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KSR Publishing, Inc.
Copyright © 2016
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         Clinical intelligence for supply chain leadership

 
 

INSIDE THE CURRENT ISSUE

December 2014

Products & Services

New Technology

Cleveland Clinic Announces Top 10 Medical Innovations for 2015

1. Mobile stroke unit

High-tech ambulances bring the ER straight to the patient with stroke symptoms. Using telemedicine, in-hospital stroke neurologists interpret symptoms via broadband video link, while an onboard paramedic, critical care nurse and CT technologist perform neurological evaluation and administer t-PA after stroke detection, providing faster, effective treatment.

2. Dengue fever vaccine

More than 50 to 100 million people in more than 100 countries contract the dengue virus each year. The world’s first vaccine was developed, tested, and scheduled for regulatory groups in 2015, with commercialization expected later that year.

3. Cost-effective, fast, painless blood-testing

The new art of blood collection uses a drop of blood drawn from the fingertip in a virtually painless procedure, delivering test results within hours and lowering traditional Medicare reimbursement costs to as little as 10 percent.

4. Inhibitors for cholesterol reduction

Several PCSK9 inhibitors, or injectable cholesterol lowering drugs, are in development and scheduled for FDA–approval to treat patients who cannot tolerate or don’t benefit from statins. The new drugs are expected to significantly lower LDL cholesterol.

5. Antibody-drug conjugates

A promising new approach for advanced cancer selectively delivers cytotoxic agents to tumor cells while avoiding normal, healthy tissue.

6. Checkpoint inhibitors for cancer

Combined with traditional chemotherapy and radiation treatment, new immune checkpoint inhibitors drugs boost the immune system and offer significant, long-term cancer remissions for patients with metastatic melanoma, and possibly other types of malignancies.

7. Leadless cardiac pacemaker

Vitamin-sized wireless cardiac pacemakers can be implanted directly in the heart, without surgery, to eliminate malfunction complications and restriction on daily physical activities, and prevent infections traditionally caused by breaks and cracks in the leads.

8. New Drugs for Idiopathic Pulmonary Fibrosis

American adults with idiopathic pulmonary fibrosis may breathe easier in 2015 with the recent FDA-approval of two new experimental drugs – pirfenidone and nintedanib – that slow disease progress and scarring of the air sacs.

9. Single-Dose Intra-Operative Radiation Therapy for Breast Cancer

Early-stage breast cancer treatment with intra-operative radiation therapy, or IORT, focuses the radiation on the tumor during surgery as a single-dose, and has proven effective as whole breast radiation.

10. New Drug for Heart Failure

Angiotensin-receptor neprilysin inhibitor (ARNI) was granted "fast-track status" by the FDA because the unique drug compound represents a paradigm shift in heart failure therapy.

 

 
 


 

Getting smart about storage techniques

How can you do more with less when you have more stuff?

by Rick Dana Barlow

Defining smart storage

What does "smart storage" really mean and look like? Six storage experts share their insights.


"The best utilization of existing storage space and a system that’s easy to use and follow."

– Scott Wiley, Industrial Product Line Manager,
Akro-Mils
 

 


"Smart storage has a software and technology solution/component imbedded in the cabinet, shelf or bin that requires no human compliance to activate accurate inventory information and replenishment notifications."

– Dick Felger, Vice President,
Sales and Marketing, PAR Excellence


"We define smart storage as storing supplies in a manner that minimizes labor costs of handling supplies, while supporting the workflow needed for patient billing and meeting the regulatory requirements of item security. The result of a properly designed smart storage system is better control of your inventory through simplified recording of supply transactions."

– John Freund, CEO, Jump Technologies


"Smart Storage solutions provide automated, real time inventory visibility that enable healthcare facilities to provide safer, better patient care and controlled costs."

– Joe Pleshek, President and CEO,
Terso Solutions


"Smart storage would tie a part number and or part number and lot number combination to a specific shelf or bin-on-shelf location via a visual label and or machine readable bar code.  Sophisticated applications of smart storage may include ‘pick/put-to-lite’ or even RFID technologies."

