Tuesday, June 27, 2017

Expansion: Building your global sourcing program to maturity.


Five part series:

How Value Analysis Teams (VAT) can improve overall quality, reduce costs and positively impact patient experience by engaging in global sourcing. 





Part  Five- by 
Bethany Gleim, Director of Value Analysis, ASP Global

Expansion: Building your global sourcing program to maturity.


You have completed your clinical trials, engaged your staff [Go Time: The last critical steps implementing a value based, VAT-led global sourcing program] and now your first batch of globally sourced hospital products are being used throughout your facilities. Now what?

Validate your success:

Once the products have 3 months of utilization in the clinical setting, compare their performance to the legacy products they replaced. You should also be hearing from clinicians that the patients for whom they care are being made more comfortable by their new custom blanket or amenity kit (as an example). You should then validate the cost savings and report the results to the value analysis committees and senior leadership.

You always want to do more of what works and less of what doesn’t. Regular review of the performance of your globally sourced and custom hospital products should more than likely lead you to ask the following question: how do we expand the program?
 
Phase 2: Identifying the next batch of globally sourced hospital products

After successfully converting the first group of products, it is time to identify the products that you will want to review in the second group of products you want to globally source. Similar to the first round of products, the next group needs to have ease of conversion, potential for quality improvement, patient experience improvement, potential branding opportunities and significant savings.  Listed below are examples of some of the products that have been successful in the second phase of enhancing the globally sourced product model.

     Patient Slipper Socks.  Are the socks you are placing on your patient fitting properly?  Are the slippers too tight around the ankle causing poor circulation? Do they have ample tread to assist with preventing a fall on the nightly mopped floors? Do your clinicians have all the sizes and colors required to make the best selection for their patients? Is this what your patients are experiencing? If yes, then by working with your VAT teams and your global sourcing partner you will be able to determine how the socks can be improved.  

     Tourniquets. Do the tourniquets the staff is using have adequate elasticity?  Would the staff rather have smooth or textured, flat packed or rolled and banded?  Which style and color works best for your clinical staff?  Together with your global sourcing partner you will make an impact on what the staff’s satisfaction as well as your patient’s when selecting a clinically acceptable product.

     Emesis Bags. Many health systems have chosen to eliminate the plastic basins in favor of converting to emesis bags.  An example of how global sourcing and listening to clinical staff feed-back can influence product design, a new emesis bag was created with an easy lock design providing additional containment, decreasing the potential for cross contamination, and improving clinical safety.

Building towards maturity:

Through the collaboration of your clinical staff, VA committees, supply chain team and global sourcing partner you have successfully converted and validated the new products.  It is now time to build the framework for continuing to add new globally sourced items over the next several years.  One idea is to meet with each of your department managers, all departments have different needs by meeting with the managers they can assist in determining items that can be globally sourced to meet their needs. Continue to meet monthly with your teams and global sourcing partner reviewing the potential new opportunities that were identified when meeting with department managers. While meeting monthly review the product ideas, possible clinical improvements, how the new products could impact patient satisfaction and savings impact to their individual departments and the hospital. 

Program Elements

Given its value, your hospital global sourcing program is not a one-shot proposition. Your value analysis team should provide regular, ongoing clinical education and communication to support the program and its associated benefits. The team should continue to track program items, quality improvements, newly branded products, new opportunities for patient experience measures and cost savings reporting the results to the Value Analysis Committee who supports the Global Sourcing Program and Senior Leadership.  The team should continue to meet with clinical liaisons on any and all possible improvements to currently used products evaluating usage and opportunities for standardization.


At a minimum, global sourcing helps the hospital value analysis team accomplish its mission of delivering clinically acceptable products at the lowest possible prices. But its potential is much greater: by optimizing many of the medical products used in the hospital with improvements in quality, utility, price and the patient experience. 




About the author
Bethany Gleim is director of value analysis for ASP Global, a leader in global sourcing strategies and programs that enable IDNs, hospitals and large group practices to take advantage of lower costs and improved quality in hospital medical supplies available through direct sourcing, an efficient supply chain model and the global marketplace.

Tuesday, June 13, 2017

Go Time: The last critical steps implementing a value based, VAT-led global sourcing program


Five part series:

How Value Analysis Teams (VAT) can improve overall quality, reduce costs and positively impact patient experience by engaging in global sourcing. 





