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new inventory in the operation theatre and challenges
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- 2. What in theimpact of Poor inventory management? 1. Financial impact 2. Patient safety 3. Staff
- 4. Challenges Physician preference Diversity ofOR procedure Typical practice Preference card management Limited data Lack of automated inventory system Multiple categories of supplies Duplication
- 5. Duplication • Surgical suits •OR core area • Specialty carts • Case pick area • Case carts /baskets • Bulk storage area • Other non official areas 7 location where exactly you can find same products
- 6. Procedure challenge Just incase(JIC) practices
- 7.
- 8. Typical practice Lack datato support inventory levels • Perioperative nurse ensuring that surgeon has every thing on their preference on table Supply acquisition and distribution are happen by people who does not know any this about OR • Lack of integration between supply chain and operation services
- 9. Typical practice No definedPAR level Perioperative nurse lacking knowledge and understanding about inventory management Preoperative nurse focus on patient care not on inventory management
- 10. Data analysis gabs •Lack of technology • Data master file • Issues and usage report • OR It system reports • Determine where you are –annual spend,inventory & return • Decide where you wants to be –targets ,goals • Preference cards/ or lack of preference cards
- 12. Taking greater controlon OR inventory Product consignment Product consolidation Product standardization Control new products and vendor Improve Acquisition and distribution
- 13. Next steps • Establishabase line • Set measurable goals • Assemble a team • Determine appropriate solutions • Develop and action plan measure your success
- 14. What is inventory? 1. Reusable equipment and consumable items that are used to provide healthcare services for patients. 2. Only consumable items 3. The surgical equipment
- 15. Inventory Reusable equipment andconsumable items that are used to provide healthcare services for patients.
- 16. Inventory Types Consumableinventory Reusable inventory (lower cost) Reusable inventory (higher cost) All items are considered assets and represent a significant financial inestment by the facility.
- 17. Consumable Inventory Cycle (DisposableItems) Purchase Copyright IAHCSMM 2007 Store Use Discard
- 18. Consumable Inventory Items Cleaning Supplies Disposable gloves Gowns Sutures
- 19. Reusable Inventory Lower Cost Assets that are relatively inexpensive that such as medical devices and sterilization containers that can be reused as healthcare services are provided to patients.
- 20. Reusable Inventory Higher Cost Items such as operating table ,diathermy machines ,laparoscopic . High cost, reusable inventory items are called capital equipment.
- 21. Inventory Must bemanaged to prevent Stock Outs. Must be managed to provide equality patient care. Must be managed to control operating costs.
- 22. Common Causes of LostSterile Items Expiration Contamination Obsolesence – item replaced by a new version Loss Taken by unauthorized individual
- 23. Expiration Dates Somecommercially sterilized items have expiration dates. Those dates must be checked and outdated (expired) items must not be dispensed for use.
- 24. Package Symbols DoNot Reuse – Single Use Only Date of Manufacture
- 25. “Contents Sterile UnlessDamaged or Opened” Packages with this type of statement are determined to remain sterile unless their barrier is compromised by an event.
- 26. Event-Related Sterility Applies toall packages.Even packages with expiration dates can have a shortened shelf-life if they are compromised by an event (i.e. moisture, holes, tears, etc.)
- 27. Inventory Replenishment andDistribution Systems • A variety of systems used to replenish consumable supplies in patient care areas.
- 28. PAR-Level Systems PeriodicAutomated Replenishment (PAR) An inventory replenishment system in which the desired amount of products is established and inventory replenishment returns to the quantity of products to this level.
- 29. Automated Supply Replenishment Systems Use a computerized system to gather and track the issuing of patient items. Automated systems are generally connected to healthcare facility’s inventory managing system.
- 30. Case Cart Systems An inventory control system primarily used in the operating room, that uses a cart that is specifically prepared for one procedure. Folowing the procedure unused, unopen sterile items are returned to storage, all soiled instruments are sent to decontamination area.
- 31. Stock Out A conditionthat occurs when inventory items that are needed to provide healthcare services to patients are unavailable.
- 32. Too Much Inventory... Too much cash invested in excessive stock levels More storage space needed Greater Risk of Damage, Loss, Obsolescence or pilferage/theft Requires more time to Manage
- 33. Too Little Inventory... Supply Shortages Emergency Purchases Negative Effect on Patient Care
- 34. Storage Standards Storagelocations must be kept clean. Clutter or overstocking can lead to package damage. Packages must be protected from “events” that can contaminate them.
- 35. Manual and AutomatedInventory Systems
- 36. Manual Inventory Systems Use a paper method to document and track transactions.
- 37. Automated Inventory Systems Use a computerized method to document and track transactions. Automated systems yield more data because the information is more easily managed and stored.
- 38.
- 39. Automated Inventory TrackingSystems Used to facilitate the accurate tracking of inventory. Usually done using Bar Codes or Radio Frequency Identification.
- 40. Inventory is Constantly Changing New Items are constantly being introduced. New Equipment and Technologies often require disposable components. Planning is important to ensure that operating room nurses is made aware of the new items and educated about them.
- 41. The Role ofperioperative nurses in Inventory Management Learning processes such as: • How orders are placed. • How to identify items. • How to locate items. Learning about new products entered in the system Understanding the info on the commercially-sterilized packages. Reporting concerns, such as: • Excessive demands • Low quantities • Storage issues
- 42. Nurses are onlyresponsible about the inventory management? 1. True 2. False
- 43. Organize supply chainteam Team member should include •Material management •OR leadership and clinical expert •Administrator Review all policies related to inventory management
- 44. Do a walkthrough • Include entire team • Visit stocking location • Look for duplication and excess inventory • Look for mission bins • Observe case pick process • Review pick list • Evaluate daily return from OR • Review group observations
- 45.
Editor's Notes
- #7 A driving factor behind the “high cost of doing business” in the operating room has long been physician preferences. Many surgeons develop preferences for specific products or vendors early in their careers. In the past, there was little reason for surgeons to change from the products they used since beginning their practices. While many products are similar, one study showed that surgeons select surgical products without any comparative performance data, like products do not have equivalent performance profiles.6 So something as simple as a suture or an endo-mechanical trocar may not perform equally when being used in surgery. This supports the case that surgeon preferences do need to be considered when a facility is looking to standardize on products. At the same time, many products used in the operating room may be clinically equivalent and could be standardized. For example, basic gowns and drapes should not affect the performance of the procedure, or the patient outcomes, and may offer facilities the ability to standardize and consolidate products as a cost savings measure. According to a report by the Studer Group, surgeons seek four things from hospitals: quality, efficiency, input, and appreciation. Responding to physician preference requests, according to Eric Studer, demonstrates to surgeons that the facility values them, respects their time, cares about their patients, and wants them to have an efficient environment in which to do their work.7 So, the dilemma is how to affect cost savings and not create a hostile work environment. There are strategies to accomplish this in a way that is beneficial for both the facility and physicians. Specific strategies will be discussed later in this activity