Presentation Transcript

1. Perioperative Enterprise: Re-Designing Ambulatory Surgery Center Supplies Replenishment

   Presenter: David Bivens Team Members Materials: Lisa McMillian, Lauren Smoke, Patrice Jordan, Brodrick Thompson, Mary Murray Supply Chain: Jim Ishikawa IT: Wade Altman, Craig Owen, Keith Shook, Irvin Serra Institution The University of Texas MD Anderson Cancer Center
2. So What Kind of Project is This? Focus: OR Supplies Management Involves: Physical setup of supplies storage Path Supplies take to arrive in the OR Supplies ordering process
3. Geographical Proximity of the Main and Ambulatory ORs Main OR & Supplies Storage Ambulatory Surgery Center & Supplies
4. Overview of Baseline Condition 2 Locations Performing Surgical Functions Main OR Supporting 29 OR Rooms plus the Ambulatory Surgery Center Ambulatory Surgery Center (ASC) 6 OR Rooms 1 stock location Supplier Ordering and Receiving in Main Only Automated, receipts daily Ambulatory Surgery Center orders from Main OR Stock Manual ordering requisitions to Main OR daily
5. Geographical Proximity of the Main and Ambulatory ORs Main OR & Supplies Storage Ambulatory Surgery Center & Supplies
6. Catalyst For Starting the Project Why did we start this project? Logical 2nd Step of a project that separated the two electronic stock locations in our OR Management Software Large quantities being returned to Main OR Stockroom Some Items getting close to expiration Backup staff from Main stockroom struggling with workflow demands unique to the ASC
7. Baseline Conditions: ASC Workflow Only Generalized Work Processes No Standard Way to Perform a Task What is the effect? Inconsistent service to the Operating Rooms No documentation for consistent training No “Best Method” from a quality and performance standpoint No clearly defined pars Result: Too Much and Too Little $’s tied up, expired material, lots of expediting
8. Baseline VSM
9. Baseline Data Inventory Level Total Inventory on hand $ 322,500 This equates to a days on hand of…. >30 days = 620 SKUs, >60 days = 546 SKUs, ... out of 1210 total items >90 days = 504 SKUs In Terms of Dollars $ > 10 days = $186,830 $ >15 days = $118,979 $ >20 days = $51,128 The Opportunity? Set a goal of 30% reduction in On-Hand Inventory
10. Aim Statement “To reduce the amount of supplies transferred from the main POE materials center to the ASC materials location by 50% by August 31, 2011” Secondary Aim “To reduce the inventory on hand in the ASC materials location by 30% by August 31,2011 through improved par management”
11. ASC Ishikawa Exercise
12. ASC Ishikawa Exercise
13. VSM Idea Sheet
14. VSM: Future State Plan
15. Project Timeline
16. PAR Analysis Based on a combination of actual usage documented in the OR Case Record and staff review for validation. PAR calculations: If JIT: PAR = (Avg. Day) + (Highest Day) Non-JIT: PAR = (5) x (Avg. Day) Both were rounded up to next Order Unit, either each, box or case
17. Sample of PAR Analysis
18. New Stockroom Setup
19. Barcode Scanning Replenishment No more scrolling through each item or typing items and quantities Just scan locations needing re-supply and type in quantity remaining
20. Job Guidance Sheet: New Process Posted in the Work Area Training Aid As-Needed Quick Reference
21. Data Over Time: Revisiting the Aim Statement “To reduce the amount of supplies transferred from the main POE materials center to the ASC materials location by 50% by August 31, 2011” So, using QI Analyst software an Individuals and Moving Range chart was created to monitor the progress.
22. IDT History Prior to Intervention Nov. 10’: PAR Analysis Mar. 10’: Baseline Physical Inventory July 09’: First Data Available Jan. 10’: Physical Inventory Setup
23. Intervention Timeline Nov. 10’: PAR Analysis July 09’: First Data Available Mar. 10’: Baseline Physical Inventory Jan. 10’: Physical Inventory Setup
24. Intervention Timeline Nov. 10’: PAR Analysis Feb.11’: Begin Direct Ordering/ Receiving at ASC July 09’: First Data Available Mar.11’: Start JIT handheld Ordering Mar. 10’: Baseline Physical Inventory Jan. 10’: Physical Inventory Setup Aug. 11’: Follow-Up Physical Inventory
25. VSM: New Current State
26. Results – Primary Aim 71.5% Reduction in transfers from Main to ASC ($298/case to $85/case) through 8 Months of post implementation data available (Feb. ‘11 through Sept. ’11). Looking at the last 6 months to get beyond the learning curve, transfers have reduced by 79.9%, exceeding goal by 59.7%. This translates to a labor savings of $47,376 annually
27. Chart of Total Transferred by Month Go Live
28. Results – Secondary Aim 48% Reduction in on hand inventory. This is a reduction from the baseline physical inventory of $322,534 to $169,220 recorded in the first post implementation annual inventory (Aug. 31, 2011). The goal of a 30% reduction in on-hand inventory has been exceeded by 58%
29. Next Steps? Explore Implementing bar code scanning replenishment in the main POE Materials location proved out at ASC. Re-Allocate some of the staff hours gained by the project to case cart picking of instruments. This would free Sterile Processing staff to focus on improving instrument set turnaround time and quality.