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Mayo Clinic Physician Reiterates Need To Focus On Safe Endoscope Reprocessing

August 15, 2019Sri Mandava Hospital Management Infection Control Managing Endoscopes Patient Safety Regulatory Compliance

Hospitals continue to focus on duodenoscopes and their successful reprocessing in order to reduce the incidence of superbug breakouts related to endoscopes. The primary concern that hospitals have to address regarding duodenoscope reprocessing revolves around some of the manual components of disinfecting these devices.

Bret T. Petersen, MD of the Mayo Clinic in Rochester, Minnesota recently spoke with Healio regarding some of the current updates around duodenoscope reprocessing, and endoscope reprocessing in general. Dr. Petersen pointed out that while endoscope-related outbreaks have declined over the past year, they are still a persistent risk for hospitals and ambulatory centers performing endoscopic procedures. Dr. Petersen also discussed some of the key updates on reprocessing best practices:

“Since 2015, much of our field has been focused on the need to attend to adequate endoscope reprocessing to avoid further outbreaks like those we’ve seen in multiple major centers from duodenoscopes,” Petersen told Healio Gastroenterology and Liver Disease. “The advice at the present time hasn’t changed greatly, in that we’re still emphasizing the importance of attending to pre-cleaning, cleaning, high-level disinfection, adequate drying and appropriate storage.”

Petersen said the manual components remain weak points in the process, as well as adequate drying after high-level disinfection. However, although outbreaks still occur, overall incidence has been in decline.

FDA oversight remains the most active current issue, Petersen said, with a focus on post-market surveillance studies. Two duodenoscope companies have completed their studies and are awaiting a compilation of all their data, and data from the third company should be ready by the end of the year.

“All of them are, unfortunately showing persistent levels of contamination,” Petersen said. “This brings to play the importance of single-use devices, including colonoscopes and duodenoscopes, which are very close to the marketplace.”

Read the entire article and view the accompanying video here: VIDEO: Focus remains on safe endoscope reprocessing

With all the protocols that endoscope techs and sterile processing staff must follow to properly high level disinfect every scope, hospitals and ambulatory centers must put in the proper checks and balances to make sure scopes are reprocessed properly every single time. While supervisors can spot check and catch a certain percentage of these errors, it’s not feasible to keep a pair of eyes on staff 24×7. This is where a scope tracking system, such as iRIScope from Mobile Aspects, can come into play. The system’s built in artificial intelligence analyzes all reprocessing steps in real-time to assess whether critical steps are missed. The system can then send immediate alerts to supervisors, and even display alerts on storage cabinets to warn end-users not to use any potentially poorly reprocessed endoscopes. While staff can be trained ad infinitum, all employees are prone to occasional mistakes. Help mitigate this risk with a smart tracking system like iRIScope and you could potentially save patients’ lives.

How To Increase Endoscope Reprocessing Protocol Adherence With Technology

August 8, 2019Sri Mandava Hospital Management Infection Control Joint Commission Managing Endoscopes Patient Safety Regulatory Compliance

Flexible endoscopes have been the source of many superbug breakouts over the past decade. In order to protect your facility from the patient safety and legal nightmares that superbug breakouts lead to, you need to make sure that your staff is following your standard operating procedures for reprocessing endoscopes every single time.

Even the best trained staff members can make mistakes when they come under high-pressure situations. So how can you make sure that you catch any of these mistakes when they occur and what can you do to prevent them from happening in the first place? As this article from Cynthia Saver at OR Manager discusses:

“Policies and procedures. Policies and procedures should be specific, sufficient, and congruent with current guidelines, [Scott Lucas of ECRI Institute] says. If they aren’t, they should be revised. Lucas adds that it’s best to have separate policies for instruments and endoscopes because each category has unique needs. He advises reviewing and updating policies on a regular basis and whenever any new equipment is added.

Compliance. Sometimes the best policies and procedures aren’t followed because of pressures such as time constraints. To assess for compliance, the team can review reprocessing logs for completeness, check biological indicator and test procedures and results, and conduct audits.

