The OR supply chain: An untapped resource for cost savings

Hospital leaders are laser-focused on reducing costs amid declining reimbursements. However, when making supply chain improvements, many leaders overlook one of the most expensive areas of the hospital to run: the operating room. 

The OR supply chain faces a unique set of challenges that, if not met, can drive up costs and threaten patient safety, according to Lisa Zierten, director of marketing for hospital services at Dublin, Ohio-based Cardinal Health.

"Because of the expense and unique challenges of running an OR, we're continuously exploring ways to improve the procedural supply chain," she says.

To better understand inefficiencies within the OR supply chain, Cardinal Health and Sermo polled 305 OR nurses, surgeons and supply chain stakeholders on their firsthand supply chain needs and perceptions.1

Ms. Zierten discussed the importance of optimizing the OR supply chain and shared insights from the survey with Becker's Hospital Review.

Editor's note: Responses have been lightly edited for style and length.

Question: What are the unique challenges facing the OR supply chain?

Lisa Zierten: There are many unique challenges of supply chain in the OR. However, the same core goal exists in all departments — having the right product, in the right place at the right time. When a supply is not in the OR in time, a number of issues can result, such as distraction, wasted OR time and clinician dissatisfaction. For example, sometimes a nurse will need to run to the supply room, which can delay a case. Or worse, cases can be cancelled altogether, which can adversely affect patient care and experience. The vast number and range of procedures, physician preferences and sheer breadth of products needed to support those procedures further complicates this process. Additionally, some products — such as tissue and implants — require special handling and unique tracking and documentation. A majority of hospitals attempt to manage all this with manual approaches and inefficient workflows.

Q: What are the biggest consequences of supply chain inefficiencies in the OR?

LZ: Supply chain inefficiencies in the OR have the greatest potential impact on patient safety and overall costs. Commonly used manual inventory management approaches are ripe for error — human or otherwise. Manual approaches are inconsistent and often do not effectively track expired or recalled products. In fact, our survey found 27 percent of respondents had witnessed or heard of an expired product being used on a patient.

Additionally, manual approaches generally lack the ability to provide the robust tracking, data and analytics to ensure availability of crucial products when needed. Nearly three-quarters (73 percent) of OR surgeons and nurses recalled a time when a physician didn't have the product needed for a procedure during the surgery. This lack of supplies can threaten patient safety — 23 percent of survey participants reported having seen or heard of a patient experiencing an adverse event due to a lack of supplies.

A lack of right supplies in the OR can also put pressure on a hospital's bottom line through case delays and cancellations. 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, and 40 percent knew of cancellations due to missing supplies. With the sheer volume of cases, even a small percentage of cancelled cases not returning can cause decreased revenue.

Q: Are there any other consequences?

LZ: It's also important to note the effect of supply chain tasks on clinician stress and burnout. Operating room environments are already stressful. With 51 percent of clinicians reporting too many manual inventory processes, these tasks aren't helping. When we asked clinicians to name the most stressful part of their job, the number one reply (26 percent) was too much paperwork, followed by not having enough time for patients (23 percent).

Turnover plays a large role in employee shortages. Over the next five years, the turnover rate is expected to double to 68.7 percent for physicians and 62.7 percent for nurses, according to the 2017 HIDA Acute Market Report. Job satisfaction is listed as the primary reason for turnover. Eliminating inefficient manual tasks can allow clinicians to spend more time on patient care and may reduce the likelihood of turnover.  

Q: How can supply chain leaders and clinicians collaborate to take action?

LZ: I think clinicians commonly (and grudgingly) accept that supply chain tasks are "part of their job." In our survey, 54 percent of OR nurses and surgeons perceived inventory management as either "complicated" or a "necessary evil." But in today's environment, few hospitals can afford to have clinicians spend their time physically counting inventory, or running down the hall to grab a missing product, especially when time could be better spent focused on patients.

It doesn't have to be that way. I believe the key word is collaboration. As savings from more traditional expense areas become harder to find, it is critical for supply chain and OR clinician stakeholders to unite. 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 of improvement.

Our survey revealed OR clinicians recognized the importance of supporting efforts to save money — 42 percent said "saving money helps us all." The key to getting stakeholder buy-in is justifying the return on investment of inventory management improvements, not only in the context of saving money, but also with regards to potential improvements in patient safety and employee morale.

To learn more about OR Supply Chains, click here.

1. 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 healthcare 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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