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May 2014 Back- breakingworkbreaking · 10 May 2014 | The ournal of Healthcare Contracting...
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Nurses lobby for patient-
handling equipment
and supplies
Back-breakingworkBack-breakingwork
May 2014 • Vol.5 No.3
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The Journal of Healthcare Contracting | May 2014 3
The Journal of Healthcare Contractingis published bi-monthly
by mdsi1735 N. Brown Rd. Ste. 140
Lawrenceville, GA 30043-8153Phone: 770/263-5262FAX: 770/236-8023
e-mail: [email protected]
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Mark [email protected]
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Senior EditorLaura Thill
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PublisherJohn Pritchard
Business Development DirectorKatie Brunelle
CirculationWai Bun Cheung
The Journal of Healthcare Contracting (ISSN 1548-4165) is published bi-monthly by Medical Distribution Solutions Inc., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2013 by Medical Distribution Solutions Inc. All rights reserved.
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CONTENTS »» May 2014
4 Independents: ‘Hear us out’Independents believe they have a good story to tell the supply chain executive whose IDN has just purchased a physician practice
10 Healthcare Exchanges
16 Back-breaking workNurses lobby for patient-handling equipment and supplies
24 The ROI of safe-patient handling
24 Standards for safe patient handling and mobility
26 Numbers talk
28 Equipment important part of pending legislation
30 What Are You Becoming?
32 In the HeadlinesHospital and health system news from across the country
36 Benchmarking Your Way to SuccessEveryone needs benchmarks to up their supply chain expense game
pg16
“In any setting where healthcare
workers are manually lifting patients, they’re
at great risk.” – Jaime Murphy Dawson
May 2014 | The Journal of Healthcare Contracting4
DIStrIButIoN
Distributors get understandably nervous when their phy-sician-practice customers are acquired by a hospital or hospital sys-
tem. After all, hospital supply chain executives don’t know them,
nor are those executives always aware of the cost to serve non-
hospital customers. Challenging as the situation is, independent
distributors believe they can retain the business of newly acquired
physician practices, provided they demonstrate their unique – and
quantifiable – value to hospital supply chain executives.
“Distributors who have been
successful in retaining business
have proactively worked with
the [hospital] system; met with
the appropriate stakeholders,
that is, decision-makers; and
delivered solutions to meet
their unique needs,” says Dave
Rose, vice president, business
development and corporate
programs, National Distribu-
tion & Contracting, Nashville,
Tenn. NDC is a member service
organization providing distri-
bution, logistics, marketing and
other services to more than 300
independent medical, physical
therapy, rehabilitation and den-
tal product distributors.
“In large part, our distribu-
tors have been successful in
retaining business, but not
without selling their unique
value proposition and how it
translates into measurable and
sustainable value for the hos-
pital system,” he says. “Those
who have been successful have
also taken the initiative to un-
derstand and implement GPO
Independents: ‘Hear us out’Independents believe they have a good story to tell the supply chain executive whose IDN has just purchased a physician practice
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May 2014 | The Journal of Healthcare Contracting6
DIStrIButIoN
contracts, assist with contract compliance and product for-
mularies for their customers. They have become an anchor
tenant at the facility and positioned themselves as a partner
who can solve problems and provide solutions.”
Rose began his career in the healthcare industry with C.R.
Bard, Inc., holding various sales positions in the Bard Uro-
logical Division. He was also the Southeast region manager
of extended care for General Medical Corp. (now McKesson
Medical-Surgical) and vice president of sales and marketing
for Chester Labs, a manufacturer of personal care products
in Cincinnati, Ohio.
Steps to takePhysician-office distributors understand that the “status
quo” is no more, says Rose. “It goes without saying that de-
cision-makers will be different, and new relationships/part-
nerships will be forged. [Independent distributors] will need
to deliver easy-to-implement, cost-effective, supply solu-
tions to meet the needs of the new business relationship.”
Distributors must realize the new customer will demand a
more collaborative and transparent relationship.
Successful distributors welcome these changes as op-
portunity, and they give IDN/hospital supply chain execu-
tives compelling reasons to do business with them, says
Rose. “Customers need to have confidence they are in better
hands with you than without you.”
One way to start is to demonstrate that independent
distributors can react quickly and decisively to customer
requests, he says. What’s more, independents have a great
story tell about their ability to serve
providers across the care continuum.