Part  Four - by 
Bethany Gleim, Director of Value Analysis, ASP Global

Go Time: The last critical steps implementing a value based, VAT-led global sourcing program

Having successfully achieved organizational strategy acceptance for your hospital’s global sourcing program [How Value Analysis Can Gain Strategy Acceptance for the Global Sourcing Program Throughout the Entire Organization], your hard work is about to pay off. The following are the final steps needed to launch the program that will deliver clinically acceptable or superior products at 20 - 50 percent savings and improvements in the customer experience compared to the legacy products they replace.

Completing any required clinical trials

Your clinicians know best what products they need, want and how those products need to perform. Among the 10-15 pre-selected launch products in your global sourcing program (the easily convertible, high volume low hanging fruit), feedback from sample products in either formal or informal clinical trials needs to be acquired.

Once complete, the VAT and sourcing partner will together confirm the final specifications, pricing and contracts as required.




Coordinating the conversion dates

Within the overarching communications program, the team will need to be alerted to, and prepared for, the depletion of the legacy products and the arrival of your globally sourced replacements. Any lingering or foreseeable hurdles in delivery and receiving or other ‘last mile’ logistics issues must be resolved at this point. All inventory locations including patient rooms, crash carts, departmental stockrooms, unofficial inventory locations and the hospital’s main stockroom must be identified at this point as well.

Continuing communication

As discussed throughout the first three series, communication is critical to the success of your new program.  Ask yourself the following questions; has the entire supply chain team been made aware of the approved conversion? Has proper communication been sent advising the clinical staff that a legacy product is being eliminated and new product is being introduced to the organization? Has literature including product descriptions, possible differences and new MMIS number been placed in the stockrooms and breakrooms?  Once again, the communication element of your global sourcing program is critical to assuring smooth product conversions. Your global sourcing partner is available to help with any communication and education to the staff if needed.

Stay tuned for the final piece in the series: metrics evaluation and program expansion.




About the author
Bethany Gleim is director of value analysis for ASP Global, a leader in global sourcing strategies and programs that enable IDNs, hospitals and large group practices to take advantage of lower costs and improved quality in hospital medical supplies available through direct sourcing, an efficient supply chain model and the global marketplace.

Friday, June 9, 2017

Amid healthcare uncertainty, hospitals will lean even more on their GPOs

The debate over the future of the Affordable Care Act (ACA) and the ongoing transition from fee-for-service to value-based care suggest a healthcare system full of uncertainty for American hospitals. Hospital executives who were already operating under severe budget constraints will be asked to do even more with less. This moment of great change for healthcare portends an expanded role for an often-unheralded supply chain player: the group purchasing organization.

As a physician and former CEO of Regional Health, I know firsthand what it takes from a clinical and business perspective to help healthcare providers deliver first-class patient care.

The core mission of the GPO remains cost-savings – GPOs aggregate the purchasing power of providers to secure discounts and help procure the best products and services at the best value. A 2014 American Hospital Association (AHA) survey of hospital executives found that 90 percent of respondents were satisfied with the ability of their GPO to deliver cost savings, and an economic analysis of GPO operations prepared for the Healthcare Supply Chain Association (HSCA) estimated that GPOs save the healthcare system up to $55 billion annually.

Many providers, including some small and rural hospitals, lack the purchasing volume to obtain discounts on their own for specialized equipment and critical medical devices such as implants and diagnostic equipment. For these providers, the savings delivered by GPOs are particularly critical and will be even more so in the face of ongoing reimbursement challenges.

But the impact of our GPO extended far beyond cost savings. At Regional, our GPO was an invaluable partner for creating communities of knowledge – bringing together hospitals, physicians, and other experts and healthcare stakeholders to find collaborative solutions to pressing challenges and improve patient outcomes. For example, when we experienced drug shortages in the anesthesia space – medications that are critical to the day-to-day operation of hospitals – we were able to work with our GPO and their existing network to identify providers who had a surplus of these drugs so that we could continue providing critical patient care. These GPO collaborations extended to financial benchmarking, process improvements and best practice sharing, assessments of clinical advancements and new technology, and many other challenges.                                                                    
 Central to the utility of our GPO was its ability to anticipate and get out in front of timely and emergent healthcare issues. GPOs provided comprehensive educational material on complex issues. Additionally, when addressing future policy shifts or changes – a new Medicare initiative, for example –  GPOs worked with members like Regional Health to identify what providers should prepare for and what potential vulnerabilities we faced in order to guarantee that we were as strong as possible moving forward. When the threat of the Zika virus emerged, GPOs worked with government agencies, hospitals, and first responders to identify treatment best practices, to track and procure necessary emergency supplies, and to develop educational materials on how to safely and effectively treat cases of the virus.

