Question: I work in the distribution area where we prepare case carts and pick supplies to be stocked in the O.R. core. I have often heard the term official and unofficial inventory used by my manager but I really have no idea what she is talking about and what the difference is. I don’t understand why it’s important, and I am embarrassed to ask. Can you share your thoughts?

Answer: There is absolutely no reason for you ever to be embarrassed to ask a question when you don’t understand something especially when it pertains to the important job you do. Asking questions is how we grow and learn. Trust me there was a time when your manager didn’t know what these terms meant either.

As we continue see the cost of healthcare spiral upward the financial resources available to hospitals to maintain quality operations continues to diminish. It has been estimated that materiel resources such as, medical supplies, surgical instruments and the like can easily consume as much as 40% of a hospital’s operational budget and possibly more. For that reason effectively controlling and managing a hospital’s inventory is critical. Inventory management is the science and art of maintaining appropriate levels of supplies on hand to support patient care needs and providing the right goods when and where they are needed. Understanding and applying the basic concepts and principles of inventory management and the control of these assets can have a positive impact on the bottom line and can help preserve an institution’s ability to sustain quality services and prosper through these turbulent times.

Generally inventory includes any consumable goods maintained on hand for some undefined period of time prior to use. The terms official and unofficial inventory may be defined as follows;

• official inventory refers to consumable products that are carried on the balance sheets (the books) as current assets. This would include the stock maintained in the warehouse or stock room;

• unofficial inventory refers to consumable products which are not carried on the books / balance sheets as current assets (generally supplies are expensed to user units when they are dispensed from the stock room). Basically the consumable goods maintained in user departments is considered unofficial inventory.

Regardless where inventory items are located each item represents a dollar value. Unused items or excess stock kept on shelves, carts or storage closets throughout a hospital is costly and wasteful; it is consuming monetary and financial resources that could be put to better use in providing better patient care or procuring new technology, or maintaining facilities. To minimize the amount of waste resulting from overstocking it is imperative to know where stock is maintained and to implement protocols to manage and control its distribution and use. Many organizations place a great deal of emphasis on monitoring and managing their official inventory but fall short in controlling products once dispensed to user units. When not controlled, unofficial inventory could easily consume financial resources equal to or likely greater than official inventory. The goal is to maintain just the right level of stock, both official and unofficial inventory to meet the real needs of user units. There should be a steady flow and turn around of inventory.

Question: I work the evening shift in a very large teaching hospital as a CS technician. Every evening when my shift starts we come in to find a real mess. There are sets piled up waiting to be done. I think it is totally unfair that the day shift leaves their work for us to clear up. We have complained to our supervisor but nothing ever changes. Every time the issue comes up at staff meetings hostility just mounts between the day and evening staff. Any suggestions?

Answer: I think that it is very unfortunate that people get so concerned and focused about what they perceive others are, or are not, doing in the work place. Such obsession most often results in the deterioration of a department’s overall performance. I think we all need to focus more on the quality of the work that we do and be less concerned that someone may be doing less. You only have control over your own actions and the responsibility to be a conscientious productive worker during your eight-hour shift. I have often heard complaints such as yours, it’s not uncommon that one shift feels the other has or does less work. While of course there are exceptions, and maybe your department is one of them, I have found that most CS workers really take their jobs seriously and want to do a good job.

In my many CS department assessments I have found a pretty good balance in work distribution between shifts. The work between shifts however may be very different. The day shift is on duty during the peak operational hours of the O.R., clinics, patient care units, and various ancillary departments. They are confronted with many demands, interruptions and calls throughout the day. Of course when the evening shift comes on there are likely to be many surgical sets waiting to be assembled and processed, surgical cases usually don’t start breaking and items sent back for reprocessing till mid to late morning. The returns continue to accelerate and accumulate throughout the afternoon from the O.R. and other areas. The greatest volume and demand for instrument set assembly processing therefore occurs on the evening shift. Night shifts generally have the least amount of staff on duty. Their job function usually involves finishing up set processing, sterilization tasks, restocking, case cart preparation and supply distribution. Since there are less staff on duty unanticipated surgical emergencies, deliveries, etc., can disturb their work flow causing a back up which is passed on to the day shift. So you then hear the same complaints you voiced coming from the day shift about the night shift. I think we all need to be sensitive to what others are dealing with. It sounds like your department could benefit from some team building exercises. Why not start by requesting a meeting between your supervisor and your shift? Be prepared to objectively voice your concerns in a positive way free of emotion. There are many tools available for managers to measure shift and individual staff productivity. Most managers are on top of this and want to maximize the potential of the human resources available to them. I am sure your manager will be willing to work through this with you. HPN