

clinics, and physician practices

8 Hospitals

25 Primary Care Facilities

4 Extended Care Clinics

Specialty Clinics located throughout East Mississippi

and West Alabama

Supply Chain Profile Annual Supply Spend $7,474,650

JIT Delivery System – Medline

McKesson

Supply Chain Management

Surgical Manager

Supply Source (eCommerce)

Point of Use Supply (IntelliShelf)

STAR Financials

32 locations LIVE since 2003

Cath Lab, ER, GI Lab, Pain Treatment Center, L&D, and

all Nursing Locations

Stock and Non-Stock (direct buys) managed by Point of

Use Supply

Implemented Hybrid Solution

Open Bins – Nursing, Cath Lab, GI Lab, Pain Treatment,

L&D

Closed Cabinets/Open Bins - Emergency Room

Beta Partner-four major releases of POU

Point of Use Supply Implementation

Nurse issues supplies to patients from supply areas

Nurse pulls sticker from supply and adds

to patient charge card

Ward Clerk manually enters charges from

charge cards in billing system

Charge Capture Process Before

Nurse scans supply barcode:

- Charges sent

automatically to

billing system

- Decrements

physical inventory

automatically

Nurse pulls sticker from supply and

adds to patient charge card

Ward Clerk manually enters

charges from charge cards in billing system

Charge Capture Process After

Automated, streamlined and more reliable!

•Performs daily manual count of each item against Par quantity

•Uses Hand Held

Supply Tech

• Prints Pick Ticket

MMIS

• Picks Supplies

• Deliver supplies

Supply Tech

• Puts supplies away

Supply Tech

Replenishment Process Before

•Reviews non stock supply levels

•Manually enters requisition in MMIS

Nurse

• Processes PO

• Sends PO to Vendor

Buyer

• Receive Supplies


Materials Staff


Nurse / Clerk

Stock Process

Non Stock Process

• POU sends requisition for items at or below minimum

POU

• Generates pick ticket

• Creates PO (JIT and Non JIT)

MMIS

• Pick supplies

• Receive supplies


Materials Staff


• Perform regular cycle counts

Supply tech

Replenishment Process After

Clinician control within replenishment process

Consolidates Stock and Non-Stock Process

Before • Lack of data available

to capture total cost of care

After

• Real-time data capture at POU

• Available data to monitor supply usage, increased inventory turns for POU supply areas


Access to Relevant Data

Before

• Lost patient charges with revenue losses

• Higher percentage of

revenue loss in procedural areas

After

• Increased supply revenue over $149,000 in first two quarters

• Continue revenue increases with POU roll out


Revenue Capture

Before

• Mismanaged supply inventory

• Lacking available supplies for clinicians

After

• $86,000 inventory reduction in Cath Lab

• Quick identification of consignment items

• Less stock outs and costly same day / overnight orders


Inventory Management


Before

• High labor costs to manage daily cycle counts for multiple supply and PAR inventory locations

• Labor costs for manual ordering and receiving

After

• Reduced labor costs -Eliminated daily cycle counts -Automated ordering and receiving

• 50% FTE reduction (redeployment) to focus on improved department service

Labor Management

Lean Process Next Steps

Moving JIT functions in-house with onsite

warehouse

Managed by Rush

Centralized Operation for all facilities, clinics,

physician offices under Rush Health Systems

Help with standardization of supplies

OR Integration - Clinicians scan all add-on supplies in

Point of Use Supply with integration to Surgical Manager

Identify item location, quantity within department via POU

Eliminate time searching for items in Surgical Manager

Eliminate duplicate supply charting, workflow steps

Capture inventory usage, cost data for multiple perpetual

locations to identify true inventory turns

Decrease inventory, increase revenue (proven in all locations)

Ensure right supplies, right location, right time

Lean Process Next Steps

Lean Management

of High-Cost Supply Items

Questions?

[email protected]

Lean Management of High Cost Supply Items

Documents

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