Interdisciplinary committee on infusion-control devices: managing product use.

The development of an interdisciplinary approach to the management of infusion-control devices (ICDs) in a university teaching hospital is described. An ICD committee composed of staff from the pharmacy, nursing, bioinstrumentation, and materiel management departments was created to identify and solve problems with the existing system of ICD management. These problems included untimely delivery of malfunctioning ICDs to the bioinstrumentation department for repairs, chronic shortages of ICDs, inappropriate use of these devices, and lost charges for ICDs and cassettes. The committee decided on joint control of the ICD program by the pharmacy and nursing departments. Guidelines for appropriate use of ICDs were developed and distributed to all nursing units and pharmacy satellites. The pharmacist was responsible for screening requests for ICDs to determine whether they conformed to those guidelines. New policies for delivery of malfunctioning ICDs to the bioinstrumentation department resulted in improved turnaround time for repairs. Responsibility for billing was shared by the pharmacy and nursing departments. These changes resulted in increased availability of ICDs for patient use and an increased charge capture of $247,000 per year. Through the combined efforts of the pharmacy and nursing departments in this institution, the distribution and collection of ICDs has been made more efficient and lost patient charges have decreased.

Interdisciplinary committee on infusion-control devices: containing related-product costs.

A program for decreasing expenditures for i.v. sets and related items at a 530-bed university teaching hospital is described. A multidisciplinary committee originally formed to evaluate infusion-control devices (ICDs) developed a cost-containment strategy for reducing the number of accessories and amount of equipment used in i.v. therapy and for reducing inappropriate use of these items. Major problems identified in an audit were excessive use of secondary sets; inappropriate use of add-on flow-control devices, extension sets, and metered-chamber sets; and use of the wrong type of i.v. set with ICDs. New procedural guidelines, inservice-education programs, evaluation of new and different i.v. products, and increased enforcement of policies and procedures by the pharmacy department were implemented to address these problems. For fiscal year 1986, the bid process for i.v. equipment was divided into 10 sections so that manufacturers who may not have been able to bid on every item could bid only on individual sections if they desired. A follow-up audit six months after implementation of the strategy showed increased compliance with guidelines for use of i.v. sets and devices. Compared with the previous year, data for fiscal year 1986 showed total savings of $142,223 attributable to decreased use of i.v. equipment. The competitive-bid process saved $54,942; the total amount saved was $197,165. The trend of appropriate use as a result of adherence to the guidelines continued through fiscal year 1987. This multidisciplinary cost-containment approach was effective in reducing expenditures for i.v. sets and equipment.

Interdisciplinary committee on infusion-control devices: evaluating new products.

Evaluation and selection of volumetric infusion-control devices (ICDs) by an interdisciplinary committee in a university teaching hospital is described. The committee, which was originally formed to evaluate problems with the existing system of ICD management, determined that the ICDs in use at the hospital were outdated. After gathering information on the types of ICDs available and identifying options for replacing the existing equipment, the committee decided to replace some of the devices with new volumetric ICDs. A six-page evaluation form was mailed to ICD manufacturers, and representatives from 16 manufacturers were invited to demonstrate their devices to the committee members. Five manufacturers were then invited to participate in a two-week, inhouse comparative trial, during which the devices were objectively evaluated by nurses, the bioinstrumentation department, and the ICD committee. The results of that evaluation were used to construct bid specifications. The decision of which ICDs to purchase was based on cost factors and the degree to which the devices met the specifications. The use of a multidisciplinary committee to evaluate and select new ICDs was an effective strategy. The devices that were purchased represented improvements in patient safety and cost-effectiveness.