Journal of healthcare materiel management最新文献

Since revenues are fixed for a growing majority of patients, healthcare providers need to develop creative mechanisms for fixing and reducing costs in all aspects of their operations. Froedtert Memorial Lutheran Hospital in Milwaukee, WI, wanted to find a supply distributor, or distributors, interested in becoming our partner to accomplish five main objectives: 1) stabilize current supply costs at or below current line item pricing, 2) reduce supply costs per unit of patient service, 3) consolidate a broad range of supply sources to achieve economies of scale and more cost-efficient systems, 4) reduce supplier line item profit margins in exchange for broader market share within the hospital, and 5) establish a mutual commitment to supply cost measurement and control that evolves from the current focus on line item pricing to a system of procedure or unit of service pricing and cost control. Froedtert selected one prime vendor after an RFP process. Material Management will manage and monitor the program, with primary supply recommendations to come from the medical staff, nursing services and the Product/Service Analysis Committee.

A study conducted by Deloitte & Touche examined the use of minimally invasive surgery (MIS)--specifically laparoscopic cholecystectomy, laparoscopically assisted vaginal hysterectomy laparoscopic inguinal hernia repair and thoracoscopic wedge resection--at nine U.S. hospitals. From a total hospital cost perspective, two procedures studied reduce hospital costs, one is a breakeven and one increases hospital costs. In addition, with MIS there is a major shift in resource consumption from nursing care units to the operating room. Best practices, defined as most efficient staffing levels, operative times, lengths of hospital stay and other treatment characteristics practiced at the study hospitals, were also identified. Hospitals can maximize their return on MIS by providing ample training to surgical and processing staff, standardizing on equipment, wisely choosing when to use custom kits, block scheduling for MIS and incorporating MIS into the hospital's strategic plan.

Concerns exist about effective methods for endoscope cleaning, disinfection and sterilization. The aim of this study was to establish a model for controlling the function of automatic washer/disinfectors for flexible endoscopes under routine conditions. The team developed a dummy endoscope channel system representing two complete gastroscopes and a colonoscope, with channels joined together and fitted with adaptors to allow the models to fit into different washer/disinfectors. The models were artificially contaminated with various combinations of four test organisms and coagulating blood and run through test cycles in different washer/disinfectors. A total of 24 test runs were performed. The reduction of a given microbial burden by at least five log steps is an established measure of efficacy of a decontamination procedure. When the two challenge tests (45 channels) and the six positive controls are excluded, only 13/309 channels (4.2%) failed the proof of efficacy. In contrast, the failure rate in the challenge test was 65.3%. The difference of the final bioburden is statistically significant. The data suggest this test model could be regarded as a first step in rational and reliable biological control of flexible endoscope reprocessing.

To avoid the heavily increasing costs of ethylene oxide, and with the imminent demise of 88/12 EtO at the same time that heat-sensitive endoscope use was on the rise, Saint Barnabas Medical Center in Livingston, NJ was urgently interested in choosing among low-temperature sterilization alternatives currently available. They decided to compare the costs of 100% EtO with the 88/12 system and a new, low-temperature hydrogen peroxide gas plasma system (HPGP) called STERRAD. The HPGP system proved to be less expensive overall than either EtO system due to quicker total cycle times, lower utility use and virtually no regulatory compliance issues. The hospital was also satisfied that the system effectively sterilized the items on which it was used.

The minimally invasive surgical revolution has brought great benefits to patients and healthcare providers alike. Along with the successes have come some challenges, particularly for those who must clean and reprocess the reusable parts of scopes of all types. We have put together this special section to highlight some of the ways manufacturers of scopes, instruments, cleaning equipment and solutions have endeavored to make processing easier. This section is not all-inclusive, but it should give those facilities with continuing scope reprocessing problems a helping hand.

In the culture of most healthcare organizations, change is described by anecdotes or represented by new structures such as buildings. Change in the systems and processes that enable work in healthcare organizations often goes unmeasured and underreported.

At Munroe Regional Medical Center in Ocala, FL, an effective partnership between Materials Management and the Operating Room was begun by building consensus around a shared concern--minimizing the Operating Room's impact on the environment. To accurately evaluate cost-in-use issues, Materials Management and the OR needed a better understanding of each other's processes, procedures and decision-making criteria. Materials Management observed surgical procedures to understand product requirements, and OR personnel were given financial information on such matters as group purchasing and disposal costs. After considering all the data, the MM/OR team decided to continue using single-use polypropylene gowns rather than switch to reusable gowns. Success in this endeavor led the team to institute a disposable wrap recycling program. Lasting benefits of the collaboration include higher cost consciousness among clinicians, open communications, greater supplier accountability for cradle-to-grave cost estimates and team building.