atewood 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 managed 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 architecture
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 re-ordered 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 improved 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 utilization. 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.