As hospitals face near total uncertainty over what will happen to the Affordable Care Act, and with Medicaid expansion, Medicare reimbursement, and a range of other challenging issues, hospital executives are assessing their vulnerabilities and trying to figure out how to best prepare for all contingencies. One of their first calls should be to their GPO. And for GPOs, the coming systemic change will be an opportunity to continue to prove their mettle.

Dr. Charles Hart is a retired physician and the former CEO of South Dakota-based Regional Health.

Thursday, June 1, 2017

COMING OUT ON TOP








NEWS IN BRIEF


Saraguro Caton, Ecuador



PROGRAMS SERVED 

Animal Services & Welfare Community Development 

Dental Clinic 
Dental Services & Care 
Disability & Low Income Services Educational Programs 
Emergency Response 
Homeless Support Services 
Maternal Health & Infant Care
Medical Clinics & Hospitals 
Medical Missions


BY THE NUMBERS APR YTD
Countries served 8 23
Orders shipped 60 273
Charity partners 33 105
Product sent ($M) 9.3 13.4

OUR MISSION


To improve the delivery of healthcare worldwide by gathering, processing and distributing surplus medical and health supplies to charities at home and abroad.




There are not many civilizations that can claim they avoided conquest during the Spanish invasion of South America in the mid-1500s, but the Saraguro people of Ecuador may be one of them. Located in the southern Andes mountains, their ability to band together to defend their people and their land centuries ago contributes to the continuation of their lively and distinct indigenous culture today.

As John Allison, an anthropology researcher who studied the Saraguro people, has said, “The Saraguros were fierce warriors and the Spanish were content to keep their distance so long as they received a share of the produce... Records indicated that in armed conflict, the Saraguros often came out on top. In a real sense, they were never really conquered.”

Much of the Saraguro culture hearkens back to the culture of the Incas. Similar to the Incan tradition, the Saraguros work within an agricultural system that emphasizes the interconnectedness of families, neighbors and the community. This interconnection and sense of community - of sharing, reciprocity and internal strong families - is part of what has helped the Saraguros overcome in the past and continue moving forward today. 

Today, many of the canton’s approximately 30,000 inhabitants make a living through farming, raising livestock and several industrial arts - weaving, bead work, embroidery, and carpentry - though some are employed in health care, teaching and other professions as well. They continue to reach out to
help each other as families, neighbors and friends.

Working with the Charity Anywhere Foundation Globus Relief was able to support two shipments to further assist the people of the Saraguro region. The shipments, containing medical instruments, wheelchairs, hygiene kits, diapers, and dental equipment, were distributed amongst the community. The Charity Anywhere Foundation has also completed medical missions and other local projects using medical goods provided by Globus Relief. Like the Saraguro people of centuries ago and of today, we believe that when we serve each other as family and neighbors, we all come out on top.




Globus Relief is Your Humanitarian Non-Profit Inventory Solution. Please contact us if you have medical or dental equipment, instruments, and supplies or other resources available for donation.

Tuesday, May 30, 2017

How Value Analysis Can Gain Strategy Acceptance for the Global Sourcing Program Throughout the Entire Organization


Five part series:

How Value Analysis Teams (VAT) can improve overall quality, reduce costs and positively impact patient experience by engaging in global sourcing. 





Part Three- by 
Bethany Gleim, Director of Value Analysis, ASP Global

How Value Analysis Can Gain Strategy Acceptance for the Global Sourcing Program Throughout the Entire Organization

Now that the team has been developed, [How Value Analysis Can Introduce Global Sourcing to your Organization.] and has been introduced to the global sourcing concept including the clinical and financial benefits it can provide your organization, it is time to gain strategy acceptance.

Building strategic consensus

Timeline tracking documents laying out every step that needs to be completed and by whom are important for an efficient program launch. Organizations that have successfully done so, like NewYork-Presbyterian & ROi Mercy have proven that the established timeline kept them on track assuring a smooth transition. Case studies have shown that hospital-wide program buy-in is made easy by sharing real metric driven outcomes from other hospitals that are currently taking advantage of the opportunities and value global sourcing provides.

