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Cultivating Collaboration

10. Link Nurses and Physicians To Supply Chains

Affect productivity through change in supply-chain procedures

Heads together: Nursing Finance Director Andrew Wood, Dr. Courtney Scaife, and Biomed Technician Curtis Mason worked with a multidisciplinary team to increase supply access while dramatically reducing costs.

Unlocking Omnicell access to increase supply revenue

For hospital nurses and physicians, time is measured in minutes, even seconds. So when Dr. Courtney Scaife told us that she and her fellow physicians were losing precious time just trying to get the supplies they needed, and that nurse productivity was also being affected, we knew we had a problem. The culprit? An automated Omnicell supply cabinet that could only be opened by nurses. “It was so inefficient,” says Dr. Scaife.

$2.2 million improvement

In 12 months, nurse managers have decreased floor/lost supply charges from $155,171/month to $4,673/month for a total of $1.32 million in improved charging to patient accounts. We have also been able to appropriately bill our ED supplies, adding $929,323 in charges.

“Imagine trying to see 30 patients during rounds and having to constantly stop and interrupt nurses just to get simple things like gauze and tape.” And when they did get into the cabinet, residents often took more than what they needed, simply so they wouldn’t have to interrupt a nurse again for access. This led to a different kind of waste: expensive supplies were being thrown away at the bedside.

“It wasn’t just time that was being lost, but also hard, green dollars,” says Nursing Finance Director Andrew Wood. Although the Omnicell supply cabinet tracked supply usage, the data wasn’t being translated into actionable information that physicians and nurse managers could understand. And when you can’t see exactly how much money is being lost, it’s hard to be conscientious about saving it.

We needed to hold every Omnicell user accountable for the supplies they took, while simultaneously allowing more staff to access the supply cabinet. It seemed like an insurmountable challenge—until we connected Dr. Scaife’s access problem with Andrew’s data issue and set out together to build a better system.

Turn frustration into collaboration

Drawing attention to a problem can be a powerful first step to solving complex problems—especially when we take our own individual frustrations, connect them to other related issues and come together to create comprehensive solutions. And that’s precisely how we solved our Omnicell conundrum. By initiating an open conversation between nursing, physician and administrative leaders, new ideas began to take shape.

“Once we started talking together, the lines between disciplines began to blur. The problems suddenly seemed less difficult to transcend.” Dr. Courtney Scaife, Associate Professor of Surgery

 

We put those ideas into action immediately, forming a pilot project to give physicians the Omnicell access they needed. At the same time, we began creating powerful new supply reports that enabled unit managers to see exactly who was using supplies, what they were being used for and how the supply charges were being attributed.

Build accountability with actionable data

“A big glob of data doesn’t mean anything to anyone,” says Biomed Technician Curtis Mason, who teamed up with Andrew to turn unreadable Omnicell data into useful monthly supply reports. The new reports identified the employee IDs of staff members who were floor-charging supplies and pinpointed units that were having problems with lost charges. “Once we started tracking everything, staff knew that they were accountable every time they got into the Omnicell,” says Curtis.

But that was just the beginning. After sending out the reports, Curtis and Andrew met with unit managers to identify trends and discuss opportunities for improvement. Nurse managers took the data one step further, posting the reports right on their units, so everyone could see who had the most floor charges and lost charges. “People’s competitive nature came out,” says Andrew. “No one wanted to be on the top of that list.”

Educate staff on the whys and hows

Change didn’t come just by implementing better reporting and communication. It required education too. Our training team worked with Curtis and Andrew to create an online learning module that showed nurses and physicians why Omnicell tracking mattered and how much the hospital lost when they overused supplies or charged them incorrectly. “Once we helped people connect the dots, they became passionate about doing the right thing,” says Curtis.

Staff also received an in-person introduction to the Omnicell system, so that physicians and nurses who were new to accessing it could quickly learn how—and start using it immediately. This combination of in-person and online training, along with the collaborative efforts of the nursing, physician, administration and supply chain teams, allowed the project to go from an initial idea to full implementation in just six months. Dr. Scaife and Andrew both attribute the project’s success to the willingness of our leadership team to try the pilot and the ability of diverse disciplines to come together and think differently.

The results of all these collective actions have been nothing short of transformational. Nurse managers have been able to decrease nursing floor charges from $155,171/month in August 2011 to just $4,673/month in August 2012. This is a savings of over $1.32 million in one year. As a result, our Emergency Department has also been able to appropriately bill more supplies, adding $929,323 in charges in 12 months.

Decreased nursing floor charges housewide.

Decreased nursing floor charges housewide.

Increased ED supply revenue per visit.

Increased ED supply revenue per visit.

What’s more, many people on the clinical team have even started identifying less expensive supplies, working directly with Curtis and Andrew to decrease costs in inventive new ways. And residents have stopped stockpiling supplies and started using only what they need, when they need it.

“It’s a huge positive culture shift,” says Dr. Scaife. Andrew smiles. “And it’s a huge positive revenue shift, too.”

What savings discoveries are you making in your work? Share your experiences.