从手术室经理会议中学到的三个重要经验

围手术期供应管理需要协作性的、战略性的、数据驱动的决策

围手术期领导者面临的两个主要挑战是劳动力和供应. These two areas also happen to be the largest and second-largest expense category at most hospitals, 使挑战更加明显. 领导者可以采取什么行动来确保最有效地利用临床人员? 我们怎样才能使临床医生专注于病人护理, 同时解决供应链成本和低效供应管理造成的浪费?

这是全球赌博十大网站午宴上讨论的焦点 & 小 hosted for over 300 participants representing a range of titles from OR Manager to Director of Surgical 服务 to Nurse Manager at the 2022 OR Manager Conference in Denver. 在我们与美国各地的手术室团队的合作中.S., 我们听到了关于医疗服务效率重要性的第一手资料, 以及一些减损它的因素, 最明显的是在供应相关的任务上过度依赖临床医生. 我们通过引人入胜的小组讨论与参与者分享了这些见解, 反过来, 让他们说出自己的具体问题，并集思广益，想出可能的解决方案.

论坛总结了三个重要经验.

麦肯锡最近的一份报告 & U公司调查.S. health system executives and 供应链 executives found that clinical engagement is a critical element of a high-performing 供应链,  how can 临床医生 delegate more of their time to supply-related tasks when they are already understaffed and overworked?

答案不是临床医生花更多的时间在供应任务上, 而是更有效地利用时间. 与会者一致认为，临床医生参与供应链应该是战略性的(决策)。, 不是战术(日常)供应管理.

今天，大多数临床医生花太多时间挑选、清点和存放物资. The consensus among participants was that supply management is a task better suited to 物料管理 so 临床医生 can focus on patient care.

Another outcome is that OR 临床医生 can have a meaningful impact on clinical and financial outcomes through participation in their hospital’s value analysis teams, offering expertise on product selection based on real-world experience of using products during surgical procedures.

一旦产品交付, 临床医生 ensure that new or replacement items are included on physicians’ preference cards and in kits prepared for surgical cases. 通过提前做决定, 合适的药物会在合适的时间提供给合适的病人, 尽量减少临床医生寻找丢失的物资或补充未使用物品的需要.

在当今供应链持续中断的环境中, participants voiced the need for greater collaboration and communication among stakeholders where they can each bring their individualized expertise to the table to make the best decisions for the healthcare organization and its patients.

我们在美国西部的一个大型学术机构看到了这一点.S. 在咨询期间. We found they did an excellent job getting all the necessary parties to the table when addressing product shortages. 多学科团队包括临床医生, 物料管理, 行业合作伙伴, 还有供应商代表，他们聚在一起审查哪些产品是延期交货的, 他们什么时候会被释放, 有什么可比较的替代品.

医生偏好卡也成为这些挑战之一. 偏好卡驱动OR供应链流程. 因此, keeping them clean and up to date helps to eliminate rework and can provide consistency in case pick management. 观众们承认，积极主动地进行卡片更改是一项重大任务, 因此，它经常被搁置一边，以换取竞争的优先事项.

The other challenge is lacking the data to determine how big the problem of inaccurate physician preference cards is. 在很多情况下, 直到我们去现场进行评估, gather the data and compare the items picked for a case based on the physician’s preference card to those that wind up in the put-away or expired bins that the data even exists to quantify how big the problem of waste is. Having the data is incredibly important when discussing changes with surgeons and clinical staff and can help streamline changes for efficiency.

一位听众分享了她与全球赌博十大网站合作的故事 & 辅修手术用具计划. 她的医疗系统建立了一个多执照的手术中心, 他们面临的挑战是在一个非常小的空间里储存物资. 解决办法是给全球赌博十大网站的 & 小 to build ready-to-use custom surgery kits (or “totes”) containing all the necessary consumable supplies for pre-operative, 术中, 麻醉后护理单元(PACU)护理, 根据程序和医生的喜好, 然后直接送到基地. The concept is still in place today though modified over the years to address changing product needs.

与会者评论了这次合作, 声明, “我们和Sheri合作过, 这是最了不起的事情. 打开这些箱子只需要几秒钟，我们现在可以更好地跟踪我们的软货成本.”

有了这样的服务, 手术室团队接收定制的用品, 以及准确及时的产品消费趋势数据, 包括箱子中使用的物品和返回的物品.

有了这些知识, 领导者可以根据偏好卡的变化做出数据驱动的决策, remove unnecessary items and improve the management of associated processes reducing the number of supplies that are opened, 未使用的, 和浪费. Materials management can also use the data to increase the number of on-contract supplies in the kits for less variability and greater savings.

如果你能减少任何过程中的可变性, 它变得更加高效和有效，在控制成本方面有很长的路要走. 论坛期间, we discussed the benefits of reducing variability in the perioperative 供应链 – both in products and processes.

One participant voiced the problems his hospital faced when a surgeon requested the procurement of new supplies not used by other surgeons. 那位外科医生在一两年内就辞职了，留下未使用的东西在架子上过期. 医疗系统引入了由手术室团队成员组成的标准化委员会, 供应链, 和金融. 在外科医生获得一个新项目之前，委员会必须从价值角度对其进行审查.g.比如，好处是什么，谁会使用它，成本是多少，等等.).

“The surgeons are now hesitant to order something we don’t want whereas before they ordered whatever they wanted,参与者说. “We have been working to standardize products across all surgeons so they are all using the same items.”

另一位分享了她的医疗系统如何实现供应和仪器标准化的故事. 了解在他们的设施网络中如何使用常见的项目, 标准化将允许手术室团队相互“借用”项目. 换句话说, it would enable the health system to maximize its supply and instrument inventory by directing items to where they are needed.

One challenge with standardization in today’s environment is the risk that chosen items are unavailable when needed. 这位与会者解释了她所在机构解决这个问题的方法. 她说，卫生系统供应链的所有关键利益相关者, 临床医生, 采购, 配置管理, 质量管理部门每周开一次会，讨论哪些产品没有交货, 需要什么?, 以及哪些可比项目可以被替代.

While technology solutions and services can provide the data needed to drive effective standardization, 比如对产品消耗和浪费的洞察, 当将这些见解应用到现实世界场景时，涉众必须利用他们的专业知识.

手术室的临床医生了解病人, 供应链 knows the organization’s contracts and has visibility into items procured across departments and facilities; and as a distributor and manufacturer partner, 我们从制造商的角度对这个行业有独特的看法, 他们的产品组合, 以及提高效率和节约成本的解决方案.

Effective and efficient Perioperative services are critical to the well-being of a hospital’s patient community and its bottom line, 但手术室队伍人手不足，不堪重负. 供应管理是手术室临床医生的巨大负担, 特别是考虑到今天的劳动力和供应链挑战. We need to find ways to free them up from day-to-day supply tasks so they can focus on strategic decisions that improve clinical and financial outcomes.

Materials management teams and 行业合作伙伴 can leverage their knowledge and resources to manage supplies in a more efficient and cost-effective manner. 然而, 一种协作的方法，每一方都能把自己的专业知识带到谈判桌上, 扮演他们最擅长的角色, can help proactively work toward addressing today’s challenges and build a sustainable foundation for the future.