The power of clinical assessment: How ASCs, surgical hospitals can thrive

Surgery centers and surgical hospitals are operating in an increasingly competitive healthcare market and leaders must adapt to the many changes coming their way. To successfully navigate the various trends taking hold in the industry, ASCs and surgical hospitals should conduct a clinical assessment to identify areas for improvement.

During a webinar sponsored by Cardinal Health and hosted by Becker's Healthcare, healthcare leaders discussed how Jenks, Okla.-based Center of Orthopaedic Reconstruction Excellence, a 25-bed specialty surgical hospital, benefited from working with Cardinal Health on a clinical assessment and demonstrated best practices that drove excellent clinical, operational and financial performance. Speakers included:

•    Beverly Morris, BSN, RN, director of surgical services, CORE
•    Kim Morris, director of materials management, CORE
•    Deb Miller, RN, MS, senior consultant of clinical operations, Cardinal Health

The makings of a Cardinal Health clinical assessment
Within a clinical assessment, leaders have many moving parts to consider to ensure their operations are running smoothly. The first component of a clinical assessment entails identifying opportunities to improve a practice's processes and safety standards. For example, leaders should look at their case-pick process and should examine how much inventory is kept on their shelves. When facilities have too much inventory on shelves, they run the risk of reducing space for necessary inventory on the shelves that would accommodate updates in caseloads as well as scheduling. Clinical assessments can:

•    Show practices that waste time/money and identify areas for improvement.
•    Evaluate safety practices to ascertain compliance with national and state standards.
•    Identify improper labeling.
•    Assess whether there is a sufficient amount of pause during a timeout process.  
•    Determine patient flow patterns and examine the potential for wait time reduction.

After analyzing a practice's processes and safety standards, leaders should next evaluate their supply chain and look at ways they can reduce waste. Identifying areas to trim waste in the supply chain can not only save money, but can also improve practice efficiency. ASCs and surgical hospitals can accomplish this through ensuring the right procedure pack is designed for the appropriate procedure and by examining how to consolidate different areas of the supply chain for high-volume, supply-intensive procedures.

Within a clinical assessment, surgery centers and surgical hospitals can find new ways to yield savings by identifying waste in their pack components and considering product standardization. Standardizing products can benefit staff members as they don't have to manage a significant amount of stock within the surgical units. Product standardization saves clinicians time and yields higher efficiency by reducing the amount of supply variation, which can translate to cost-savings.

For example, Cardinal Health, a company specializing in healthcare supply chain transformations, conducted a clinical assessment of a multispecialty ASC with an annual case load of 5,000. After conducting the assessment, Cardinal Health found the ASC could save $24,700 by examining existing packs and creating new custom packs for high-volume procedures, as well as using pack supplies as opposed to the same supplies found on shelves.

How CORE developed a robust pack program
CORE surgical hospital opened in July of 2015 and worked with Cardinal Health before opening to develop their pack procedure program. After opening, they worked with Cardinal Health to perform a full clinical assessment. CORE's pack program had several goals including lowering their SKU count, finding ways to eliminate time-consuming processes when locating supplies, reducing inventory and limiting the amount of time clinicians have to leave the operating room to retrieve supplies. To achieve these goals, CORE standardized their procedural packs based on case mix and volume. CORE continues to evaluate their pack program based on volume changes, practice changes, addition of new procedures/surgeons and recommendations from clinical assessments.

CORE also focuses on continuing to align clinical and operational stakeholders for increased collaboration. For the surgical hospital to be successful in driving efficiency and supporting patient outcomes, team members across departments should work together. As surgical services director for CORE, Beverly Morris works closely with Kim Morris, who oversees the surgical hospital's materials management. The two leaders were strategically aligned on the pack program and any other necessary facility changes, and worked together to establish best practices.

Using data to identify best practices
To better gauge how CORE could achieve its financial and operational goals, the surgical hospital is establishing a data warehouse that provides a wealth of information on important areas, such as supply usage. Equipped with customized dashboards, CORE's goal is to have a clear picture of its cost and an understanding of how those costs are attributed across physicians and procedures. The knowledge accrued from the data will allow CORE to evaluate its progress and identify areas for improvement.

By continually taking advantage of the Cardinal Health clinical assessment program CORE accrued numerous benefits. The surgical hospital lowered it SKU count, reduced bulk stock in its storage room, improved cost management with all-in-one packs and yielded higher efficiency among staff members. With the improved OR efficiency, CORE clinicians spent more time on patient care while also achieving the dual benefit of cost savings.

Moving forward, CORE plans to implement a clinical assessment with Cardinal Health about every 18 months. The presenters advised healthcare leaders to conduct their own clinical assessments, utilizing Cardinal Health, or an outside perioperative RN, to learn how to turn waste into real savings. The “fresh set of eyes” is critical to identifying needed pack and/or process changes.  These assessments can also show how current clinical practices can support stakeholder satisfaction, patient safety and OR efficiency. Overall, clinical assessments reveal best practices that meet healthcare providers' goals to bolster patient care.

To view the webinar's recording, click here.

To view the webinar's slides, click here.

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