The following article is written By Robert Edelstein, CEO of Millennium Surgical Corp./SurgicalInstruments.com.
Here are seven of the top challenges surgery centers need to overcome when purchasing surgical instruments.
1. Overburdened nursing administrators have limited time. Nursing administrators tend to wear many hats in the current economy, making it difficult for them to take on time-consuming tasks like researching surgical instruments from a plethora of vendors. In addition to simply locating the correct instrument, administrators must still compare several different branded versions of the same instrument for price, since a single instrument can be branded by various manufacturers at multiple price points.
Nurses can save thousands of dollars by streamlining their purchasing process, focusing on only the instruments they need. Sets are often designed by instrument companies and include unnecessary parts. So for instance, when buying a Bookwalter-type ring, nurses should target only the necessary components and avoid complete sets.
2. Surgical instruments have become more complex and specialized. The number of instruments in the typical vendor catalog has increase by approximately 30 percent in the past five years, according to Millennium Surgical's observations. This gives nursing administrators many more choices to pore through in making purchasing decisions, and in comparing different versions of the same instrument from various vendors. This process can be delegated to an educated supply consultant with prior knowledge of the industry, leaving nurses free to focus on more care-related duties.
3. Surgeons make requests by brand or specific item, requiring nurses to track down and compare items from a roster of vendors. Surgeons often request a specific instrument solely by brand. It's important for the administrators to determine whether that item must come from that specific vendor. If the vendor name or part number is provided only for reference, it presents an opportunity: Many U.S. surgical instrument suppliers outsource their manufacturing to a number of companies. This means that identical instruments are multi-branded and sold at varying costs, allowing the facility to possibly source the same item for less money.
4. Budgets are limited, so the acquisition of higher-paying surgical specialties is on the rise — leaving staff to fill unfamiliar instrument sets. As the healthcare industry becomes more competitive, surgical centers have felt the pressure to add services that yield higher reimbursements and greater profit margins. This often requires the staff to assemble an unfamiliar and complex new sets of instruments — not an easy undertaking for an overtaxed OR administrator, who must maintain current quality of care at the same time. New specialties, such as the introduction of spinal procedures, mean new vendors and instruments that are hard to identify and to source.
5. Surgeons make off-beat requests for hard-to-find and discontinued items. Surgeons can be adamant about their preferences – but their requests can be vague and mystifying to the rest of the staff. They often demand that a certain set of surgical instruments be reproduced in their new OR, yet few of them know what vendors make what instruments and where they came from. OR personnel are left to figure that out on their own.
6. Quality of instrumentation has followed prices down. Instruments may be cheaper but need to be ordered more often. Prices have declined, but you get what you pay for. Purchasing agents should invest selectively in quality in order to avoid the frequent replacement of instruments. Prioritize: Certain items, such as needle holders and scissors, are more likely to breed surgeon contention than others if quality or maintenance is sub-par. Purchase the highest grade of these and similar instruments, and your surgeon and staff satisfaction will rise.
Practice intelligent cost-cutting: Identify target areas that will significantly help a center's bottom line. Cutting costs on the purchase of handheld retractors, sponge forceps, towel clips, dressing, tissue forceps and basic hemostats will not directly affect surgeon satisfaction, where as a lesser-quality rongeur might have a greater impact.
7. Changes to policies by CMS, The Joint Commission and state survey inspections have put set inventory and decontamination/sterilization processes under the magnifying glass. As flash or immediate-use sterilization continues to be examined and/or criticized, the importance of having an adequate instrument inventory becomes more critical. Instances of flash sterilization can be reduced by maintaining a reasonable stock of instruments. It helps to maintain accurate expectations of instrument utilization in assembling an inventory. If new surgeons or new procedures are coming to a facility, the nursing administrator should research whether he or she will be able to receive a strong ROI on an instrument wish list before filling that list.
Learn more about Millennium Surgical and SurgicalInstruments.com.
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