To achieve both cost and quality goals in today’s ASCs, it’s important to combine supply chain and clinical perspectives. A clinical assessment does just that by bringing these teams together to help spot otherwise hidden opportunities to improve inventory management and clinical practices.
This holistic perspective allows surgery centers to better understand, prioritize, and pursue opportunities that will improve the health of not only your patients, but also your practice.
A clinical assessment comprises 3 major components, and each play a critical role in helping your surgery center identify hidden waste and find real savings in the OR.
1. Identify process improvements and safety standards
Maximize the efficiency of your surgery center’s case pick process. Inefficiency can make inventory management more difficult. For example, a surgery center may believe that picking five cases in advance will improve efficiency. On the contrary, this practice results in having too many products sitting on carts and in totes, waiting to be used. Meanwhile, inventory shelves are depleted and need to be restocked for the inevitable changes in OR schedules, including accommodating add-on cases. A clinical assessment can help identify this waste of both time and money and recommend improvements to mitigate both.
Evaluate safety standards compliance. During a clinical assessment, the team observes and can advise your surgery center’s clinical director on compliance with such safety issues as safe medication labeling; AAMI protection levels for staff; eye protection and complying with JCAHO, AAAHC and CMS standards.
Assess the level of gown protection achieved via current practices. This can be both a safety and a cost savings opportunity. The assessment process can confirm that the surgery center staff is providing the correct amount of protection for each type of procedure performed. Sometimes, more protection is used than needed — and revealing this could save you money. For example, a surgery center may be using an AAMI Level 4 gown for a particular procedure, when a lower-cost Level 3 gown would offer adequate protection.
Assess draping practices for optimal and efficient coverage. For example, a surgery center may be using an extremity drape and then adding extra drapes for adequate coverage. The Clinical Assessment Team may recommend replacing that practice with an extremity drape that has attached arm board covers. This would eliminate the cost of extra draping, while reducing the number of steps in the draping process.
2. Evaluate efficiency of current procedure supply
Validate the right pack for each procedure. This step alone can represent significant cost savings. In an actual case study, one surgery center had not reviewed its pack program for years.3 During that time, case volume had grown substantially and there were new procedures added to the case mix. The clinical assessment revealed that this surgery center was using its original hand pack as the “basic pack” for most procedures, creating about $30 of waste each time it was opened. Once this waste was revealed, the surgery center had the knowledge to update and align its pack program with the current case mix.
Assess the supply chain’s impact on the practice, patient throughput and overall costs. Aligning inventory levels with actual utilization — and ensuring that the pack program minimizes the need to pull off-the-shelf items — can increase efficiency, lower costs and help improve your surgery center’s bottom line.
Evaluate the level of returns to the case pick area following each procedure. As mentioned earlier, tying up too much inventory in case carts and totes depletes inventory on the shelves. This inefficiency makes it more difficult to cost-effectively have products available to accommodate changes in caseload and scheduling.
Identify supply consolidation opportunities for high-volume, supply-intense procedures. This standardization effort can improve both efficiency and lower costs. At the same time, the team conducting the clinical assessment reviews new procedures to determine to what extent they require different bundles of supplies altogether.
3. Uncover new cost savings initiatives
Identify waste in custom pack components. Surgeons can change their preferences over time. The clinical assessment can spot packs that need to be updated due to evolving clinical preference needs. Otherwise, items may remain in the packs and be wasted.
Explore ways to standardize products. Using the same single items both inside and outside of your packs is a prime opportunity to standardize with the lowest cost alternative. As long as the products are clinically acceptable inside the packs, you’ll save money and maintain quality of care at the same time.
Review the cost benefits of incorporating single-sterile items into packs. If a surgery center is pulling a particular single-sterile product from the shelves most of the time, adding it to the pack as part of the standardization effort can save money.
Increase efficiencies and savings by evaluating clinical practices. An example is how towels are layered on the OR back table. If using a heavy-duty back table cover, no layering is required. But if the OR staff feels more comfortable double layering, use a ¾ drape to save money.
Determine the need for optimizing the surgery center’s pack program. The key is to keep the pack program aligned with changes to case mix and procedure volume. For example: 1) Have you added new procedures, but are using packs not built specifically for them? 2) Have surgeons left, but their preferences are still built inside your packs? 3) Do you really need to keep packs for low-volume procedures?
Completing a clinical assessment on your own is a large undertaking and can seem quite daunting considering all the priorities of ASC staff. If you’d like to understand opportunities for improvement but don’t have the time or resources to conduct your own clinical assessment, you should consider taking advantage of Cardinal Health’s clinical assessment at no-cost to you.
Click here to schedule your assessment today.