Executive director of Langhorne, Pa.-based The Ambulatory Surgery Center at St. Mary's, Ashley Verbitsky, discusses her biggest pain points in supply chain management and how she's tackling the toughest challenges.
Question: Where have been the biggest pain points in your center's ASC supply chain management? What specialties are most difficult?
Ashley Verbitsky: Our biggest pain point has been taking years of inventory build up and establishing appropriate par-levels based on schedule and need. We also deal with many duplicitous supplies and equipment in our multispecialty, physician-owned center as our early years were spent catering to individual physician interest. Establishing parameters for case costing and providing feedback on variations between surgeons for the same procedure is on the docket for the coming months.
We struggle with ophthalmology due to the high volume of cataracts and consignment lenses that must be managed — and lens lists often change numerous times prior to the procedure. We also struggle with orthopedics from an implant perspective, finding the balance between volume and expense as most of our contracts do not provide adequate implant coverage.
Q: How do you handle device representatives in the operating rooms at your center?
AV: They accompany the surgeon in the OR after signing in at our front desk and being escorted to the locker room. We are pretty lax — as a small center, we see the same reps over and over again, so the relationship is familiar and well-established. Reps pushing new products must meet with myself and the director of nursing before any purchases and uses are approved.
Q: What has been the most effective tool you've implemented to make your supply chain more efficient and cost-effective?
AV: Working through EMR reporting and analytics to provide accurate case costing. Incentivizing staff through profit-sharing to minimize supply costs. Leveraging GPO pricing as needed for favorable agreements.
Q: What disruptive forces in healthcare do you see making supply chain management easier or harder to manage in the future?
AV: Payers — whether Medicare or commercial (in our market, one dominant commercial payer in particular) — that become the driving force behind the types of cases and procedures we can accommodate based on reimbursement and their willingness to cover the newer technology.