“It’s good to use peers to conduct some of the audits,” Lucas says. For example, staff can check a percentage of trays for proper processing. Supervisors can conduct random audits at various points in the processing cycle. Some instrument tracking systems may make it possible to link trays to the specific patients on whom they were used.

Staffing. Lucas says the team should ask, “Where are the bottlenecks?” because staff may cut corners in these situations. Bottlenecks may occur during a specific shift or in a specific point in the reprocessing cycle, such as the manual cleaning station.

It’s also important to assess staffing levels, what percentage of staff are from agencies, whether staff have had sufficient training, and how long it takes for staff to clean an instrument. (If cleaning takes a long time, it may be necessary to change the technique so that the instrument is still clean, but the time is reduced.) Lucas recommends that organizations commit to having an SPD supervisor on each shift to support staff and manage problems that arise.”

Read the entire article here: ‘Coming clean’ in the SPD requires collaboration and competency–Part 2

With all the protocols that endoscope techs and sterile processing staff must follow to properly high level disinfect every scope, certain steps may be skipped from time to time. While supervisors can spot check and catch a certain percentage of these errors, it’s not feasible to keep a pair of eyes on staff 24×7. This is where a scope tracking system, such as iRIScope from Mobile Aspects, can come into play. The system’s built in artificial intelligence analyzes all reprocessing steps in real-time to assess whether critical steps are missed. The system can then send immediate alerts to supervisors, and even display alerts on storage cabinets to warn end-users not to use any potentially poorly reprocessed endoscopes. While staff can be trained ad infinitum, all employees are prone to occasional mistakes. Help mitigate this risk with a smart tracking system like iRIScope and you could potentially save patients’ lives.

How To Create Accountability With RFID Technology

August 1, 2019Sri Mandava Hospital Finance Hospital Management Operational Efficiency Supply Chain The Business of Surgery

The procedural areas of hospitals, including the Cath and EP Labs, Interventional Radiology and the Operating Rooms, typically go through tens of millions of dollars per year in expensive implants and supplies. With so many different individuals – from reps, to techs, to nurses, to physicians – touching those expensive supplies, what can hospitals do to make sure that individuals are being held accountable for making good decisions with these expensive assets?

Whether with good or bad intentions, staff will inevitably make poor decisions from time-to-time with your expensive supplies and implants that could be costing your hospital hundreds of thousands or millions of dollars per year. These poor decisions can result in such outcomes as unnecessarily expired inventory, poorly documented or undocumented item use, supply loss or shrinkage, frequent stock-outs and bloated inventories.

Just like any other industry, hospitals must hold their employees accountable for financial decisions that affect their bottom line. The case may even be even more acute in healthcare, where razor-thin margins can be impacted by a small improvement or drop in supply management practices.

In order to introduce employee accountability into supply management decisions, many hospitals have turned to RFID technology. Using RFID tags to track items and a series of sensors to read them at various locations throughout a campus can give hospitals visibility into their expensive supplies that can’t be had through manual or semi-manual (e.g. bar-code, push-button) processes.

The foremost way that RFID technology can increase accountability is by keeping a perpetually accurate count of items on hand. With RFID cabinet systems, such as iRISupply from Mobile Aspects, eyeballing inventory to find expiring items or to calculate re-order levels become a thing of the past. The RFID technology replaces all antiquated inventory management systems with a real-time inventory count that can be as accurate as 99% ˗ which is 15% higher than typical experiences with manually intensive systems such as bar-codes, push-buttons or eyeballing. With this technology in place, on-hand inventory counts become much more accurate and product expirations can be reduced or even eliminated.

RFID cabinet systems like iRISupply also keep your expensive supplies and implants behind closed doors. This simple idea can have an outsized effect on your bottom-line. Because employees and reps now know that all of their inventory transactions are being recorded by the RFID cabinets automatically, they tend to act more responsibly with their decisions. For example, if items aren’t use in a procedure, employees will be more likely to return it to the cabinets than to dispose of it because they know the unused item can be traced back to them. Small psychological “nudges” like these can save your hospital untold amounts of wasted spend. Push-button or bar-code based systems open up your hospital to undocumented shrinkage that RFID technology can eliminate.

