Healthcare managers and directors, especially in materials management and other departments with similar responsibilities, are often faced with the challenge of balancing an organization’s need for medical equipment with established budgets. What many organizations may not realize is that they might have more equipment than they actually need – and could be spending unnecessarily.
At Ellis Medicine, a hospital system in upstate New York, we were able to find $700,000 in savings through asset management, combining workflow and process change with real-time tracking technology.
Ellis Medicine has operated in the Schenectady, N.Y., community since 1888, first as Ellis Hospital, which served the vibrant, 19th-century manufacturing community on the Erie Canal. Within the last five years, Ellis merged with two other local hospitals in the area and is now Ellis Medicine, a healthcare organization comprising three campuses, as well as various outpatient locations.
Two years ago, our chief operating officer encouraged staff to consider RFID technology for asset tracking, with the goal of increasing staff efficiency by spending less time searching for mobile equipment.
To kick off our clinical asset-management work, we first addressed IV pumps. Ellis had about 500 pumps, but that never seemed to be enough. Nurses were constantly looking for the pumps and making calls to locate them. Moreover, Ellis was in the process of considering an upgrade from analog IV pumps to newer, “smart” pumps. In addition to being expensive, these newer-generation pumps also required wireless capabilities. Before we purchased new equipment, we wanted to be sure we understood what we had on hand, how our staff was using the pumps and what we really needed to purchase.
IV pumps: a case study
Before any organization can make changes to equipment inventories or workflow processes, it needs to understand what the real situation is and what the real needs are – otherwise, perceptions could be off, resulting in avoidable waste. In 2009 we partnered with GE Healthcare, which is known for its expertise in boosting productivity and efficiency, for a mini-LEAN/Six Sigma exercise to find out what the real issues were with our IV pumps, and why there never seemed to be enough units.
The LEAN/Six Sigma exercise revealed that workflow and pump management were the underlying reason for the staff perception that there were not enough IV pumps. Working with GE, Ellis discussed the organization’s desired future state of operations and developed a procedure for managing IV pumps on nursing floors, the OR and the ED.
We implemented the AgileTrac real-time location system from GE, which allows us to tag each piece of equipment and track it on computers – in real-time – anywhere within the facility. This means that staff is able to know exactly where any given IV pump is at any given time. If a nurse needs a pump, all she or he has to do is log into a local computer and find out where the equipment is.
When this new workflow plan and technology were implemented, it was discovered that although there were 500 IV pumps in circulation, we really only needed around 340 to meet the needs of our patients effectively and efficiently.
How is this possible? The new process implemented as a result of mini-LEAN/Six Sigma helped to improve the overall distribution of IV pumps. In addition, the AgileTrac tool is used to maintain the effectiveness of the new processes. Instead of a pump being left somewhere obscure, where no one could find it, or left where it wasn’t needed, the IV pump was now easily located and put back into circulation.
With this newfound insight into how many pumps were actually needed to treat patients and accommodate caregiver needs – 340 units – Ellis was able to avoid significant unnecessary expenditure right off the bat when buying the new IV pumps.
One crucial takeaway from Ellis’ work tracking assets and implementing AgileTrac is that purchasing infrastructure isn’t enough – you can’t just buy technology and expect results to follow. Staff needs to adopt usage of the technology. The organization-wide culture has to support and nurture use. Everyone involved in the use of tracking technology – from the nurses searching for equipment to the biomedical staff maintaining the individual units – needs to be onboard.
While there was some initial resistance from staff, who were already learning and using a number of other new systems and technologies, such as EMR, adoption and usage were very good once they saw how well the new procedure worked and how easily they could track down equipment with AgileTrac. Another lesson learned was the necessity for ongoing education of staff to make sure the AgileTrac tool and the new IV pump process were working consistently. We were especially mindful to educate new nursing staff when they came on board.
The takeaway from this experience is that you can change your technology – but unless you change your process and procedures, the organizational investment won’t automatically result in improvements. Humans power technology, so be sure that staff knows how to use it and feels comfortable doing so.
A challenge at any size
Asset tracking and inventory management are not challenges unique to Ellis; industry-wide, every hospital and health system of any size struggles with these same issues.
Where mobile equipment is located, determining the appropriate number of units to buy and maintain, and getting each piece of equipment to the right patient at the right time are complicated, costly issues. Due to inefficiencies in workflow and not knowing how many physical pieces of equipment there are on campus, organizations can end up paying for unnecessary pieces of owned or rented equipment. While it may seem elementary to determine how much technology is in a hospital at any given time, assets could easily number several thousand, depending on the size of the facility and the number of patients and staff manipulating mobile medical equipment.
Ellis continues its journey of asset management
Since the IV pump project, we’ve tagged a number of other pieces of mobile medical equipment, including telemetry units, which were sometimes lost when tangled up in soiled linens, or when patients accidentally wore them home. We’re now beginning to tag rental units, such as specialty beds and wound vacs, which are very costly pieces of mobile equipment. Already, we’ve been able to prevent losing this equipment, thus avoiding the cost of having to pay rental companies for lost units.
We’re also tagging wheelchairs and stretchers to better enable our transport department to quickly find necessary pieces of equipment. The biomedical department is more efficient with preventive maintenance, as staff doesn’t have to search as long for equipment needing to be serviced. Also, there have been fewer pieces of missing equipment reported as being unable to be serviced.
Asset management is certainly a huge undertaking for an organization, but this is an industry challenge that will not go away. As we found with our $700,000 in savings, managing the efficient usage of mobile medical equipment offers long-term value and supports our ongoing efforts to take the best possible care of our patients.
About the author
Paul Segovis is director of materials management at Ellis Medicine in Schenectady, N.Y. For more on GE Healthcare, click here.