First and foremost, it takes the clinicians away from their primary role of patient care. This alone is sufficient reason to get away from such a practice. But there is more. Left to their own judgment clinicians will often over-order – ordering too soon and ordering too much. This can partially be due to perceptions on how much they use and how long it takes to come in. It can also be due to their need to fit ordering into their busy days. Of course, the other extreme often occurs as well. They will forget to order or delay until the last minute, which causes increased demands for supply chain personnel and increased costs for expedited delivery.

While the ideal is still out of our reach, a better practice is to maximize automatic resupply wherever you can. Almost all supply chains now incorporate some form of automatic resupply of storeroom items for nursing units. This most frequently consists of a periodic inventory by supply chain staff of current quantities and restocking to established par levels. Alternately, some form of tracking usage is employed – like closed supply cabinets or other automated tracking systems. In this case supply chain staff only has to restock periodically based on those items that the system identifies as having dropped below their reorder points.

To get closer to the ideal, organizations should expand the scope of the automatic resupply program to all other supply intensive departments and expand the types of items supplied to the existing customers. This might be accomplished using the same method as currently employed for the nursing units. Alternately, one of many other methods could be used.

The easiest way to expand the program is to incorporate non-storeroom (direct purchase) items into the existing program. Most current systems will accommodate adding non-stocks to the par program. They get counted just like stock items, but the system creates a purchase order instead of a storeroom order. Because these tend to be slower moving items – at least on nursing units – they may not need to be counted as frequently as other items. But don’t forget to adjust the min/max values to take into effect the longer order/ship time.

Expanding the program to other departments is more challenging. It takes labor to inventory and restock additional locations. Since materials management will be assuming work currently being performed by departmental staff, the department may be able to transfer at least a portion of an FTE to materials. Another option, if the organization hasn’t already done so, is to reduce the par or restock frequency (another best practice). Moving from a daily program to a 2-to-3 times a week program will save between 30 percent and 40 percent of the work. This saved labor can be used to expand the program without adding FTEs. Furthermore, storage areas may have to be reconfigured and/or consolidated to make the par process possible.

When setting up par type programs for supply intensive departments, do not try to cover all items. Start with stock and high-use non-stock items. And limit the program to a single storage area for each item. Defer to the department personnel when setting initial par levels. Once they gain trust in the system you can use the data from several months of activity to suggest modified levels that more closely match their usage patterns.

Add departments in a phased manner. Some of the departments you should consider for this expanded service are surgical services, including PACU, anesthesia, and same-day; radiology, particularly diagnostic and interventional; cath lab and respiratory.

While an active par program will work in these departmental areas, a better option may be setting up a perpetual inventory. Most systems will allow multiple inventories. The only challenge with departmental inventories is recording issues. Some options for setting up perpetual inventories will be covered in a future best practice – managing departmental inventories.