Another way RFID technology such as iRISupply can help increase accountability is by keeping accurate data about inventory usage. Built-in data analytics arm you with the data you need to make the best re-ordering and stocking decisions possible. iRISupply will not only provide you with the usage data and reports you need, but will take it one step further and provide actionable recommendations about which products are overstocked, understocked or that can even be eliminated altogether. Mobile Aspects supply chain experts will also sit down with you quarterly as part of a best-in-class customer success program to discuss strategies to optimize your inventory mix and review the data behind those suggestions. By closely managing PAR levels and setting up interfaces for automatic re-ordering, supply management practices can be greatly improved.

How RFID Can Streamline Your Hospital’s Supply Chain

July 25, 2019Sri Mandava Cost Reduction Hospital Finance Hospital Management Operational Efficiency Supply Chain The Business of Surgery

With hospitals turning over every cushion to find new ways to reduce costs without sacrificing quality of care, RFID technology is coming up more often as a worthwhile technology to consider in order to save millions of dollars per year. One of the most effective use cases for RFID technology in healthcare is to track expensive supplies and implants used in the PeriOperative environments of hospitals.

With so much waste in the healthcare supply chain, RFID technology can help by bringing an Internet of Things (IOT) approach to expensive assets in hospitals. Every PeriOperative area of a hospital has numerous supplies and implants that cost anywhere between $500 to $50,000, and can add up to hundreds of thousands or millions of dollars in on-hand inventory. Some of these products are moving at rapid velocities, while others are sitting on the shelf until they expire and are replenished. With so much happening in these busy surgical areas, it’s understandable that employees are unaware of the money being wasted on supplies. After all, they’re too busy keeping an eye on patients, where they should be – not on their supplies. That’s why RFID technology can add so much value to these busy areas, since they can keep an “eye” on these expensive supplies 24×7.

Having a second pair of eyes on your expensive inventory can yield numerous benefits to your hospital’s supply chain. This article by Meeta Ramnani at Enterprise Talk discusses three primary benefits of RFID/IoT technology in a hospital setting:

“Developing a holistic view of the supply chain

Hospitals can leverage IoT to enable data analytics with their cloud-based, system-wide inventory management. This can help connect products and processes with their actual cost. Experts opine that now healthcare supply chain is not just about manufacturing, transporting and distributing products; to properly evaluate the value chain it has to be viewed holistically and encompass the direct as well as the indirect costs. This type of system-wide valuation demands a lot of data that can be collected, visualized, aggregated, and acted upon.

Improve the efficiency of clinical staff

According to the Cardinal Health Supply Chain Survey that included responses of 600,000 medical professionals in the US, 42% of professionals believe that supply chain work takes time away from patient care. Almost 45% of frontline providers also said that the manual supply chain tasks even has a “somewhat” or “very” negative impact on patient care. IoT’s connectivity and data-sharing capabilities can be used to free the frontline staff from such inventory-related burdens. Experts advise using the advanced product-tracking technologies as well as the automated systems to help alleviate the stress of supply chain tasks and get the clinicians back to their patients.

IoT to improve accuracy, speed, as well as spend

Experts consider the healthcare supply chain as a strategic asset that has the potential to yield significant financial savings. They believe that IoT is key to propelling that change. Doctors, nurses, and surgeons have a considerable stake in improving the supply chain operations. An overwhelming 94% of the medical professionals that were surveyed identify the correlation between supply chain management and financial success.

These clinicians look at the benefits of improving the hospital supply chain, which includes appropriately balancing inventory levels to match usage patterns, freeing up capital, reducing and adequately managing product expirations, and reducing patient risk to improve the accuracy and speed of supply chain management.

Data generated from IoT connectivity provides visibility across the organization enabling proper management of consignment, product and workflow standardization, and accurate clinical documentation across entire enterprises.”

