How to find $650,000 in materials savings

ResultsLab, Inc ©20132 Step One – Define the Problem A client of ours said that needed to cut $650,000 out of their Perioperative budget Staffing and other labor expenses was off limits A premium was put on savings that would be realized year to year Guess Who?

ResultsLab, Inc ©20133 Plan of Action Savings were targeted from three areas: –Reducing PAR Levels –Reprocessing single use items –Better pricing from vendors / consolidation

ResultsLab, Inc ©20134 Reduction of PAR Levels Our on-site interim materials manager set up a complete audit of all their inventory throughout the OR and Central Sterile Supply Management Health Solutions (MHS) out of Connecticut came in with several people and, overnight, manually counted every piece of inventory

ResultsLab, Inc ©20135 Reduction of PAR Levels Over several weeks MHS analyzed and compared what was found in inventory against the client’s purchase history –Low quantities in inventory and frequent orders of an item meant it had several “turns”. –Frequency and quantities of orders were also used to calculate the ideal PAR (Periodic Automatic Renewal) level A month and a half later, the report came back to us and the client

ResultsLab, Inc ©20136 Reduction of PAR Levels What MHS Found in Inventory What MHS Suggests for PAR Levels Savings if inventory is dropped to suggested level

ResultsLab, Inc ©20137 Reduction of PAR Levels Why had inventory gotten so high? –Items stored in multiple locations –No PAR values set –No visual as to when to reorder –No guidance on how much or when to order

ResultsLab, Inc ©20138 Reduction of PAR Levels Awareness of the problem would not solve it. A new process needed to be put in place to realize the opportunities Decided to implement a Kanban (which is Japanese for “Signal”) system. It has two advantages: –Makes it easy to determine when an item needs to be reordered to eliminate being out of stock of vital supplies –Allows you to keep just the right amount of inventory at hand

ResultsLab, Inc ©20139 Reduction of PAR Levels For each item, signal cards were developed Cards have relevant information: Lawson Number, Reorder Quantity, Safety Stock, Cost, and PAR Levels Room for eventual barcode and more robust item storage locators

ResultsLab, Inc © Reduction of PAR Levels Signal Cards are secured to the relevant “safety stock”. –Safety stock is calculated based on usage and turnaround time –Staff is trained not to order until the safety stock is needed

ResultsLab, Inc © Reduction of PAR Levels When staff come across the card, all they do is drop it in the nearby “To Be Ordered” envelope Instead of having to assess each individual item storage location to determine whether it is at PAR, the person doing the ordering only has to check the envelope. Time spent ordering products is significantly reduced

ResultsLab, Inc © Reduction of PAR Levels Also looked for ways to reduce storage locations. For example – the Evicel was reduced from 4 locations to just 1 Reduced storage locations means lower overall PAR levels Evicel was originally stored in 4 locations

ResultsLab, Inc © Reduction of PAR Levels Supply levels in each room were assessed. Staff were queried as to what they really needed day to day Excess inventory was removed and new PAR levels were labeled and staff informed

ResultsLab, Inc © Reduction of PAR Levels The one time savings from the reduced PAR levels on the items we personally set up the Kanban system = $227K By following the same process on the next 144 items on the MHS list (12 a week for 12 weeks), the client would realize another $175K in savings.

ResultsLab, Inc © Reprocessing The client had been “looking into” reprocessing of single use items for the past year with no results A simple web inquiry into Stryker Sustainability’s website got a response that same day – they came in to present 3 days later The client’s materials manager (who was the one looking into it), magically, was able to get an appointment with SterileMed the next week

ResultsLab, Inc © Reprocessing Both vendors had similar processes for item retrieval, processing, and reordering In addition to reprocessing of single use items, they can re-sterilize expired items or opened and unused items Reprocessing alone was estimated to save the client $248,000 a year

ResultsLab, Inc © Vendor Consolidation The biggest opportunity for savings from consolidation involved the endomechanical equipment (staplers, scissors, and other items used in laparoscopic surgery) Their main endomechanical vendor said that they could save the client $125K if they converted completely –The client’s chief of surgery liked the competitor –This would be a difficult conversion The vendor did offer pricing for trocars that would save the client $21K a year – an easy conversion

ResultsLab, Inc © Put It All Together