– Wayne Wooddell,
Vice President, Business Development for Life Sciences and Healthcare in the Americas, Exel


"Smart storage is optimizing a space so that every item has the space it needs, not more than what it needs, not less than what it needs. Smart storage is having more items stored in less space."

– Rebecca, Dubé, Marketing Project Manager, Rousseau Metal

Saunter into one of those closet-organization stores and you’re likely to feel either relaxed, depressed, or both at the same time.

There’s something soothing about seeing stuff inside neat little color-coded boxes and containers, easily accessible and created in a mid-century modern or more contemporary design. Then you remember, with some resignation, what your own haphazard mishmash piles of stuff — tossed willy-nilly throughout your closets and living or workspace — looks like. You realize that something must be done.

Hospital and non-acute care facility storage may follow a similar scenario. They may have the ubiquitous supply storerooms and closets (but let’s not talk about those cubbies above the recessed ceiling tiles), the exchange carts and PAR shelving and the open and closed automated supply cabinets. Larger organizations may even have a warehouse or "central distribution/service center" full of products.

But in today’s information technology age of "less can offer more" and "automation makes it more convenient and happen faster," a "smart storage" strategy may not be limited to anal-retentively laid-out stockrooms with fashionable, color-coordinated containers and shelving. These days, high-tech mobile telephones and tablet computers have muscled their way into the mix to make storage and retrieval that much more effective and efficient.

Looking back, how far forward have health­care supply chain storage techniques evolved within the last decade? The consensus among storage subject matter experts is that the industry, by and large, is en route but not there yet.

Tipping points

Electronic devices certainly enable more efficient tracking and tracing of product storage and consumption data, which are necessary for patient safety and product recall efforts, but they don’t necessarily drive more efficient display, layout and workflow.

"The proper storage method can provide easy access and visibility to supplies, with the flexibility to position complementary supplies and highest-use supplies in the most prominent locations," said Dick Felger, Vice President, Sales and Marketing, PAR Excellence. "The accurate inventory information allows materials to reduce order frequency and eliminate time-consuming supply assessments."

Wayne Wooddell, Vice President, Business Development for Life Sciences and Healthcare in the Americas, Exel, concurred.

"Logical and ‘controlled storage’ solutions improve worker productivity by ensuring the correct product is in the correct place in the correct quantity," he noted. "Workers can pick and retrieve product much faster in an organized and system-controlled environment."

Scott Wiley, Industrial Product Line Manager, Akro-Mils, stressed the simplicity of "making the most of your space — using products that help turn empty or disorganized areas into a ‘productivity zone.’"

That’s why supply chain professionals should source products that maximize storage capabilities through different sizes, heights and depths, according to Rebecca Dubé, Marketing Project Manager, Rousseau Metal. "This way, the units [and accessories] will provide storage for the right size and quantity of each item," she noted. "Workflow can be improved by using products that are as ergonomic as possible and that respond to the needs for mobility and safety."

Yet the process for storing, procuring and tracking the usage of supplies and medical devices remains "extremely flawed," Joe Pleshek, President and CEO, Terso Solutions, told Healthcare Purchasing News. That’s because "approximately three-quarters of the recordkeeping for these crucial items is still conducted manually, opening the door to inaccurate data collection, poor inventory accuracy and a flawed reconciliation process."

Furthermore, the manual process adds to the labor costs in that caregivers who should be dealing with patients must search for inventory or conduct post-procedure paperwork, Pleshek emphasized.

"Smart storage solutions completely remove the barriers to accurately accounting for this inventory," he continued. "In many cases, a nurse or other user of the system can simply identify themselves to a system, take the desired item and go about their task. Because the systems are automated, there is no need to spend a significant amount of time documenting what they took manually in a log book or typing into a system."

With more accurate and real-time inventory views, clinical and supply chain staffs can keep better tabs on the availability of products as well as which products may be closest to expiring, which not only impacts supply costs but patient safety, Pleshek noted.

"Supply costs are the second largest operating expense for healthcare providers, and supply costs are growing faster than any other category. By deploying smart storage solutions, hospitals cut as much as 18 percent in labor costs associated with resupplying," he added. "In the event of a product recall, smart storage solutions provide instant data about the identification of the device, where it was manufactured, the healthcare professionals who installed it and maintained it, and device and patient health."

