OptiFlex™ SS system helps the OR track surgical supply costs and streamline inventory management.
Patewood Memorial Hospital, part of the Greenville Hospital System University Medical Center (GHS), opened in June 2007 on a medical campus a few miles east of downtown Greenville, SC. With elective inpatient surgeries taking place in four universal digital operating rooms, Patewood Memorial campus president Scott Jones knew that a standard OR information system would be insufficient. Previous experience had taught Jones that manual procedures for tracking surgical suite supplies were cumbersome, time consuming and often yielded inaccurate data
for tracking costs per case.
"We have a state-of-the-art facility with 72 patient beds, as well as a surgical suite that includes four universal digital operating rooms, eight pre-op beds and 14 post-op beds," said Jones. "We've also designed the structure to accommodate the addition of four more operating rooms, four additional pre- or post-op beds and up to 36 inpatient beds. To maximize workflow efficiency and allow for future growth, we knew we needed an automated perpetual inventory management system that would increase productivity for both materials management and staff, plus decrease inventory carrying costs."
Automation improves productivity
Geoff Hibbert, OR manager at Patewood Memorial, had plenty of experience with manual inventory systems when joining the hospital last year. During the first six months of the hospital's operation, the materials management staff at Patewood Memorial counted inventory via hand-held devices for supply replenishment. Charge transactions of used inventory were then manually keyed by clinical/billing staff for the billing of each surgical case.
The staff was consumed with manual inventory tasks that left materials management staff with less time to pull instruments and supplies for the next day's procedures. This task of 'picking cases' was relegated to the surgical staff.
Personnel's valuable time was not the only resource experiencing sub-par efficiency because of the manual inventory system. "Inventory either sat idly on shelves or wasn't readily available as a result of inconsistent replenishing processes," Hibbert said.
Omnicell systems for automated supply management were already in place, but Jones recognized the need to automate and better track inventory and supply usage in the OR. The hospital decided to add the Omnicell OptiFlex SS system which would give them that option. The OptiFlex SS is a complete physician preference card and perpetual inventory management system for supply management requirements of the surgical services department. The automated system allows for instantaneous reporting on physicians' detailed per-case supply cost data through real-time usage tracking using electronic preference, scanning of supplies and a continuously updated electronic preference card. Under Patewood Memorial's manual system, such real-time case management was non-existent.
Automating OR supply
"It is important when installing an automated OR supply system of this complexity and capability that you have the support of hospital leadership," said John Mateka, GHS' executive director of material services. "Scott and Geoff provided the vision and rallied support of the materials management staff to implement OptiFlex SS. Materials management staff immediately realized the benefits and quickly got on board."
Patewood Memorial is the first hospital in the five-campus GHS system to use the system. OR supplies that weren't previously being tracked by materials management at Patewood Memorial are now all manged through OptiFlex SS. This provides the hospital with a true closed-loop process to help accurately manage inventory and usage.
"In the beginning, there is no doubt that the ability to accurately track costs per case was a huge driver," said Hibbert. "It was clear that creating a unique barcode for each surgical case based on the physician, the procedure and the patient would provide us with tremendous capabilities in our reporting procedures. Ultimately, we anticipate a cost savings by going to this new automated system."
Hybrid system of open and closed architec ture Hibbert also understood the benefits of using Optiflex SS within a hybrid system of open shelving and closed secure cabinets. Jones agreed that the added flexibility of this combination solution would bolster the automation process and improve overall inventory accuracy. This unique hybrid arrangement gives staff quick access to materials, while at the same time providing additional security for high-dollar devices.
Patewood Memorial chose to have closed cabinets in the actual OR suites and for inventory of high-dollar items such as consigned implants. Materials management also picks supplies from open shelving in their supply area. Whether pulling items from open shelves or closed cabinets, Optiflex SS barcoded preference cards drive the process and accurately track the utilization and charge it to a specific patient case.
Focus on benefits smoothes transition
When implementing the new system, Patewood Memorial knew there would be bumps along the way. Thanks to a close collaborative effort between Patewood Memorial staff and the Omnicell trainers, however, the transition was kept smooth. In fact, one of the trainers had previously served as an OR nurse. "This real-world experience gave her a unique insight into the problems and issues of inventory flow in the OR," said Hibbert.
For two weeks, training representatives were on site at the hospital to help with the implementation. Existing physician preference cards were audited for accuracy and updated in the system. Inventory par levels were set to ensure that sufficient stock would be on hand. Within 30 days after install, on-the-job training was completed and the system was up and running. "Once you get through that, things become really simple," said Hibbert. "Omnicell technical support has been very good, and they always provide quick responses to our questions."
Automating the preference card process
The new system has completely automated the physician preference cards which can be electronically viewed in the OR suite. Items can be easily taken or added from either open or closed cabinets with a simple barcode scan or by the touch of a screen. Not only are the supplies automatically accounted for and reordered if necessary, they are tracked back to a specific patient case.
"What the staff likes most is that they rarely run out of anything," explained Hibbert. Without having to manually count inventory or key in charges, materials management staff at Patewood Memorial can now focus on picking and auditing cases, allowing the clinical staff to focus on their respective areas of expertise. Hibbert has seen at least two FTEs reallocated to different areas two to three days a week as a result of the im proved efficiency.
"We have weaned all scrub techs and nurses from picking cases," said Hibbert. "Materials distribution staff does it now."
Reduced consumption and increased charge capture
About every three months, Patewood Memorial now runs a "par vs. usage report" generated by OptiFlex SS. This report helps the hospital further optimize inventory levels based on past history of utili zation. The result is a finely tuned stock of supplies with the right balance that rarely expire or run out.
"Our system used to order twice a week; now the automated preference card driven supply locations are sending in orders nightly," said Hibbert. "The inventory turns have doubled since implementation, significantly decreasing inventory carrying costs.
Another significant improvement for Patewood Memorial was realized in knowing exactly what costs were being incurred in each OR case. By recording supply usage based on each patient case and by interfacing directly with the billing system, OptiFlex SS enables Patewood Memorial to consistently, effectively and accurately charge for product usage. Accuracy of this system is contingent upon a strong and enforced vendor policy, which imposes a logical, well-defined process that controls vendor access and introduction of new products.
There's no doubt that change can be difficult,so would Patewood Memorial do it all over again? "Absolutely," said Hibbert. "Installation isn't easy, but the benefits from materials running smoother in the OR and improved efficiencies far outweigh the investment we made in both time and cost."
"I would ask to have it installed in any hospital I worked for," said Hibbert. HPN
Reprinted with permission, Healthcare Purchasing News, November 2008.