Read the full article at: 3 Ways to Leverage IoT in the Healthcare Supply Chain

One company that leverages IoT technology to bring a more transparent supply chain to hospitals is Mobile Aspects. Their iRISupply solution collects real-time data around supply and implant usage with RFID technology and provides actionable insights to help with vendor negotiations, on-hand inventory levels and owned-consigned item mix. Powerful data analytics included with the software give specific recommendations on which items to reduce or eliminate, and which items should be owned vs. consigned, leading to millions of dollars in cost-savings opportunities. The system is also completely interoperable with Epic, Cerner and other EMR vendors, helping to drive powerful insights by looking across your clinical systems. These cost-savings opportunities can help hospitals increase their margins and could contribute tens of millions of dollars to their bottom line.

Oregon Health & Science University Implements Endoscope Tracking Software As An Investment In Patient Safety

July 18, 2019Sri Mandava Clinical Documentation Hospital Management Infection Control Joint Commission Managing Endoscopes Operational Efficiency Patient Safety Regulatory Compliance

Oregon Health & Science University (OHSU) implemented the iRIScope endoscope tracking system from Mobile Aspects to help automate the documentation of reprocessing and storage practices for endoscopes in its new Center for Health & Healing Building 2(CHH2).

As the only academic health center in the state, OHSU is where personalized patient care is combined with the latest treatments and therapies to deliver a quality of healthcare not available anywhere else in Oregon. Nationally, OHSU is the only health system in Oregon to be recognized in US News and World Report’s Best Hospitals list. The academic medical center is on the verge of opening its new, state-of-the-art CHH2 building. The new 15 story facility hosts an ambulatory hospital and research building.

Mobile Aspects was approached by OHSU to help address specific workflow and traceability challenges that the new CHH2 building would bring to the Endoscopy department.

Stepping Up to the Challenge

OHSU identified a need to ensure all infection control protocols for flexible endoscopes are adhered to closely in their new CHH2 Building. This new health care facility offers complex surgery and interventional procedures as well as clinical space for the Knight Cancer Institute and clinical space for the Digestive Health Center and Perioperative Medicine Clinic. Adding to the infection control challenge is the fact that space constraints forced OHSU to centralize scope reprocessing in the Sterile Processing department one floor above the new GI procedural unit. Many regulations surround the handling and cleaning protocols for flexible endoscopes, which become very difficult to manage when you add in to the mix moving them from floor to floor and from one group of technicians to another. OHSU needed a way to ensure each necessary step of the endoscope lifecycle was followed, tracked, reported on and (if necessary) alerted should a breach in protocol occur.

“Our new CHH2 building presented us with challenges that required us to evaluate several potential solutions from the ground up. With the loss of the direct visualization of the endoscope cleaning process, we quickly identified a need to use technology to help us manage and track our scopes effectively,” said Lisa Newman, Nurse Manager of the Endoscopy Unit at the Portland-based hospital.

The sheer size of the new space, and the reality that scopes would be reprocessed on a different floor than the procedure rooms, made solving infection control issues for endoscopes a challenge. OHSU has partnered with Mobile Aspects to adapt its iRIScope endoscope management system to the CHH2 environment. The goal of working with Mobile Aspects and iRIScope is to minimize any potential breaches in endoscope reprocessing protocol and to enable immediate notifications should a breach occur.

A Collaborative Approach To Ensuring Automation Success

OHSU’s Endoscopy staff worked closely with Mobile Aspects staff to identify key steps of the scope management workflows that they wanted to be tracked. With scope utilization and reprocessing in CHH2 spread across multiple floors, one of the key infection control protocols most at risk was the time requirement for used scopes to return to the Sterile Processing Department for reprocessing. Mobile Aspects was able to tailor the workflows in iRIScope to match OHSU’s standard operating procedures. With this intelligence embedded in the software, iRIScope can help ensure OHSU’s adherence to its infection control protocols around time requirements for the reprocessing cycle to begin after each procedure.

Another new requirement introduced by the CHH2 building was the need to ensure endoscopes are transported in an efficient manner between the two floors where endoscopes are used and reprocessed. The timely reprocessing of endoscopes in this multiple floor layout requires scopes to be quickly loaded and unloaded onto elevators as they’re being transported between floors. iRIScope was programmed to record scopes that are being loaded on an elevator so that technicians can be made aware of scopes arriving on their floor in real-time to minimize delays in the reprocessing cycle.