“What a perfect time to sell the
benefits of partnering with a region-
al distributor,” he continues. “What a
wonderful window of opportunity
that allows independents to tell their
story of relentless service, and to say,
‘I’m the company who, unbeknownst
to you, has been a viable supply solu-
tion for years.’ What a great platform
to increase your company’s visibil-
ity and expand relationships beyond
your day-to-day customers.”
Tough questionsNon-hospital distributors can expect
some tough questions
about pricing from hospital/
IDN supply chain executives.
They must be ready with an-
swers, says Rose. “It is our re-
sponsibility, as distributors,
to educate the customer
about the cost variances to
serve different market segments. We
need to explain, and more important,
demonstrate, the different costs associ-
ated with serving a physician clinic vs.
the hospital. It is not unusual for the in-
dependent distributor to drive 15 miles
to drop off emergency equipment or
supplies, in low unit of measure, to a
physician office for a community event,
such as a school sports program.
“Distributors will hear the need to
reduce overall cost – not necessarily
“ our distributors have been successful in retaining business, but not without selling their unique value proposition and how it translates into measurable and sustainable value for the hospital system.”
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May 2014 | The Journal of Healthcare Contracting8
DIStrIButIoN
at the product level, but to improve efficiency and savings
across the entire operation,” he continues. “They will hear
that the customer will want to be an active participant in
the process, who wants visibility and
some control of the supply chain
decisions and process. Large provid-
ers who buy physician practices will
need the distributor to leverage GPO
contracts and support contract com-
pliance.” Distributors will need to be
prepared to help their customer navi-
gate GPO contracts, compliance and
reporting issues.
What’s more, non-hospital dis-
tributors will need to leverage tech-
nology to provide cost-effective so-
lutions that will give the IDN/supply
chain team real-time visibility to both
process and price, says Rose. “[Dis-
tributors] can expect to assist with
common ordering platforms that al-
low customer input and control. The
independent will position itself as a
partner/consultant who can assist the
hospital/IDN with product formular-
ies and offer suggestions for reducing
overall cost.”
Viable option“Change and uncertainty always
bring opportunity for those who are
flexible and creative,” says Rose. “The
independent distributor is a viable
option for hospital systems to serve
their newly acquired physicians. To-
day, nearly half of the alternate site
market is being serviced by the inde-
pendent distributor.
“The benefits of working with a lo-
cal company are obvious and numer-
ous. They can adapt quickly
to change, make decisions
and do more in far less time
than larger companies.
“Customers will al-
ways want choice. The
independent that is cur-
rently serving the physi-
cian market is very well
positioned to help the
hospital/IDN with their al-
ternate care supply chain
needs. Existing custom-
ers can be a tremendous
advocate for independent
distributors by making in-
troductions and providing
referrals. The hospital/IDN
customer needs their help,
and expertise, beyond the
hospital walls.” <JHC
Selling pointsHere’s what independents believe they have to sell supply chain executives whose hospital or IDN has just acquired some physician practices:
• Ability to understand and implement GPO contracts.
• Ability to serve providers across the care continuum.
• Ability to react quickly and decisively to customer requests.
• Ability to service customers on a moment’s notice.
• Ability to assist the hospital/IDN with product formularies.
“the independent will position
itself as a partner/
consultant who can assist the hospital/IDN with product formularies
and offer suggestions for reducing overall cost.”
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May 2014 | The Journal of Healthcare Contracting10
HEAltHCArE rEforM NAVIgAtIoN
The Affordable Care Act (ACA) is making broad changes to the way health insurance will be provided and
paid for in our country.
If you have been paying attention to the news during the
last few months you have certainly heard about healthcare.
gov, which is the federal health insurance “exchange.” Let’s
take a look at what these exchanges intend to do.
The Affordable Care Act created a new way for consum-
ers to purchase guaranteed coverage from private insurance
companies through an online marketplace or exchange.
Similar to how you book travel today
using Priceline.com or Orbitz.com,
these sites aggregate data and give the
consumer several options to choose
from. Here is a quick overview of how
this process works.
Individuals or small employers go
online through their exchange and
enter their personal information into a
web portal. After doing so, they learn
Healthcare ExchangesSupplier success in a post-reform healthcare market depends on a lot of factors, including a fundamental and thorough understanding of the foundation of healthcare reform. This is part of an ongoing series designed to help The Journal of Healthcare Contracting readers understand the implications of reform.
