The following article is written by Regina Robinson, RN, MBA, CMPE, CASC, director of Peninsula Surgery Center in Newport News, Va.
An ambulatory surgery center is always looking for ways to control and reduce its costs and central supply is one area that should be monitored carefully. Each ASC has its own procedure for controlling and measuring the items in central supply and it is important to have solid steps to ensure this is ongoing. Here are 10 suggested steps to help maintain control of this very important site of an ASC.
1. One person in charge. Most ASCs have a materials management person that is responsible to keep up with all the supplies that are ordered and delivered and used daily. While there are many items stocked in the central supply area, this person should know exactly which items can be depleted quickly and watch these more often than others.
2. Keep a close inventory of the items that are used the most. These may be low-cost items or could be high-cost items but they are used more frequently than other items. As such, it may be harder to control the inventory because of the rapid turnover. The materials management personnel should be very mindful of these items, since inaccurate tracking might lead to count discrepancies and not having the item for surgery.
3. Establish PAR levels. This is a big undertaking but is very important to ensure proper levels are maintained on items so there is no shortage and overstocking is minimized. Items that sit on a shelf unused are equal to money and should be avoided if possible.
4. Stocking should be done by employees. Usually the employee in charge of ordering supplies for this area is the one that stocks the shelves. However, there are times when an item is ordered directly from a company and local reps will make the delivery and offer to stock the item themselves. While this may make the job easy for the employee, it also allows a non-employee in a restricted area. All non-employees should be escorted to the area and supervised when restocking the shelves. Some ASCs elect not to let reps in this area at all.
5. Check if the order is complete and accurate. The actual order sheet should be compared side by side with the packing slips, while unpacking the boxes. It is easy for an item to be missed and not sent by the company, or the items may be on back order. The materials management person must be alert to these potential variations that could cost the center money. The variations must be fixed immediately by calling the company or keeping track of items that are back ordered. A system should be in place to monitor the paper trail to ensure that all ordered items were delivered. If there is an item missing, this paperwork should be kept separate until the item has been received.
6. Review contracts. Ongoing review of contracts, especially implants, is very important. The prices of all items could change without notice and there could be an annual 3 percent increase built into the original contract.
7. Weekly or monthly inventory counts. This would depend on the center and the method of keeping track of the items. Some centers will do weekly inventory counts on the top 20-40 most used items and then monthly inventory on other items. The rapid turnover items can be easily overlooked and require more frequent ordering. This helps to maintain the PAR levels and keep costs under control.
8. Annual inventory. Each ASC should do an annual inventory to ensure the items on the shelf match the orders placed for that year. This type of inventory is for every item, and is measured to the individual items and not by boxes. This will let you know the amount of money you have on the shelf and the discrepancy amount from the orders placed. If the amounts differ greatly, it could signal a problem.
9. Review and compare new items. This should be an ongoing task. There are many items on the market that are comparable to each other. While some ASCs will only order a certain manufacturer's item, it is important to consider alternatives. This can be time consuming but it can be done for certain items every six months and add up to large cost savings. A comparison of these selected items should include the quality, quantity and price. A determination should be made about the quality of the item and if there is flexibility. If an item has that flexibility, then a review of different manufacturers can begin and how it relates to your current item and the effect of this change.
10. Ensure specific items meet the need. While it is a goal to minimize the selection of the same items, it is very important to make sure the items meet the needs of the patients and surgeons. Physician-owners are understanding of controlling costs and might be willing to look at alternatives that may assist in controlling or cutting costs. The owners learn to appreciate limiting the variables on products.
Learn more about Peninsula Surgery Center.
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