Taking the Operating Room Supply Chain Processes from ‘Necessary Evil’ to ‘Essential Ally’

Operating room (OR) surgeons and nurses face extraordinary challenges, to say the least. The OR is among the most expensive hospital areas to run1, as well as one of the most stressful.

Clinicians, especially surgeons, face high levels of burnout which can lead to turnover – or worse, increased risk of medical errors2.

How can hospitals address these challenges? The supply chain is a critical piece of the puzzle, as studies have shown that efforts to improve workflow have significantly reduced rates of burnout and support patient safety3. It’s essential to have systems and processes that put the right supplies in the right hands at the right time to decrease frustration and costly workarounds.

We wanted to better understand the OR’s supply chain needs, so we went behind the red line to investigate. We worked with SERMO to uncover what surgeons, OR nurses, OR supply chain decision-makers, and hospital supply chain leaders experience with their organizations’ inventory management process. We surveyed 305 respondents over the course of two weeks. The results were eye-opening.

They see manual inventory systems as time-consuming, stressful, and unreliable.

While nearly all respondents (97 percent) view supply chain management as an important part of achieving their organization’s goals, more than half (54 percent) of nurses and surgeons perceive inventory management as either “complicated” or a “necessary evil.” Why? Simply put, existing inventory processes add unneeded, time-consuming tasks and stress to their already overloaded plate.

Eighty-three percent of all respondents say their organizations still rely on manual counting in some part of their inventory management process, with only 15 percent reporting that they use automated supply chain solutions powered by RFID. They see increasing supply chain documentation requirements (64 percent) and wasting or overutilizing supplies (64 percent) as significant problems within their organization. More than half (51 percent) complain of too many manual inventory processes.

We also asked OR surgeons and nurses to name the most stressful part of their job. The number one reply (26 percent) was too much paper work, followed by not having enough time for patients (23 percent). Laborious tasks add up, taking surgeons and nurses away from their patients.

In the OR, supply chain problems can have serious consequences.

Inventory management challenges go beyond intensifying demands on time in the OR. When something goes wrong, there can be serious ramifications for patient safety and overall costs, especially in the OR where time is money.

Twenty-seven percent of respondents have seen or heard of an expired product being used on a patient, and nearly one in four (23 percent) have seen or heard of a patient experiencing an adverse event due to a lack of supplies. Nearly three-quarters (73 percent) of OR surgeons and nurses recall a time when a physician didn’t have the product needed for a procedure during the procedure.

What’s the impact? More than two-thirds (69 percent) of stakeholders knew of a time their organization had to delay a case because the right supplies were not on hand. More than half (57 percent) knew of a time their organization had to borrow supplies from another hospital, and 40 percent knew of cancellations due to missing supplies. Further, the fear of not having needed supplies compels half (51 percent) of OR clinicians to hoard supplies to ensure they have what they need to care for their patients.

We also asked survey participants to point to the single biggest problem facing their organizations. The top answers were financial concerns (37 percent) and reimbursement (35 percent). Three in four (73 percent) of hospital supply chain stakeholders said managing costs is their greatest challenge when it comes to contributing to their organization’s success — and more than a third (37 percent) of OR clinicians feel the same pressure.

OR clinicians want inventory management systems tailored to the specific needs of the OR.

Not surprisingly, almost all (92 percent) of OR surgeons and nurses see the need for an inventory management system that solves for the unique challenges of the OR. Day to day, they depend on a large volume of varied supplies and work under intense pressure. They need a supply chain system that can keep up. Nearly half (46 percent) of respondents say that their OR has its own inventory management system — but only one in five (19 percent) are automated.

Respondents recognize important benefits of an automated inventory management system, including cost reduction, more time for clinicians to focus on patients, and tools that support better patient outcomes. The efficiency, accuracy, and data insights automated systems provide can transform inventory management from a “necessary evil” to an essential ally, empowering all supply chain stakeholders to improve care and reduce costs.

Clinicians want to be part of the solution.

Although supply chain leaders are most responsible for cutting costs, two-thirds of those surveyed acknowledged that they do not have “a lot” of visibility into OR operations. But OR surgeons and nurses do recognize the importance of supporting efforts to save money. Forty-two percent of surgeons and nurses say, “Saving money helps all of us,” and most (77 percent) agree that equivalent – or even better – patient care can be maintained while reducing costs. And while OR clinicians trust the quality of their organization’s inventory management process, the majority (77 percent) would like more input into those decisions.

With nearly all (93 percent) survey participants saying, “I see a meaningful role for myself in reducing my organization’s cost,” the time to transform inventory systems is now. And transformation begins with collaboration.

Supply chain leaders need to talk to OR clinicians to understand their needs, and OR clinicians need to lean on supply chain leaders to understand the possibilities for improvement, including automated solutions.

While different OR stakeholders all face their own distinct challenges, they agree that a healthy supply chain leads to better patient outcomes and more effective cost management. Together, they can make important changes that move their organizations forward.

About Cardinal Health Hospital Supply Chain Survey

This study was fielded Nov. 2 - Nov. 15, 2017, using an online survey methodology. The samples were drawn from SERMO’s Online Respondent Panel of Health Care Providers, which includes over 600,000 medical professionals in the United States. The study included 305 respondents total from health care organizations varying in size, specialty and practice area. Respondents included frontline clinicians (n=128), operating room supply chain decision-makers (n=100), and hospital/supply chain administrators (n=77). All survey data is on file at Cardinal Health.

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1https://nursing.duke.edu/sites/default/files/vanwinkle_article.pdf
2https://www.facs.org/education/division-of-education/publications/rise/articles/burnout
3https://psnet.ahrq.gov/perspectives/perspective/190/burnout-among-health-professionals-and-its-effect-on-patient-safety

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