May 2014 | The Journal of Healthcare Contracting12
HEAltHCArE rEforM NAVIgAtIoN
their eligibility status for available insurance programs, such
as Medicaid, CHIP (Children’s Health Insurance Program),
public subsidy options or employer-based insurance. The ex-
change allows them to shop, compare and choose the plan
that is best for them based on their eligibility and needs.
These exchanges are federal- or state-government-run
entities intended to create a more organized and competi-
tive market for health insurance by offering health plan
choices, common rules around plan types and pricing of
insurance, and providing information to help consumers
better understand the options available to them. Some
states have chosen to develop exchanges on their own,
others have elected to fall back on the federal program,
and others have entered partnerships with other states
and the federal government.
Transparency and accountability The goals of the program are simple: Make it easy for con-
sumers to purchase insurance, and provide transparency
and accountability among the insurance companies, using
competition as a way to drive down premiums. With more
patients insured, it is hoped that insur-
ance companies can spread out their
risk and offset the costs of higher-risk
patients on their plans.
Initially, exchanges will serve pri-
marily small businesses and individu-
als purchasing insurance on their own.
There is a large focus on low- to middle-
income families who are between 133
percent and 400 percent of the Federal
Poverty Level. Individuals and families
within this range receive government
subsidies or tax credits to purchase in-
surance through the exchange.
All consumers have four standard
plans to choose from. They range
from the cost-effective “bronze” plan,
which covers 60 percent of the pa-
tient’s healthcare costs, up to the
“platinum” plan, which covers 90 per-
cent of the patient’s healthcare costs.
these exchanges are federal- or state-government- run entities intended to create a more organized and competitive market for health insurance by offering health plan choices, common rules around plan types and pricing of insurance, and providing information to help consumers better understand the options available to them.
“When I joined HISCI, I gained the knowledge and tools I needed to contract with GPOs. Now, thanks to HISCI,
I’ve been able to grow my business and provide the highest level of service to my customers.”
To join, contact Mike Copps, HISCI’s executive director | 202.367.1185 | [email protected] | www.hiscionline.org
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May 2014 | The Journal of Healthcare Contracting14
HEAltHCArE rEforM NAVIgAtIoN
Insurers in the exchanges are not required to offer plans
in all four levels, but they must offer at least one silver and
one gold plan.
All policies offered on the exchanges must cover ambula-
tory and emergency services, hospitalization, maternity and
newborn care, mental health and substance abuse, prescrip-
tion drugs and pediatric care, including vision and oral.
Because of healthcare reform, insurers can no longer turn
away patients with a pre-existing condition. But because
these patients increase a company’s risk, insurers are intent
on gaining new customers – including young people, many
of whom avoid health insurance – through the exchange to
minimize their risk. Also, lifetime and annual spending limits
have been eliminated.
Bottom-line impactSo what will the impact be on the healthcare industry?
For starters, effective March 31, 2014, everyone was re-
quired to have insurance. Those without it will be subject
to fines for non-compliance.
Regardless of how many people purchase insurance,
there may be an influx of newly covered patients into the
healthcare system. Health systems hope those newly cov-
ered patients will help them offset the cost of care they cur-
rently provide to those without insurance or underinsured.
The goal is to drive down the overall costs of healthcare.
How will providers react? They will continue to focus
on “Triple Aim.” Developed by the Institute for Healthcare
Improvement, or IHI, the Triple Aim
describes an approach to optimizing
health system performance by 1) im-
proving the patient experience of care,
including quality and satisfaction; 2)
improving the health of populations;
and 3) reducing the per-capital cost
of healthcare. All while maintaining a
focus on the patient.
Primary care is the new gatewayWith emergence of accountable care
organizations (ACOs) and patient-
centered medical homes, primary care
will become the new gateway to care.
Many of these newly insured will work
to become established with a primary
care physician, while others will wait
until they are hurt or sick to seek care
through a primary care physician or
emergency room visit.
With more insured patients entering
the healthcare system, providers will
need assistance dealing with these new
patient volumes in a changing health-
care environment focused on the Triple
Aim and patient-centered care. <JHC
MDSI – the parent company of The Journal of Healthcare Contracting – has developed the Healthcare Reform
Navigation Series, an online program designed to make the task of preparing your organization for 2014 and
beyond easier. This series will help you and your team with online courses that explain many of the key elements
integral to understanding reform and the transformation from fee-for-service to fee-for-value. The program in-
cludes a 12-month schedule of topics and live sessions with industry experts.