Several other steps of the reprocessing cycle, such as manual cleaning, leak tests and Automated Endoscope Reprocessor transactions, are also being tracked in iRIScope. With this tracking in place, artificial intelligence within the software can detect if any steps of a reprocessing cycle are skipped in real-time.

“The Mobile Aspects implementation team were able to build, test and implement all the specific changes we asked for in a timely manner. They were onsite for go-live and continued to make improvements to the system post go-live,” added Lisa Newman. “They have worked closely with our team to identify the places where we anticipate challenges in following our protocols and have put checks in the software to make sure we’re made aware of any breaches in real-time.”

Real-Time Alerts and Notifications

With artificial intelligence within iRIScope constantly monitoring endoscopes and their path along their usage lifecycle, several real-time alerts and notifications have been enabled to alert staff and eliminate any breaches of infection control protocols. For example, if the time limit to get from the bedside to Sterile Processing exceeds the internal limit for any scopes, staff are immediately notified so that they can remediate the situation per hospital protocols.

Endoscopes are also constantly being monitored by the software to ensure that they undergo all key steps of reprocessing before being returned to iRIScope’s clean storage cabinets. If any endoscope is returned to clean storage without successfully completing all key steps of the reprocessing cycle, real-time email alerts are sent to notify administrators of the scopes and their location so they can be reprocessed again as required by their infection control protocols.

iRIScope has also been integrated with one of the hospital’s internal communication systems to allow for immediate action by certain team members. For the notifications to technicians that endoscopes are ready for pick-up in the elevators, iRIScope sends alerts through the hospital’s Vocera pagers so that staff can react efficiently and continue the reprocessing cycle.

Ready To Launch

With iRIScope in place, OHSU has a system that will change as endoscope reprocessing protocols change. Any updates to infection control procedures can be mirrored within iRIScope to ensure that they are always tracking and adhering to their standard operating procedures. Additionally, the wealth of data that iRIScope collects will allow OHSU’s GI department to optimize its business operations. They will have data showing them which scope models are most and least used so they can re-balance their scope inventory as needed. They will also know which endoscopes are most often sent for repair so that they can put in procedures to reduce costly damages. Perhaps most importantly, they can track how efficiently each step of the reprocessing cycle is being completed so they can work to reduce bottlenecks and identify specific individuals who may need more training.

OHSU is pleased with the implementation of a technology which provides useful data on an essential function of their new Endoscopy Unit – flexible endoscope cleaning. “I think it is important that we don’t just track scope location, but also how we are doing with the cleaning process. By having real-time alerts to a breach in standard protocols we can remove that scope from service before it touches a patient,” said Lisa Newman. “With all of the complexity that is inherent to the endoscope reprocessing cycle, using a sophisticated tool like IRIScope will help us keep up with the ever-changing procedures and protocols and to ensure our scopes are being reprocessed properly every single time so that we can keep our patients safe. The bottom line is that it’s an investment in patient safety.”

Leading Heart Hospital Expands Use Of Supply Automation System From Mobile Aspects To Increase Efficiencies

July 11, 2019Sri Mandava Cost Reduction Hospital Finance Hospital Management Operating Rooms Operational Efficiency Supply Chain The Business of Surgery

A leading heart hospital in Texas has expanded its use of a leading supply automation technology to reduce costs and increase efficiencies in its Operating Rooms (ORs). The hospital has been regarded as one of the top cardiology focused hospitals in the state of Texas since it opened over a decade ago. The hospital has been using iRISupply RFID cabinets and inventory management software from Mobile Aspects in its Cardiac Catheterization (Cath) Labs and Electrophysiology (EP) Labs successfully for over 10 years. The system has been providing automation of the supplies and implants that the Cath and EP labs have been using by interfacing with the electronic medical record and materials management systems at the hospital. By reducing the amount of manual inventory work, including eyeballing of inventory and creating order reports, the hospital has been able to save dozens of hours per week on managing inventory, and instead has spent that time on patient care.

Expanding into the ORs

After experiencing nearly a decade of success in the Cath Labs and EP Labs, the hospital turned their attention to supply and implant management issues which had been becoming more of a distraction in their ORs. The ORs had been experiencing periodic stock-outs of key implants and supplies, especially those with high velocity, that were affecting their efficiency. They were also spending a lot of employee labor managing and reconciling inventory levels to keep their implants and supplies at adequate levels.

