A Formula for Success Standards and Communication Product formularies help drive savings and create standards for multiple items in a large integrated delivery network.
Cheri Berri-Lesh, CMRP Value Analysis Manager
A picture is worth a thousand words
Knee Brace in MMIS (Lawson)
Knee Brace in Visual Formulary
Integrated Delivery Network Member Governed 600,000 Members 25 Medical Centers 9,750 Staff 1,055 Providers Insurer and Delivery System Operating Revenue $3B Revenue $3B
To achieve best contract pricing Reduction in variation No durable medical equipment license Some Healthcare Common Procedure Coding System (HCPCS) codes eliminated Create standard process Changing the culture of “if I want it, I get it” to one of collaboration and standardization Reasons to Consolidate & Standardize
How it Began!
Gemba Process Walk
Road to Reducing Variation
Representation of Initial Choices
Physician Attendance Varied
Orthopedic Vendor Representatives Key objectives included standardization & cost savings Partnered with Materials Management to captured all product categories and annual usage An opportunity to identify products improvement or elimination Identified products for item and cost savings reduction Partner Collaboration
2008 $521, Items Orthopedics Soft Goods - Before
2008 $521, Items 2011 $419, Items REDUCTION Spend = 19.5% SKU = 65% Manufacturers From 84 to 29 Orthopedics Soft Goods - After
Sample of Ortho Soft Goods Visual Formulary
More commodities added ◦ Wound Care: Advanced & Acute ◦ Cast, Padding & Splinting ◦ Medical Tapes ◦ Disposable vaginal speculum systems ◦ Infection Prevention Expanding Use of Visual Formularies
Product Standards & Formularies
Advance Wound Care - Before
Advance Wound Care - After
Cast, Padding and Splinting
Tapes
Disposable Vaginal Specula
Infection Prevention: Hand Products
Infection Prevention: Face Protection
Infection Prevention: Nonsterile Gloves
Orthopedic physicians, physician assistants & technologists Wound Care RN & University of WA Professor Infection Prevention Team Perioperative Services Safety and Environmental Health Officer Materials Management Specialists Partnering with Experts for Visual Formularies
The Benefits to a Visual Formulary Visual Formulary Benefits Standard Work Clear Communication Patient & Staff Safety Rapid ID of Errors or Defects Increases Contract Compliance Provides Shopping list Reduction in Spend
Challenges addressed Consolidating needs of multiple physicians Working with preferences versus needs Seeking agreement Large geographic area Finding quality pictures Formatting for ease of viewing Summary
Steps/process created Order history review Collecting multiple product samples Product demonstrations road shows MMIS cleanup including description improvements Formatting images Entering into Excel Engaging with staff & active listening Summary
Key players involved Materials Management Participating departments Vendors Distributors Physicians & nurses Infection Prevention Summary
Outcomes achieved Established supply formularies Visual communication tool used as shopping list Defines best practices Managed by Value Analysis Program Reduced costs & SKU’s Promoted Lean visual systems in other areas Summary
Pre-requisites Product familiarity Engaged vendors and distributor Engaged Materials Management staff Support of Purchasing & Contracting Staff Summary
Questions?
Contact information Cheri Berri-Lesh