To learn more about the Healthcare Reform Navigation Series, contact Tim Brack, director of training, education
and meetings, at 770.263.5270 or [email protected].
Cost effective InnovativeQuality Predictable
May 2014 | The Journal of Healthcare Contracting16
Nurses lobby for patient-
handling equipment
and supplies
Back-breakingwork
As you walk the halls of your facilities, no doubt you’ve
seen nurses manually moving or repositioning patients. And with research showing the benefit of mobilizing post-op pa-tients as soon as possible, nurses are making an extra effort to do that as well.
But without assistive tech-nology, all that lifting and moving around can be haz-ardous to nurses and their patients, says the American Nurses Association.
Back-breakingwork
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May 2014 | The Journal of Healthcare Contracting18
SAfE PAtIENt HANDlINg
Government data backs up the association’s concerns. In 2011,
nursing assistants and registered nurses were among the top five
occupations with the highest number of musculoskeletal-related
injuries and illnesses resulting in time away from work, according
to the U.S. Department of Labor Bureau of Labor Statistics.
It’s time to establish a national culture of safety around safe patient
handling and mobility, says the ANA. Part of that culture should en-
compass patient-handling equipment and supplies. That being the
case, contracting executives may very well find themselves playing a
role in ensuring the health and safety of their nursing staffs.
No such thing as safe liftingThere’s no such thing as safe manual lifting or moving of patients,
says Jaime Murphy Dawson, MPH, senior policy analyst, Depart-
ment for Health, Safety and Wellness, American Nurses Association.
“In any setting where healthcare workers are manually lifting pa-
tients, they’re at great risk.”
The ANA did a survey in 2011 in an effort to assess the occupa-
tional health and safety issues that nurses face in the workplace,
explains Dawson. “One of their top concerns were musculoskeletal-
related disorders.” Sixty-two percent of respondents feared they
would develop a musculoskeletal disorder. In fact, 56 percent re-
ported working with musculoskeletal pain, and 80 percent of those
reported they experienced pain frequently.
Chances are, the real percentages are higher, as nurses don’t always
report their injuries, says Dawson. And the problem extends across the
care continuum, including home care and long-term care.
Standards, legislationLast summer, the American Nurses Association, in collaboration
with a multidisciplinary team of national experts, published sug-
gested national standards for creating, implementing and manag-
ing a safe patient handling and mobility program.
Their efforts to establish a national culture of safety could be boost-
ed by passage of a law by Congress that would establish an occupa-
tional safety and health standard to reduce injuries to patients, nurses
and other healthcare workers by establishing a safe patient handling,
mobility and injury prevention
standard. Such a measure has
been proposed in the past, and
one is currently working its way
through Congress.
Bill H.R. 2480, introduced in
June 2013 by Rep. John Cony-
ers Jr. (D-Mich.) and Rep.
George Miller (D-Calif.), would
require the Occupational Safe-
ty and Health Administration to
develop and implement a safe
patient handling and mobil-
ity standard that will eliminate
manual lifting of patients by
direct-care RNs and health care
workers, and require health
care employers to:
• Develop a safe patient han-
dling and mobility plan,
and to obtain input from
direct-care RNs and health
care workers during the
process of developing and
implementing such a plan.
• Purchase, use and main-
tain equipment, and train
health care workers.
• Track and evaluate injuries
related to the application
of the safe patient handling
and mobility standard.
• Make information about
safe handling available
to employees and
their representatives.
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May 2014 | The Journal of Healthcare Contracting22
SAfE PAtIENt HANDlINg
It’s true that – as of press time – 11 states had enacted some
form of safe patient handling and mobility standard, based, at
least in part, on the ANA proposed standard, says Jerome Mayer,
associate director for federal government affairs, American Nurses
Association. “The problem is, at the state level, each process is dif-
ferent, and language has been changed.” As a result, there is no
program applicable in all states. What’s more, it’s a slow process,
and enforcement varies from state to state. A federal law would
address those concerns.
Patient handling equipmentThe safe-patient handling, mobility and injury prevention standard
proposed by Conyers’s and Miller’s bill calls for healthcare provid-
ers to do a number of things, including train their workers on safe
patient handling and mobility, track and review data relevant to
the facility’s program, and annually evaluate implementation of the
program. It also calls on providers to – within two years of passage
of the law – “purchase, use, maintain and make accessible to health-
care workers such safe patient handling equipment, technology
and accessories as the Secretary [of Health and Human Services]
determines appropriate.”