All of this was happening even with another inventory management system from Omnicell in place. With the push button-based cabinets running in the ORs and iRISupply RFID cabinets running in the Cath and EP Labs, the hospital was able to see the benefits of each system side-by-side. iRISupply was recognized as the system that could bring more efficient supply and implant management to the ORs.

The hospital’s CEO noted that they have achieved a sustainable $300,000 reduction in inventory levels using the data from iRISupply in the Cath and EP Labs, and they hope to have similar success in the ORs. The hospital’s Service Line Director is also looking forward to spending more of his time on developing the hospital’s business. The increase in automation that iRISupply is bringing to the ORs will allow him to re-direct the disproportionate amount of time he currently spends assisting with supply and implant management issues.

As the Service Line Director mentioned after the recent installation, “If you have service lines that stock out of key supplies and you are manually controlling inventory with high cost overruns, this is a great system to help you solve your challenges.”

Are Your Endoscopes Being Reprocessed Too Slowly? How to Use Data to Speed Things Up

July 2, 2019Sri Mandava Cost Reduction Hospital Finance Hospital Management Infection Control Managing Endoscopes Operational Efficiency

With all the protocols that endoscope techs and sterile processing staff must follow to properly high level disinfect every scope, flexible endoscopes can disappear into a black hole when they are needed most – only to pop up again when it is too late. There are several contributors to this inefficiency: long waiting periods in between staff hand-offs, excessive travel time to shuttle scopes from patient rooms to sterile processing and back, and then a time-consuming process to actually reprocess endoscopes. When all is said and done, a busy facility may take 6 to 10 hours or more to reprocess a single scope.

If Endoscopy or PeriOp is allowing delays to happen in the reprocessing cycle, they are risking patient safety and department profitability. If scopes are not turned around fast enough for use in the next procedure, patients may have to wait for scopes to become available before their procedure can begin. This introduces unnecessary patient risks into the department. The business risks of an inefficient reprocessing cycle are delayed or canceled cases. These often-avoidable situations result in financial harm to the department. Some hospitals may try to cover up for reprocessing inefficiencies by inflating the number of scopes that they own, which leads to its own financial issues.

With so many moving parts, it can be a virtual nightmare to sit down and analyze the bottlenecks that are creating these long reprocessing times. There’s the time to get the scope from the bedside to sterile processing, the time to get from sterile processing through the entire reprocessing cycle, and then the time to return a scope to clean storage. There are multiple runners transporting scopes around and multiple techs involved in the reprocessing process. So how can hospitals get their reprocessing times down from 6-10 hours to a more reasonable 3-4 hours, doubling throughput for their expensive scopes?

Managers must constantly monitor accurate and verifiable data to make sure that any bottlenecks in the reprocessing cycle are identified and systematically eliminated. Slow moving employees must be identified to make sure that the good performers are rewarded while the slower performers are given the opportunity to improve. Without this data, bottlenecks are likely to persist because benchmarks cannot be set, and measurements of performance cannot be adequately tracked.

However, obtaining the proper data to analyze the roadblocks to an efficient process has proven to be quite a challenge. This is where scope tracking systems, such as iRIScope from Mobile Aspects, can help deliver the necessary data. These systems manage the tracking and usage of an entire endoscope inventory, and include analyses of scope reprocessing efficiency based on timestamps automatically gathered by the system. Data can be reviewed and targets can be set and tracked to drive improvements to the scope reprocessing cycle. iRIScope also helps track down missing scopes by recording a real-time chain of custody, so missing scopes can be identified and tracked down immediately. iRIScope will also help manage all of the usage, reprocessing and repair details of your entire scope inventory, and will offer up actionable analytics on how to improve the management of your expensive scopes. Finally, built in patient safety features also minimize the risk from adverse health events caused by inadequately reprocessed scopes. Put these together and you can minimize the amount of time required to reprocess an endoscope while maintaining the highest reprocessing standards possible and safeguarding your patients.

