July 2024 – The Journal of Healthcare Contracting
Alisha Beringer, Director, Supply Chain Distribution & Logistics, Supply Chain, Northwestern Memorial Healthcare, believes Supply Chain plays a very integral part in nurse and patient safety.
“In Supply Chain, you make sure your clinical partners have the right products, in the right place, at the right time, all while reducing expired and recalled product risk,” she said. “It is Supply Chain’s job to manage the inventory in a way the ensures there is sufficient product on the shelf that is not expired and in unusable conditions. Our clinical partners should be responsible for patient care, not supplies, so we want to do our part to ensure that is what they can focus on.
“However, at Northwestern Medicine, we believe safety isn’t just with the products on the shelves that we manage, but with all products that could be used on our patients from the other uncontrollable avenues, like vendor owned product,” Beringer continued. “In Supply Chain, we also take the responsibility for making sure we are doing our part to manage those as well.”
Reducing the burden
Manual processes and administrative burden were what Northwestern staff reported they were experiencing, both for Clinical and Supply Chain. Too much time was wasted on tasks surrounding product being used on the patient and there was no way to improve due to lack of visibility. Time was being wasted trying to physically identify and remove expired products with no confirmation of success, which can have a negative impact on patient safety.
“Additionally, we had no way to mitigate waste, we were managing inventory levels based on tribal knowledge and not utilization,” Beringer said. “We also had no checks and balances on the integrity of vendor managed product being brought in and used on our patients. We wanted to create an environment where managing the inventory provided more visibility and value-added work, made clinical supply documentation easier and more accurate, and created confidence in the products we were using on our patients.”
Northwestern wanted better expiration and recall management and to create never ever events. The standard practice was manual and relied on human intervention. This could result in patient safety risks if expired or recalled products were missed. “We decided to implement RFID technology in our surgical and procedural departments for our physician preference items to create easy visibility on the location of expiring/recalled items and to create best practice workflows for mitigating proactively,” Beringer said.
In addition, clinical users are notified if they go to document and use an expired/recalled item during a case, providing additional stop gaps for risk. On top of RFID, the Supply Chain team implemented their own Two-Bin Kanban system for commodity products. This provides a built-in stock rotation to help reduce the risk of expiration, as well as allowing them to create metrics to see how fast bins rotate so they can give attention to the ones that might be of higher risk.
In addition to inventory visibility, Beringer said they wanted better vendor tissue compliance. “We now track using RFID in a way that forces our vendors to comply with Joint Commission requirements for not only our product on the shelf, but the product walked in for a case to ensure good integrity for our patients.”
Lastly, the Supply Chain team wanted better compliance with documented products of both products they manage onsite as well as products brought in by vendors. Therefore, along with RIFD, Beringer said they also implemented a Bill Only management tool. This allowed them to catch if supplies and implants were not documented to a patient chart, which could result in issues if there were recalls and the IDN didn’t have the proper documentation to notify patients.
“We have seen significant results with both our RFID as well as our Bill Only initiative,” Beringer said. “Utilization of RFID has resulted in a 78% improvement in our overall rate of product expiration and a 50% improvement in our supply waste. We have real-time visibility into our inventory and where opportunities exist for improvement. We now can be proactive and not reactive in making sure we have the right products, in the right place, at the right time, all while knowing we have significantly reduced the chance of products using expired or recalled products on our patients. Utilization of a Bill Only tool has resulted in over 96% improvement in missing documentation. This has ensured that what is being used on our patients is documented fully and accurately.”
These initiatives have created a stronger collaborative relationship between Supply Chain and Northwestern clinical partners, Beringer said. “We now use data to help drive decisions that not only impact safety, but also create financial benefits for the departments and the organization.”