According to the ANA, research shows that the use of assistive
technology reduces injuries to workers and patients, and lowers
costs attributable to workers’ compensation, lost productivity, and
turnover. Healthcare managers and workers themselves often don’t
realize that these potentially career-ending injuries don’t always
occur as a single event, says the association. The cumulative effects
of repetitive strains result in long-term, debilitating disorders that
often require surgery.
The ANA refrains from recom-
mending any specific products
or services. That said, “there is a
lot of technology available, and
it is evolving by the minute,” says
Dawson. Equipment is available
to help lift and transfer patients;
help patients sit up, stand and
ambulate; and help them bathe
themselves and use the bath-
room. Friction-reducing sheets
can ease the task of moving pa-
tients. Ceiling lifts are the gold
standard for new construction,
but other technologies are
available to help healthcare
workers perform similar func-
tions in older facilities.
“It’s a very innovative field,”
says Mayer. “New things are
coming out constantly.”
Establishing a culture of safety
for safe patient handling and mo-
bility is a paradigm shift, much
like wearing gloves and protec-
tive equipment for all blood and
body fluid precautions was 20
years ago, says the ANA. Health-
care workers routinely practice
universal or standard precau-
tions for bloodborne pathogens.
Similarly, they will get to the
point where they act on the as-
sumption that any lifting is haz-
ardous to workers and patients
alike, and that assistive technol-
ogy must be in place.
“ In any setting where healthcare workers are manually lifting patients, they’re at great risk.”
– Jaime Murphy Dawson
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SAfE PAtIENt HANDlINg
the roI of safe-patient handlingThere is an ROI for the acquisition of equipment and the time spent training all healthcare workers on it, according to Jai-
me Murphy Dawson, MPH, senior policy analyst, Department for
Health, Safety and Wellness, American Nurses Association. With
a safe patient handling and mobility program in place, nurses
and other healthcare workers can return to work after an injury
confident that they won’t be
injured again. “These are high-
ly qualified healthcare profes-
sionals,” she says. “It can cost
up to $100,000 to replace a
nurse.” A safe patient handling
and mobility program can
help hospitals retain them.
Safe-patient handling and
mobility programs not only lead to greater employee satisfaction,
but fewer workers comp claims, adds Jerome Mayer, associate di-
rector for federal government affairs, American Nurses Association.
What’s more, when patients are moved in a safe manner, certain
hospital-acquired conditions and incidents, such as pressure ulcers
and falls, decrease. “This a big concern for hospitals, because CMS
has said they won’t pay for cer-
tain hospital-acquired condi-
tions,” he says. And the average
cost associated with a pressure
ulcer can reach $40,000; for a
fall, $20,000 or more.
“These are costs the hospi-
tals are eating,” he says. “Get-
ting buy-in to a safe patient
handling and mobility pro-
gram from the staff [provides] a
return on investment.”
Standards for safe patient handling and mobilityUniversal standards for safe patient handling and mo-bility (SPHM) are needed to protect healthcare workers from in-
juries and musculoskeletal disorders, says the American Nurs-
es Association. Addressing healthcare worker safety through
SPHM will also improve the safety of healthcare recipients, that
is, patients.
ANA’s Department for
Health, Safety and Wellness
and a team of national experts
established a uniform, na-
tional foundation for SPHM to
prevent injuries to healthcare
“ This a big concern for hospitals, because CMS has said they won’t pay for certain hospital-acquired conditions.”
– Jaime Murphy Dawson, MPH
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safe patient handling
workers and patients. In June 2013, the association published a
list of eight suggested national standards for safe patient han-
dling and mobility.Standard 1: Establish a culture of safety.
Standard 2: Implement and sustain a safe patient handling and mobility (SPHM) program.
Standard 3: Incorporate ergonomic design principles to provide a safe environment of care.
Standard 4: Select, install and maintain SPHM technology.
Standard 5: Establish a system for education, training and maintaining competence.
Standard 6: Integrate patient-centered SPHM assessment, plan of care and use of SPHM technology.
Standard 7: Include SPHM in reasonable accommodation and post-injury return to work.
Standard 8: Establish a comprehensive evaluation system.
The SPHM standards are
open and voluntary, according
to the ANA. The standards do
not require use of any specific
products or services. Nor do
ANA or the endorsing orga-
nizations promote, endorse,
or recommend any products
or services.