Are Stock Outs Giving You Headaches? How To Eliminate Them With Supply Automation Software

June 27, 2019Sri Mandava Cath Lab Cost Reduction Hospital Finance Hospital Management Operating Rooms Operational Efficiency Patient Safety Radiology Supply Chain The Business of Surgery Tissue Management

With many hospitals still relying on manual processes or antiquated technologies for managing their expensive supplies and implants, they are facing a multitude of consequences that are affecting their ability to provide safe and efficient healthcare. Some of the consequences of inadequate supply management techniques include using expired implants, gross overstocking of supplies, poor revenue reimbursement and frequent stock-outs.

Stock-outs of important supplies tend to have cascading negative effects on hospital procedural areas. Some of the results of stock-outs include:

Delayed or canceled procedures as replacement items are located or ordered
Negatively impacted patient safety from using suboptimal supplies or implants
Increased costs due to same-day or rush deliveries for replacement items

With all of these negative consequences associated with stock-outs, what can hospitals do? Most of the time, stock-outs occur due to inaccurate inventory levels. Inaccurate inventory levels begin to occur a few days or weeks after inventory reconciliations for hospitals take place using manual or other inadequate inventory management technologies. Because not every transaction is captured due to human error, negligence or shrinkage, what the system believes is on hand and what is actually on hand begin to drift apart. During these periods, as actual and documented inventory levels differ, there tend to be stock-outs on one hand and overstocked inventory on the other.

The foremost way to drastically reduce or even eliminate stock-outs is by implementing an advanced sensing technology such as RFID for keeping a perpetually accurate count of items on hand. With RFID cabinet systems, such as iRISupply from Mobile Aspects, eyeballing inventory to calculate re-order levels and inventory reconciliations become a thing of the past. The RFID technology replaces all antiquated inventory management systems with a real-time inventory count that can be as accurate as 99% ˗ which is 15% higher than typical experiences with manually intensive systems such as bar-codes, push-buttons or eyeballing. With this technology in place, on-hand inventory counts become much more accurate, making stock-outs less frequent as a result.

The second key ingredient to reducing or eliminating stock-outs is a powerful software system with built-in data analytics for robust inventory management. A system like iRISupply marries inventory management software with RFID cabinets to provide a complete system for managing key supplies and implants. This software will arm you with the data you need to make the best re-ordering and stocking decisions possible. iRISupply will not only provide you with the usage data and reports you need, but will take it one step further and provide actionable recommendations about which products or overstocked, understocked or that can even be eliminated altogether. Mobile Aspects supply chain experts will also sit down with you quarterly as part of a best-in-class customer success program to discuss strategies to optimize your inventory mix and review the data behind those suggestions. By closely managing PAR levels and setting up interfaces for automatic re-ordering, stock-outs can be successfully and sustainably eliminated.

The Problem With Broken Endoscopes And How To Avoid Them

June 20, 2019Sri Mandava Cost Reduction Hospital Finance Hospital Management Infection Control Managing Endoscopes Patient Safety

Flexible endoscopes can cost a hospital a lot of money – and cost patients valuable time – when going through avoidable repairs. Repairing flexible endoscopes often requires expensive maintenance from third-party organizations, delayed or canceled cases due to unusable scopes and procurement of expensive loaner scopes to handle the required workload. Spending time and effort to avoid these costs is an important part of running an efficient and profitable endoscopy operation.

Typically, hospitals view endoscope downtime as an unavoidable reality in running an endoscopy practice. However, this doesn’t have to be so. As this article by Kate O’Rourke at Gastroenterology & Endoscopy News discusses:

“Roughly 85% of endoscope repairs are avoidable,” said Louis Mariani, an endoscope service expert at Olympus. The distal end is the most fragile part of the endoscope, accounting for nearly 45% of all endoscope damage. The distal end houses a protective cover, charge-coupled device, camera, light guide lenses, and nozzle for air and water.

“Damage to any of these components can cause image issues, light issues, and even harbor patient debris,” Mr. Mariani said. “A broken lens cover or nozzle entering a patient can be a very serious concern, because patient debris can be lodged into a break or breach of material.” A lint-free cloth is key for cleaning endoscopes; gauze should never be used to wipe the distal end, which can potentially cause lint to enter the instrument, he said.