John Freund, CEO, Jump Technologies, stressed that supply chain pros should establish and reinforce process fundamentals first before implementing even the simplest electronic devices to take the process to the next level. That includes teaming supply chain pros with clinical staff members to understand what supplies they access on a per-procedure basis and how frequently those supplies are needed in specific areas.

With clinical help, supply chain pros will have to factor in what must be kept in secured storage and tracked at an individual item level, versus what products have less stringent requirements, Freund indicated. "Save the typing in of passwords and credentials for when it’s needed," he added.

Clinical use should determine access parameters and layout design, Freund continued. "Do they want all similar products together or do they want products grouped by use?" he said. "Nurses are powerful partners in the design, implementation and adoption of lean processes, so identify clinical champions who want to make their processes easier and more efficient. It’s been widely accepted that nurses in hospitals spend 20 to 30 percent of their time looking for, tracking and managing supplies. Reducing this time has huge cost benefit to the hospital, as labor continues to be the No. 1 expense for hospitals."

Grab-and-go workflow

A "one-size-fits-all" approach may be tempting to those supply chain pros who want a quick solution so they can concentrate on other "higher priority" issues, but that’s neither practical nor a proficient use of resources and time. Even the popular storage-themed retail outlets push modularity as an underlying theme. The key word is "flexibility," according to Felger.

"First and foremost, you choose the most flexible storage method," Felger advised. "Secondly, there is a need to analyze past usage. The hospital will then need to coordinate an experienced and reliable vendor team with the clinicians that will be utilizing the smart storage to design the best positioning."

Rousseau Metal designs modular products that can be configured and personalized as needed, Dubé noted. "Even if users are from the same medical domain, it does not mean they all have the same needs and reality," she added.

Start with louvered panels and louvered panel racks, Wiley suggested. "These products maximize available space, and get around room obstacles such as poles and electrical boxes," he said. "No wasted space means maximum potential productivity."

Combining "slotting" or what product is located where with ergonomics represents both an art and a science, Wooddell indicated. Some slotting techniques to consider:

  • Velocity — placing the fastest moving products in the most reachable locations

  • Popularity or covariance — placing products that often are picked together next to each other

  • Cube movement — where products with the highest cube and highest velocity are placed in the most accessible locations

  • Weight-based — where the heaviest products are located to minimize lift and ensuring they are picked first

"These methods can be combined to ensure the greatest productivity while protecting associates through good ergonomic disciplines," Wooddell said. "Further, sub-storage such as bins, totes, and slots can be incorporated to add additional flexibility."   

Supply chain also must design a process that meets the needs of those who are working to provide efficient patient care but should also be based on the type of care being delivered in those departments, according to Freund.

"One school of thought is to group like products together," he continued. "The other is to group products used most frequently and/or used together." Working with the clinical team can help improve business process planning and layout development.

"[The clinicians] will know the specifics of item usage, which will help define the best methods of access," Freund said. "With nursing, discuss ways to implement lean process into supply management. We all talk about lean, but remember, at its essence, it’s simply about reducing the number of touches and eliminating waste."

Supply chain must "design the system to be as easy to use as possible with the underlying technology doing the heavy lifting," Pleshek urged. Further, he said the hardware deployed must allow for re-configuration in the field.

"Some systems can only read items from inches away, meaning end users are locked into specific shelf and antenna locations, and they are not able to adjust these on the fly," he noted. "Things in a healthcare facility can change fast, so smart storage solutions must offer flexibility when it comes to configuring storage solutions for maximum readability and on-the-fly organization."

Don’t overlook the software platform supporting the overall system either. End users and administrators need "to leverage existing applications and business processes while exchanging vital product usage documents and messages in real time, with absolute security and reliability," Pleshek said.

Freund concurred that interfacing or integrating these systems into an organization’s existing business applications is vitally important for bottom-line considerations.

"For the supply chain team, there is a requirement for a solution infrastructure that ties these processes together and gets you visibility and accurate reporting to what’s being used, where, at what velocity," he said. "With this reporting — across the entire organization — supply chain leaders can be more confident in their ability to accurately plan and forecast, and importantly, reduce supply expense."

What’s on storage wish lists this season?