The Safe Patient Handling and Mobility Standards are property of the American Nurses Association © 2013. All rights reserved.
Numbers talkNursing assistants and RNs were among the top five occupations in terms of the number
of incidents involving musculoskeletal-disorder-related days away from work in 2011.
• Nursing assistants: 25,010.
• Laborers and freight- stock- and material movers- hand: 21,700.
• Janitors and cleaners- except maids and housekeeping cleaners: 16,530.
• Heavy and tractor-trailer truck drivers: 13,750.
• Registered nurses: 11,880.
• Stock clerks and order fillers: 10,250.
• Light truck or delivery services drivers: 9,600.
• Maintenance and repair workers- general: 9,300.
• Production workers- all other: 9,250.
• Retail salespersons: 8,550.
Source: U.S. Department of Labor, Bureau of Labor Statistics, http://www.bls.gov/news.release/osh2.t18.htm
C
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May 2014 | The Journal of Healthcare Contracting28
SAfE PAtIENt HANDlINg
The Nurse and Health Care Worker Protection Act of 2013 (H.R. 2480), introduced in June 2013 by Rep. John Conyers
Jr. (D-Mich.) and Rep. George Miller (D-Calif.), directs the Secre-
tary of Labor to issue an occupational safety and health standard
to reduce injuries to patients, nurses and all other healthcare
workers by establishing a safe patient handling, mobility and
injury prevention standard.
Much of that standard has to do with employee training and
participation in safe patient handling programs. But technology
and equipment are important too. That’s because patient han-
dling technology can reduce musculoskeletal injuries among
healthcare workers, and reduce skin tears, pressure ulcers and
falls among patients.
Among the bill’s provisions regarding equipment and technology
are these:
• “The safe patient handling, mobility, and injury prevention
standard shall require the use of engineering and safety
controls to perform handling of patients and the elimination
of injuries from manual handling of patients by direct-care
registered nurses and all other health care workers, through
the development of a comprehensive program, to include
the use of mechanical technology and devices to the greatest
degree feasible.”
• “[W]ithin 2 years of the date of promulgation of the final
standard, each health care employer shall purchase, use,
maintain, and make accessible to health care workers,
such safe patient handling
equipment, technology,
and accessories as
the Secretary
determines appropriate.”
• “[E]ach health care
employer shall consider
the feasibility of
incorporating safe patient
handling technology
as part of the process
of new facility design
and construction, or
facility remodeling.”
• “Where the use of
mechanical technology and
devices is not feasible, the
standards shall require the
use of alternative controls
and measures, including
trained, designated lift
teams, to minimize the
risk of injury to nurses
and health care workers
resulting from the manual
handling of patients.” <JHC
To read the entire text of the bill, go to http://thomas.loc.gov/cgi-bin/thomas
Equipment important part of pending legislation
You worry about the bottom line...
We’ll take care of your front line.
Approximately 8 million U.S. healthcare workers (HCW) are potentially exposed to hazardous drugs, including pharmacy and nursing personnel.1 These drugs are known or suspected to cause cancer, miscarriages, birth defects, or other serious health consequences.2
At B. Braun, we’re protecting those who dare to care with innovative, closed system devices designed to help reduce the risks associated with admixture, transport, delivery and disposal of hazardous drugs.
For more information on exposure and reducing the risks, visit www.CytotoxicExposure.com
1 US Bureau of Labor Statistics, May 2006 National and Occupational Employment and Wages estimates, Washington DC: United States Department of Labor, Bureau of Labor Statistics; 2007 2 www.invw.org/chemo-mainRx Only. ©2013 B. Braun Medical Inc. Bethlehem, PA. All Rights Reserved. 13-3928B JHC_9/13_KE
B. Braun is committed to
PatientSAFETY
EnvironmentalSAFETY
HCWSAFETY
FinancialSAFETY
ONGUARD™+ CYTOGUARD
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May 2014 | The Journal of Healthcare Contracting30
By Dan Nielsen
“What are you becoming?” This is a critical question every leader should frequently ask him
or herself – and answer in detail. This is also a
question every leader should frequently ask each
and every direct report and team member.
Not only is the question critical to achiev-
ing your potential and reaching your personal
and professional goals and dreams, it is critical
to the future of your direct reports, your team,
and your organization! Just as important, very
seriously and frequently ask-
ing this question sets an im-
portant expectation and
will dramatically and
positively impact the
culture of your team and
your organization.
