Supply chain optimization at an academic medical center.

PURPOSE: A successful supply chain optimization project that leveraged technology, engineering principles, and a technician workflow redesign in the setting of a growing health system is described. SUMMARY: With continued rises in medication costs, medication inventory management is increasingly important. Proper management of central pharmacy inventory and floor-stock inventory in automated dispensing cabinets (ADCs) can be challenging. In an effort to improve control of inventory costs in the central pharmacy of a large academic medical center, the pharmacy department implemented a supply chain optimization project in collaboration with the medical center's inhouse team of experts on process improvement and industrial engineering. The project had 2 main components: (1) upgrading and reconfiguring carousel technology within an expanded central pharmacy footprint to generate accurate floor-stock inventory replenishment reports, which resulted in efficiencies within the medication-use system, and (2) implementing a technician workflow redesign and algorithm to right-size the ADC inventory, which decreased inventory stockouts (i.e., incidents of depletion of medication stock) and improved ADC user satisfaction. CONCLUSION: Through a multifaceted approach to inventory management, the number of stockouts per month was decreased and ADC inventory was optimized, resulting in a one-time inventory cost savings of $220,500.

The real costs of surgical instrument training in sterile processing revisited.

The need for properly trained sterile processing staff members has grown with the increased sophistication of surgical procedures. In 1998, I conducted a survey of hospitals about various aspects of training sterile processing personnel, including the length of time for training employees to process general surgical and specialty surgical instruments. To evaluate trends, I conducted a second survey 10 years later. A majority of the 2008 respondents indicated that training would take three to six months (60%) or six to 12 months (31%) and that most preceptors (52%) spend two to three months working with new employees. A calculation of the cost to train a sterile processing technician to the competent level, including the salary of the preceptor, was $41,414 for 2008, an increase of more than 100% from the 1998 calculation. These costs must be weighed against the loss of revenue when procedures are delayed because of missing, damaged, or unclean instruments and the patient safety issues that could result if an employee is not well trained.

Optimizing cost and service in sterilization.

Controlling sterilization costs is a necessity if medical device manufacturers are to remain competitive. This article looks at ways the industry can reduce these costs and also considers the benefits to be gained by improving relationships with sterilization contractors.

Significant savings achieved by implementing event related outdating.

The event related outdating(ERO) theory is based on the assumption that items that are properly cleaned, wrapped, sterilized, stored and handled will remain sterile indefinitely unless the integrity of the package becomes compromised. The authors describe how one Surgical Suite (performing approximately 600 cases/month) implemented an ERO program with estimated annual savings of almost $10,000/year.