Case Study: Surgical Instrument Service Consolidation/Internalization

1. Case Study: Surgical Instrument Service Consolidation/Internalization I/T Technology Management Division Clinical Engineering – Diagnostic Imaging Service - Technology Assessment & Planning

2. Banner Health Non-profit multi-state health system 28 Acute care hospitals; MDACC, BIMC, BGFMC, BCGMC, BFCMC, UMAC I/T Technology Management Division

3. Banner Health Vital Stats • 275,000 pieces of medical equipment • Medical equipment net asset value = $35 billion • 5,500 beds • 43,000 employees • 205 operating rooms I/T Technology Management Division

4. 20/20 Vision I/T Technology Management Division

5. Background • Banner Technology Management • Clinical Technology Assessment and Planning • Diagnostic Imaging Service • Clinical Engineering • ENTECH (ISO) I/T Technology Management Division

6. Background • Charged by leadership to: • “Think outside the Box” • Budgetary challenges • HealthCare Reform; Obama Care, Affordable Care Act, etc… • Decentralized service expense • Centralized service expense I/T Technology Management Division

7. Target Services • Flexible Endoscopes • Rigid Endoscopes • Surgical Power Tools • Stryker System 6 & 7 • Surgical Hand Instruments • Sharpening & Repair 2 I/T Technology Management Division

8. I/T Technology Management Division

9. “Herding Cats” • Key stakeholder multi-disciplinary team • C-Suite • Endoscopy • Perioperative • Sterile Processing • Clinical Engineering • Supply Chain I/T Technology Management Division

10. Communication • Meet on a regular frequency • Develop charter • Subcommittees • Financials • Selection criteria • RFP I/T Technology Management Division

11. RFP • Scope of work • Specific timelines for deliverables • Vendor site visits I/T Technology Management Division

12. RFP • Repair service evaluation • Per modality • Per discipline • Risk share model • Create win-win opportunities for both organizations I/T Technology Management Division

13. RFP • Escalation Protocol • Original Equipment Manufacturer • Specialty Scopes • Olympus flexible ultrasound scopes • Divinci I/T Technology Management Division

14. “Go Live” • Expense realignment • Escalation protocol • Customer web portal • Onsite instrument service lab I/T Technology Management Division

15. “Entrance Area” I/T Technology Management Division

16. “Surgical Service Lab” I/T Technology Management Division

17. “LEAN Work Bench” I/T Technology Management Division

18. “Flexible Scope QC Station” I/T Technology Management Division

19. “Flexible Scope Sink” I/T Technology Management Division

20. “Metal Filter System” I/T Technology Management Division

21. Monitoring • Scheduled partnership reviews • Operational metrics • Turn times • Educational opportunities • Operational efficiencies • Loaner pool utilization I/T Technology Management Division

22. Monitoring Cont. • Warranty repairs • Financials • Share best practices • Work flow analytics I/T Technology Management Division

23. Questions • ? Frank Cabrera Sr Director Clinical Engineering Banner Health 602-747-9088 Frank.cabrera@bannerhealth.com I/T Technology Management Division