Frequently and very seriously
asking yourself, your direct
reports, your team, and your entire organization
this critical question will result in the following:
• Every person within your entire organization
will quickly come to understand that this
critical question is a high priority to be seri-
ously considered and answered, if a person
– regardless of their title or level within the
organization – is to remain a part of and suc-
ceed within your organization.
• Asking and seriously answering this question
will dramatically and positively affect corporate
culture throughout your entire organization.
• Your organization, and the people within
your organization will succeed at a much
higher level and rate than they otherwise
would. Of course they will – they know what
they are becoming!
• Many people throughout your organization,
for the first time, will seriously and con-
sistently think about, plan,
and take serious, consistent,
intentional and purposeful
action regarding what they
are becoming.
I suggest you add this criti-
cal question, “What are you
becoming?” to the discussion
of every annual or quarterly
review and evaluation you conduct. And that
you set a policy that this critical question will be
discussed during every review and evaluation
conducted throughout your entire organization.
Not just in general, but specifically, the “who,
what, when, where, why, and how” of “What are
you becoming?”
You will be absolutely amazed at the results.
I guarantee it! <JHC
HEAltHCArE lEADErSHIP
What Are You Becoming?
Dan Nielsen – www.dannielsen.com
National Institute for Healthcare Leadership – www.nihcl.com
America’s Healthcare Leaders – www.americashealthcareleaders.com
CAT SCAN
May 2014 | The Journal of Healthcare Contracting32
Washington: Providence Health & Services sees decreased operating income in 2013Providence Health and Services (Renton, WA) reported lower-than-expected operating income
for 2013 due to flat inpatient volume and an adverse payer mix. The system reported $37.7 mil-
lion in net operating income for 2013, ended December 31, which was 81.5 percent below the
$204.1 million it earned in 2012. Revenue increased about five percent to $11.1 billion, from
$10.6 billion in 2012. Inpatient volume was nearly flat, declining 0.1 percent, but commercial
volume was 4.9 percent lower than expected. Providence instead saw a greater percentage of
Medicare and Medicaid patients.
IntheHeadlinesHospital and health system news from across the country
Editor’s note: The following news has been compiled by Major Accounts Exchange (The MAX), health care’s leading provider of real-world intelligence for the supply chain. The MAX serves as a Supply Chain “Community” where senior-level executives can easily Find, Digest, and Act on vital business and mar-ket intelligence. For the latest news impacting the supply chains of over 1,200 IDNs and all the GPOs, visit http://www.uslifeline.com/
Michigan: Three health systems plan mergerBeaumont Health System (Royal, Oak, MI), Bots-
ford Health Care Continuum (Farmington Hills,
MI), and Oakwood Healthcare System (Dear-
born, MI) signed a LOI to form a new IDN. Un-
der the proposal, the three systems would pool
their assets and operations into a single orga-
nization designed to improve patient access to
care and take advantage of economies of scale.
It would function under a unified leadership
structure initially led by Beaumont Health CEO
Gene Michalski. The organizations are currently
undergoing due diligence procedures and the
merger will require regulatory approval.
The Journal of Healthcare Contracting | May 2014 33
Pennsylvania: DLP Healthcare signs LOI to acquire Conemaugh Health SystemDuke Lifepoint Healthcare (DLP Healthcare)
(Brentwood, TN) signed an LOI to acquire Co-
nemaugh Health System (Johnstown, PA). Un-
der the proposed deal, DLP Healthcare will in-
vest more than $500 million in Conemaugh over
the next 10 years, retain its existing employees,
and allow its board of directors to control local
operations. A Conemaugh spokesman said the
acquisition was part of the system’s plan to part-
ner with a larger organization to better position
itself for changes in healthcare delivery. Pending
due diligence and regulatory approvals, the ac-
quisition is expected to close in fall 2014.
North Carolina: Carolinas HealthCare System opens Behavioral Health DavidsonCarolinas HealthCare System (Charlotte, NC)
opened Carolinas HealthCare Behavioral Health
Davidson (Davidson, NC) after slightly less than
two years of construction. The $36 million,
67,000-sq-ft hospital features three 22-bed
units, two dedicated to mood disorders, with
another reserved for patients suffering from
depression and substance abuse. The cam-
pus also features a 10,000-sq-ft medical office
building for outpatient mental health care. Car-
olinas HealthCare expects the hospital to oper-
ate at a loss, but the psychiatric ER
and other services should ensure
patients receive appropriate care
and reduce costs at other Carolinas
HealthCare facilities.