The capabilities and solutions associated with the global sourcing program must ensure equivalence or increased clinical utility, cost savings, high fill rate levels and improvements in patient satisfaction. They should be supported by case studies from some of the most highly ranked hospitals in the country in order to achieve strategic acceptance from the team as a whole.

The communication launch and beyond

By introducing the UP↑, DOWN↓& OUT→ methodology to your value analysis committees, clinicians, and senior leadership, you will be able to reach both your financial and clinical goals.  

  • UP↑, Quality UP: global sourcing can help you achieve the highest standards of quality.  Your global sourcing partners will continue to work with your value analysis committees to engineer products to their desired specifications and quality requirements. 
  • DOWN↓, Risk Down: Transparency, from production to consumption, including quality, financials and working conditions, is the cornerstone of your relationship with your global sourcing partner.  
  • OUT→, Cost Out:  Your global sourcing partner will consistently deliver a greater than 20% savings – and often as much as 50% - on sourced products. By choosing high-quality, low-cost manufacturers, the non-value cost that sits between the provider and the factory will be eliminated.


The Inside-out model can help enhance Value Analysis

Today, most hospitals are not taking advantage of global sourcing and are following what we typically refer to as the outside-in model. Product choices are pushed on your clinicians based on what’s available in the market.  

Results:  

  • Decisions are made based on what’s available versus what’s best for the patients. 
  • There is a compromise between quality and costs.
  • Clinicians accept rather than buy-in
  • The model of outside in limits the ability to improve both cost and quality.
On the contrary, ASP Global’s unique Inside-out global sourcing model allows your clinicians to have direct input into products designed for quality of care.

Results:

  • Decisions are based on the highest quality products at the lowest cost.
  • Clinicians engage and buy in to the global sourcing concept.
  • Improved patient satisfaction and outcomes with the inception of higher quality products.
  • Value analysis is improving the balance between quality and costs.
  • Implementing the Inside out model will drive cost out of both the supply chain and departmental budgets.

What’s next?

Planning the implementation of the global sourcing program.  Stay tuned.




About the author
Bethany Gleim is director of value analysis for ASP Global, a leader in global sourcing strategies and programs that enable IDNs, hospitals and large group practices to take advantage of lower costs and improved quality in hospital medical supplies available through direct sourcing, an efficient supply chain model and the global marketplace.

Tuesday, May 23, 2017

How Value Analysis Can Introduce Global Sourcing to your Organization.


Five part series:

How Value Analysis Teams (VAT) can improve overall quality, reduce costs and positively impact patient experience by engaging in global sourcing. 





Part Two - by 
Bethany Gleim, Director of Value Analysis, ASP Global

How Value Analysis Can Introduce Global Sourcing to your Organization.

Understanding the what and why [What is global sourcing and how can it impact your value analysis team?] about global sourcing is key to introducing your team to the strategic value-based implementation of global sourcing. It is all about improving quality and the patient experience while reducing costs associated with thousands of your common hospital products.
Once you have determined this is a value-based course of action, here’s what you can expect from your global sourcing partners in order to make it as easy as possible for you to introduce and help launch the program.

Identifying and picking off the low hanging fruit

Start slow by identifying 10-15 high volume medical products with the least amount of conflict. Stethoscopes, digital thermometers, personal protection apparel and patient belonging bags are a few of the most common, “low friction,” products many facilities use to launch and validate their global sourcing programs. These products regularly demonstrate savings of 20 - 30% annually and easy conversion from products currently on formulary.

A good metric for defining "high volume" products are those with a minimum 10,000-unit annual purchase, though many large hospitals will find plenty of opportunities in products of which they buy 100,000 to 1 million or more annually.




Cross reference against your formulary for savings expectation

Your global sourcing partner, someone who knows what is required to successfully design, source and deliver products direct from factories across the globe, will complete a cross reference review of those identified items currently in use. The resulting cost analysis will detail the anticipated savings on products at or exceeding current levels of clinical acceptance. You should expect full visibility on pricing all the way from the factory to your shelves.

Building a team primed for success

Your global sourcing partner can assist you in identifying the key stakeholders, executive sponsors, VAT leaders, clinical representatives and supply chain representatives needed to implement and maximize the value of your global sourcing program. 

