Materials Management in the Operating Room

BEST PRACTICE in SURGERY MATERIALS MANAGEMENT

OR Materials Management: The Cycle  

Effective Management of OR Materials  

OR Materials Management: Dual Focus  

OR Materials Management Logistics Review  

5 Major Aspects To Efficient And Effective OR Materials Management:  

OR Materials Management Logistics Review  

Organization and Staffing

• Roles relative to OR materials coordination should not place clinicians primarily with this responsibility.
• Staffing for materials management functions within the hospital storeroom is often greater than that dedicated to supply management within the OR, yet surgery supply expense and inventory can be greater than that of all the rest of the hospital.

Trends found from hospital to hospital:

• The lower an operating room’s labor cost, the higher its materials cost;
• Adequate numbers and types of personnel are required to manage and control clinical supply usage and costs;
• Majority of surgery programs can reduce at least 25 percent of their supplies expense;
• To achieve this savings, it is essential to invest in and establish a cost management program.

OR Materials Management: Procurement  

OR Materials Management: Distribution  

OR Materials Management: Cost Reduction  

Achievement of total cost reduction potential is a multi-phase process. The best results are achieved by undertaking the less sensitive (e.g., not surgeon preference items) opportunities first.

Cost Reduction: Areas Which Should Be Reviewed

Cost Reduction: Inventory Reduction  

The key is using Business Data vs. an exclusively Clinical (and fear) Based Approach to Establishing Appropriate On-Hand Inventory Levels.

Common Practice is for Surgery department staff to order “stuff” as needed, to order it infrequently because materiel management is not a clinician’s priority nor desire, and fear of surgeons’ criticism for “running out” is paramount! Supplies are expensed when received; inventory just grows and grows.

Action: gradual shift of OR inventory from an expense item to “booked” inventory assets to booked assets that undergo formal review to establish usage patterns to build reorder points to a managed inventory.

Inventory Reduction: Transition  

Managed Inventory: Outcomes  

1. One time expense "reduction"
2. Recognition of expenses when used (rather than when purchased)
3. Lower inventory, hence lower $$ tied up in supplies on shelves
4. Better record keeping
5. Reduced obsolescence

Cost Reduction: Preference Card, Custom Pack
& OR Back-table Utilization  

Don’t take on too much at once! Start with custom packs and examine how much of what is included is utilized on every single case – eliminate items used less than 90% of the time.

Examine preference cards the same way. Mark up copies of high volume doctors’ highest volume preference cards. Identify items used 50% of the time and mark as “hold” rather than "open." Eliminate items never/rarely used.

Cost Reduction: Practice Variation Analysis  

• Review Preference Cards and actual practice in order to develop a:
  - Complete listing of resources routinely used by your high-volume surgeons.
  
• The analysis should incorporate:
  - Clinical nurse participation.
  - Case observation.
  - Surgeon acceptance.
  - All charge and non-charge items.
  

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  Practice Variation: Knee Arthroscopy.(Example)  

  
  

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  Rewards Reflect Investment