Washington DC: US Naval Hospital Guam begins transition to new $158M facility
US Military Health System (DoD) (Washington,
DC) and US Navy Bureau of Medicine and Sur-
gery (BUMED) (Falls Church, VA) announced the
transition from US Naval Hospital Guam (FPO, AP,
GU) to the US Naval Hospital Guam Replacement
(Agana Heights, Guam) will begin on April 11 and
run through April 20, 2014. The new $158 million,
281,000-sq-ft, 42-bed hospital features four oper-
ating rooms, two c-section rooms, and improved
diagnostic and ancillary services including MRI
and Cat scanning suites.
May 2014 | The Journal of Healthcare Contracting36
By Robert T. Yokl
VAluE ANAlYSIS
Benchmarking Your Way to
Everyone needs benchmarks to up their supply chain expense game
If you aren’t aware of it, benchmarking is your key to becoming the best-of-the-best in sup-
ply chain expense management. No longer can we
guess where our savings reside. We need to know,
with clarity and certainty, where our savings are
hidden for the following three reasons:
• No one has the unlimited resources to search
in the weeds for buried savings that might
never result in realizable dollars.
• No one has the visibility that is necessary to ferret
out savings that are obscured from your view.
• No one has the time that is required
to uncover where your next savings
opportunities are coming from.
• Yet, all of these negatives can become
positives, with the right benchmarking system.
May 2014 | The Journal of Healthcare Contracting38
VAluE ANAlYSIS
A system in placeBenchmarking, if done artfully and scientifically, can solve
your challenges of not having unlimited resources, unre-
stricted visibility and limitless time to search for new savings
opportunities, because benchmarking pinpoints with near
certainty where your best savings opportunities reside. For
instance, a Children’s hospital client of ours saved $525,233
on their lab reference tests when our benchmarks identified
a 6 percent savings gap with their cohort group. Without this
yardstick this hospital, in our opinion, would have continued
to spend half-a-million dollars a year unnecessarily for their
lab reference tests for many years.
As you know, your department heads and managers
are super busy and often don’t even have the time to at-
tend your value analysis team meetings. So when you get
them to a meeting you had better not have them work on
projects that end up as “dry holes,” or they will surely start
skipping your value analysis meetings in the future. This is
another benefit of benchmarking, it can give the fuel that
is necessary to almost guarantee savings for your value
analysis project managers.
Another advantage of benchmarking is that you can es-
timate your savings opportunities before, during and after
your value analysis projects to ensure that your value analysis
project managers have squeezed the
towel dry on any given savings that
were identified through benchmarking.
Here’s how this works. If your bench-
marking tells you that there is a $127,987
savings opportunity on pulse oximeters,
you then have a targeted savings goal
for this value analysis project. If at the
end of the project your team member
has only uncovered $56,322 in realiz-
able savings then you need to audit this
project to find out what happened to
the other $71,167 that was your
original goal.
We often find that value
analysis project managers miss
their targeted savings goal
because they didn’t dig deep
enough into the data, didn’t
work hard enough to make
savings happen, the data was
flawed or the benchmarks
were calculated improperly. No
matter what the reason, we in-
sist that our clients audit their
value analysis projects if they come up
short on their estimated savings goals.
It just makes sense to do so! This is how
to develop a learning organization,
rather than point fingers at each other!
To recap, benchmarking is the
search for best practices that lead to
superior performance. There are no
shortcuts to this process, but there are
big rewards for those supply chain pro-
fessionals who benchmark their way
to success in turbulent times. <JHC
No matter what the reason, we insist that our clients audit their value analysis projects if they come up short on their estimated savings goals. It just makes sense to do so!
A well-designed apparel programcan help patients feel:
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A positive patient experience has a directeffect on HCAHPS® scores and reimbursements.
Big things can happen when you focus on the details.
5YOUR TRUSTED GUIDE
In today’s healthcare environment, it’s difficult to anticipate the challenges that will emerge. Relying on an expert guide who has traveled the path and avoided the pitfalls is key. SolutionsTrust leverages “operator experience” to optimize your performance and ensure a successful supply chain journey. Learn more about SolutionsTrust at www.totalcostmanagement.com
“Experience matters. I recommend a TRUSTed partner to help you not only
survive, but thrive.”