INSIDE THE CURRENT ISSUE

May 2008

News

Pros offer 30 strategies and tips to keep the supply chain fluid
in critical care areas

Let’s face it: For any clinician, be it a doctor or a nurse, running out of something is no fun. In fact, in some areas, including the critical care territories known as the intensive care unit, it can be downright dangerous and life-threatening.

Ask a critical care nurse about materials management’s customer service or ask a materials manager about ICU’s supply demands and you’ll likely generate some eye rolling and sighs, followed by complaints. "Materials management doesn’t understand the ICU’s needs; the ICU makes too many demands without any forecasting or predictive planning."

Clearly, critical care nursing’s supply needs and materials management’s perceived customer service tends to be disconnected – either due to a lack of communication or miscommunication between the two departments. Sometimes priorities may be misunderstood, overlooked or ignored. Other times, there may be unrealistic expectations about service capabilities.

Whatever the case, Healthcare Purchasing News has interviewed dozens of experts – including critical care nurses – over the years, and moderated educational panel discussions at the annual National Teaching Institute & Critical Care Exposition of the American Association of Critical-Care Nurses about bridging the gap between the two areas.

Here’s what the experts shared with us as surefire ways to achieve success.

1. The critical care nurse manager should get to know the materials manager who orders supplies for the ICU. They should discuss needs and priorities.

2. If possible, assign a "stocker" to each individual unit. Each individual unit then should get to know its dedicated stocker and make them part of the unit’s activities, including lunch, special days.

3. Materials management should dedicate someone to be on call for weekend issues.

4. If the ICU still works on an exchange cart system, talk about turning. Critical care nurses may be doing patient baths at the time materials managers want to change carts. That’s a bad time to be changing carts.

5. Be sure to discuss materials management’s practices, in terms of projects and product standardization. Be open to differing priorities. You may not always get exactly the product you want but through training is a particular product useful and does it work?

6. Actively participate in the value analysis processes. If you’re not part of that process you’re part of the problem.

7. Establish a collaborative working group to compare costs and benefits of products, particularly if that’s not part of the value analysis committee.

8. The materials manager should get to know the nurse managers – where they keep supplies, what their issues are and material priorities. Be open to differing opinions.

9. Empower the front line critical care nurses to make suggestions for setting PAR levels. Some things absolutely cannot run out. Others must continue to remain in PAR even if it hasn’t been used in a long time.

10. Look for opportunities to engage them in groups working on cross-functional teams. If you’re having problems in a particular unit during a particular shift you may need to attend a staff meeting or work with the ICU’s ordering clerk.

11. Communication between the two areas must be succinct, open and frequent. Both sides should be sending information and listening – seeking their input or opinions.

12. Use bar code scanners or automated supply systems to control PAR levels and ensure stock availability. Manual PAR level supply management is a major contributor to nursing dissatisfaction with materials management and still exists in many hospitals.

13. List supplies by common names and not by the manufacturer’s name.

14. Materials managers should go on rounds with critical care staff members for feedback. At the very least they should visit the ICU because the critical care nurses would welcome the opportunity to show them around.

15. PAR levels should be closely monitored by materials management, with PAR levels set higher than conventional nursing units to accommodate peaks in critical care census.

16. Rely on emergency department supplies as backup due to ER’s usage of similar critical care products. These departments are generally adjacently located.

17. ICU needs help with inventory management systems that produce user-friendly usage and cost reports.

18. Materials managers should consult with the clinical experts for product selection and support. Critical care nurses are very concerned about quality and durability, as well as the latest and greatest.

19. Critical care nurses actively seek warranty information and support – how to plan for equipment support, useful life, repair costs and overall management within the needed time frames.

20. Keep resource material close to the respective equipment, particularly if the equipment is used infrequently. Quick reference guides may be helpful.

21. Create an equipment pool for cleaning and distribution of equipment.

22. Materials management should develop a process to support crisis issues (such as not enough supplies, essential equipment breakdown) and share this information (spare parts or backup equipment are available) with critical care nurses.

23. Strategies and tactics used in other industries, such as "lean manufacturing," are fair game for implementing in critical care areas to organize supply rooms. Make sure a critical care nurse leads the charge.

24. Don’t hesitate to approach other internal departments, such as the pharmacy or surgical services, for supply management advice and tips.

25. Check with your group purchasing organization (GPO) to see if it offers supply contracting services, be it consulting or third-party management, to direct, drive or influence process changes.

26. Work with materials management to enlist your distributor to deliver products on a just-in-time basis, organized by care unit or even supply location, if possible.

27. Organize supply carts and/or individual supply bins on carts by type of care or specialty.

28. Broach the issue from a patient care perspective or standpoint, rather than by a supply availability or expense management perspective or standpoint so you set the tone right away. Nurses should go beyond supply shortage complaints; materials managers should go beyond line-by-line budget issues and usage reports.

29. Recruit your vendor(s) – manufacturers and distributors – as well as your
GP(s) to provide you with accurate and relevant clinical data and cost-in-use data that apply to real-life situations.

30. Channel the creativity used to locate and hoard supplies without apparent detection into solving the supply deficit problem.