OR SUPPLY CHAIN IMPROVEMENT CASE STUDY Aligning Value
Reducing costs, improving efficiency
COLLABORATION INCREASES EFFICIENCY, REDUCES COST
When a health system decided to improve supply-chain practices, it turned to Medtronic Integrated Health Solutions (IHS). The collaborative effort between IHS clinical and operational subject matter experts and hospital staff improved efficiency and saved costs after a few short months.
ELIMINATING VARIATION IN PREFERENCE CARDS
Surgeons' preference cards typically include a “supply pick list,” which directly affect both the supply chain and clinical performance in the OR. Outdated or inaccurate preference cards cause 23 percent of the OR door openings during a procedure1 when nurses must leave the room to find missing supplies. Each time OR doors open during a procedure for a supply run:
- Patients could be at a higher risk of infection due to surgical delays2
- Nurses spend more time running for supplies and moving around the OR
- Physicians must wait
- Procedures take longer
The partnership started work by focusing on physician preference cards for one procedure, laparoscopic cholecystectomy (lap chole), at one hospital, a Level III Trauma Center, where 30 percent of the system’s lap chole procedures are performed. Eventually the health system and IHS expanded the preference card optimization process to two other procedures at the hospital.
TACKLING THE CHALLENGE WITH DATA ANALYTICS AND SURGEON ENGAGEMENT
IHS integrated clinical, operational, and economic data from the health system into its web-based Performance Analyzer, a proprietary analytics technology platform, to assess the hospital’s perioperative performance. The assessment showed that the variation in lap chole preference cards contributed to supply chain inefficiency, avoidable costs, OR downtime, and differences in clinical methods.
To be honest, when we started, I wasn’t 100 percent into it and didn’t believe lap chole had a lot that could be changed. The Medtronic team showed the different supplies across all surgeons, which was great to see. The best part for me was someone was able to get all the surgeons together — THAT WAS A MIRACLE. Without that part, this would not have happened.
–OR Team Leader
Working closely with the surgical staff affected by the current inefficiencies, IHS was able to:
- Decrease the number of line items and variability of items between preference cards
- Reduce staff time associated with pulling supplies, setup, and put-back
- Improve inventory management, sterility, efficiency, and costs through kitting
- Develop a culture of collaboration and continuous improvement with clinical staff
IMPRESSIVE RESULTS SHOW VALUE-BASED HEALTHCARE IN ACTION
Based on an annual volume basis of 450 lap chole cases at the hospital, the preference card optimization effort resulted in:3
- 30% fewer line items across preference cards
- 50% less variation in surgical supplies across surgeons
- 50% fewer door openings during lap chole procedures
- 30% less time spent on picking and putting back supplies
- $90 decrease in cost per case
- $42,000 overall savings annually from efficiencies made to the OR
The health system improved its operational and economic outcomes — thanks to a well- defined process and highly collaborative team. By bringing together the right health system and hospital staff and using IHS as an expert resource and facilitator, the hospital has better outcomes and a more engaged and satisfied staff. Nurses now shift some of their time from materials handling back to patient care, and lap choles are performed more efficiently with fewer resources.
1
Panahi P et al, Clinical Orthopaedics and Related Research (2012) 470, 2690-2694.
2
Pryor F, Messmer P. The effect of traffic patterns in the OR on surgical site infections. AORN Journal. 1998; Vol 68, No 4: 649-660.
3
Data on file.
