THE PROCESS OF INTRODUCING A NEW CONTINENCE PRODUCT. INITIATING CHANGE: THE PROCESS OF INTRODUCING A NEW CONTINENCE PRODUCT. Dianne Ogle & Sheryl Geddes

We serve a large district 5/21 DHBs by population 353,000 people including 75,000 Maori (21%) 60% live outside Hamilton From the top of the Coromandel Peninsula in the north To Taumarunui and National Park in the south West to Raglan and Kawhia East to Waihi, Matamata and Tokoroa

access continence pad products over the region. 2000 people access continence pad products over the region.

Aims of product change Consistent supply over : Waikato Hospital Campus 4 Rural Hospitals, 2 Continuing Care Hospitals & Community patients. MONEY Pad pack size for monthly prescriptions Streamline supply/contracts. The reasons for changing our products were to have a consistent product supply between community and inpatient areas and where possible across boundaries. We needed a product that was packed in units that aligned itself with our monthly supply process. Cost was an issue in that there was a need to reduce/stabilise current costs in the face of increasing aging and disabled population.

Main Stakeholders Patients Company Medical Representatives Waikato Hospital Campus Rural & Continuing Care Hospitals Community Services Equipment & Supply Department Product Co-ordinators Purchasing Department Several people and departments were involved in the process. Complex process involved in making any change over a wide geographical area. The contracting and provider arm at Waikato DHB covers several departments. The purchasing dept are involved in contract negotiation, product co-ordinators in sourcing, trialling and quality and risk safety issues. The equipment and supply dept is involved in all ordering and delivery processes to community patients. This dept also holds the budget for community supply. The medical reps were active in the process providing information, education, resources and competitive pricing options.

We decided on the rationalised range because it was the most effective option that met the clinical needs and cost effectivity.

Preparing the Way Benchmarking with National Colleagues Formulation of Trial process Trial/audit/collation of results Notification of Staff Spent considerable time researching what product was used in each DHB and their experiences and preferences. The trial process was carried out in an inpatient setting and in the community. It was selective in that we had to use people who could give us accurate written and verbal feedback. The process was formulated and collated by purchasing/product co-ordinator in accordance with the requirements of the Waikato DHB for introducing new products. Staff covering all inpatient areas and 23 DN bases had to be notified of the change. Methods used – email, fax, meetings with nurse educators & leaders and phone conversations.

Initiating/Supporting the Change Altering codes and computerised information Notifying all the patients Educating Hospital & Community Staff The provider arm had an access data base of 2000 patients. All patients required notification of the change by letter, education on the product, and their details and product descriptions had to be manually altered on the computer system. There is only one systems operator and she required extra time and reassurance during this process. Education of staff was a major undertaking by us and product representative. All the inpatient areas, inclusive of the rural hospitals and 23 regional DN bases had to receive consistent information.

Evaluation Complaints, complaints, & more complaints Acceptance Outcome Supply & Distribution Effectiveness of product Cost Savings Complaints were inevitable and we received quite a number ranging from dislike of the colour, shape, thickness, capacity of the product. You name it we got it!! The complaints were essentially a fear of change. 12 weeks following implementation, the complaints stopped. There has been no problems reported by new patients. Pad pack size is more suitable for monthly prescriptions Rationalisation has been clinically and cost effective.

Lessons learnt Was it worth it? Long, slow, demanding process. It required patience and negotiation. It required an understanding and respect of a variety of people/departments motives and viewpoints. If we were to do it again, we would spend more time preparing the way and being certain that staff were supportive. From a cost perspective for the organisation it was worth it. From a clinical perspective for the patient, no change was effected. We ensured that the products would meet their need.