Planning a successful kickoff meeting 

Once your team has been established, your next steps would be to coordinate with your global sourcing partner a successful kickoff meeting.  The agenda should include the savings results from the cross-reference analysis and product samples of the 10-15 identified commodity items used to validate the value of the program. Testimonials will be provided by your global sourcing partner from other hospitals currently taking advantage of the benefits global sourcing provides to their organizations.  

What’s next?

Building strategy acceptance for global sourcing. Stay tuned.  





About the author
Bethany Gleim is director of value analysis for ASP Global, a leader in global sourcing strategies and programs that enable IDNs, hospitals and large group practices to take advantage of lower costs and improved quality in hospital medical supplies available through direct sourcing, an efficient supply chain model and the global marketplace.

Empowered by real science


SKU'd




NASHVILLE — Not surprisingly, many Sterile Processing and Distribution professionals exude sincere passion for their performance, mission and importance within their organizations.

More than 1,400 attendees here at the 2017 IAHCSMM Annual Conference & Expo clearly demonstrated that as they roamed the show floor and hotel hallways. In fact, several educational sessions taught them how to defend, protect and reinforce the knowledge, experience and confidence they (should) possess about what they do every day — even as others try to force SPD to atone for the logistics, occupational and process miscues of others who avoid responsibility.

SPD pros learned techniques and tricks to deflect blame strategically, and dismiss bullies tactfully and politely, all while simultaneously working on solutions to the problems. One SPD manager from a surgical hospital perhaps said it best during her presentation: “Don’t let others throw SPD under the bus…If they make the mistake then you have to get them to own it.” She referenced how vendors, nurses and doctors can use SPD as a convenient scapegoat to cover their errors in judgment.

Defend and document the issues — especially when you’re right —  to protect the credibility and expertise of the department and the pros that support the operating room and patients every day.

Unfortunately, government and media reports of infectious outbreaks among patients, tied to improperly reprocessed devices and instruments, can hinder that credibility. Of course, an SPD department that adopts and implements the Unique Device Identifier (UDI) codes on products should definitively establish the links between reprocessing and outcomes via track-and-trace capabilities, attendees learned in another session.

Against that stark backdrop, conference speakers stressed the obvious need for thorough cleaning, disinfection and sterilization of devices and instruments used on patients, preferably guided by manufacturers’ detailed instructions for use. To that end, certain working groups strive to develop and establish standardized IFUs, independently validated by third-party laboratories, to reinforce high-quality SPD performance with minimal drama and process inconveniences.

Until then, SPD pros must continue pursuing reprocessing competency as a baseline, and performance improvement rooted in real science as an ongoing objective. This conference exposed attendees to useful tips for effective reprocessing, including proper inspection and leak testing of endoscopic equipment, the type of water, cleaning, disinfecting and sterilizing agents to use and how those agents affect the body. SPD pros also learned about the characteristics and hazards of bioburden left behind somewhere in a patient’s body cavity or “internal plumbing.”

Several sessions exposed device areas missed by reprocessing, including blood, tissue and water droplets in device cavities, crannies and crevasses, and what that material left behind could do to the device or instrument over time and to the patient. Seeing patient photos on giant viewscreens generated audible gasps.

What SPD pros couldn’t see alarmed them, too — from a single strand of seemingly harmless laundry lint to skin cells shed by clinicians in the sterile field to microscopic bacterial retention. All were attacked as organic invaders by a phalanx of white blood cells dispatched by a patient’s immune system. In some cases, this activity morphed the bioburden with catastrophic consequences.

SPD pros learned how these bacteria and other particles behave in a way that should motivate not only SPD, but also doctors, nurses, infection preventionists, supply chain pros and C-suite leaders to understand and act. SPD pros learned how bacteria and residue shield themselves behind organic fortress walls (biofilms) and don biological suits of armor (think Iron Bug) to defend against internal immunity system attacks and external reprocessing materials.

Who would have thought that errant particulate matter expunged from a new filter in the air duct, from the movement of new surgical drapes or the turn of a clinician’s head, for example, could profoundly impact patient outcomes?

SPD does now. They know the science behind these facts and can share that knowledge with clinicians and administrators through reprocessing performance and environmental audits they can conduct. Will those areas listen to SPD’s wisdom?


Rick Dana Barlow