The main cause of damage to the distal end is impact, with the floor or peripheral equipment. “Impact can occur during transport, inspection or maintenance, and can have serious consequences,” said Eric Smith, an Olympus endoscope support specialist. The air/water nozzle has a small opening that flushes water and air over the objective lens, and this can be deformed or slightly serrated by impact.

… Minimizing fluid invasion, which accounts for nearly 25% of endoscope damage, can save a facility thousands of dollars. To prevent this type of damage, users should perform a leak test by submerging the entire endoscope in water. “Once the scope is submerged, you want to rotate both the knobs, so you are going to go up, down, left and right, to ensure the bending section isn’t leaking,” Mr. Mariani said. “Most leaks occur in the flexible section of the scope’s distal end.”

…Insertion tube damage accounts for 10% of endoscope damage and manifests as buckles, dents and lacerations. Improperly positioning the scope can easily cause the insertion tube to buckle. “We live by the ‘see something, say something’ rule,” Mr. Mariani said. “If you see anyone putting unnecessary pressure on the insertion tube, speak up in a kind manner and explain what can happen when the insertion tube is compromised.”

…Damage to the biopsy channel accounts for another 10% of endoscope damage. This channel is surrounded by other channels, fibers and cables, so any direct damage or puncture can damage the surrounding components. “Imagine if an open forceps was retracted through the biopsy channel. You can see how that could cause some serious damage,” Mr. Mariani said. Small punctures in the channel show up during a leak test as tiny bubbles that can be missed, and scrapes and scratches in the channel pose many challenges to cleaning.

…Proper storage is key to keeping endoscopes functional. Endoscopes should hang freely in a closed, well-ventilated storage cabinet to avoid damage and facilitate drying. Cabinets should have a HEPA filter, support the endoscope control body, allow the distal end to hang freely, avoid crowding, and provide a place to store accessories or supplies. “If you don’t have one, make sure a written policy and procedure for cleaning cabinets is developed,” Mr. Smith said.

Roughly 8% of repairs fall into the other category and include chemical damage, which can be prevented by following the manufacturer’s instructions for removing chemical residue. Applying too much pressure or misaligning an endoscope when connecting it to a light source also can cause damage.

…Taking a few extra precautions in handling reprocessing, transport and storage of endoscopes can help facilities reduce repair expenditures while maximizing scope uptime. “Endoscopes are complicated instruments with complex parts and components,” Mr. Mariani said. “It is so important to routinely inspect your endoscopes for damage and functionality.”

Read the full article here: Avoiding the Broken Endoscope Blues

In order to reduce downtime with your endoscopes, you must first have access to data about your endoscope repair history and who is handling and damaging your scopes. Systems such as iRIScope from Mobile Aspects track all transactions in the endoscope usage lifecycle including all incidences of repair. With this data, you can closely examine the causes of all of your endoscope repairs and trace back damages to individuals within the organization. You will be able to identify techs and physicians who need to be re-trained on how to properly handle scopes in a way that minimizes damage to delicate parts like the distal tip or the channels. You will even be able to use the data to understand which scopes are being used most often and those that are being underutilized. With this data, you can plan to balance the load on each of your scopes so that the same few scopes aren’t being used over and over again, reducing the need for costly repairs. Having access to the data and using it reduce the incidence of endoscope repairs can mean a much more efficient and profitable practice and happier patients.

Survey: Hospital CFOs Planning To Focus On Cost Reductions In 2020

June 13, 2019Sri Mandava Cost Reduction Hospital Finance Hospital Management Operational Efficiency The Business of Surgery

According to a recent survey, a vast majority of hospital financial leaders agreed that focusing on cost reductions will be one of their main priorities in 2020. The same survey also revealed that hospital CFOs and other financial leaders need to bulk up their investment in data analytics and management dashboards.

The survey, conducted by Black Book, included responses from nearly 1,600 hospital and health system Chief Financial Officers, Vice Presidents of Finance and other finance leaders to spot trends about organizational priorities for the upcoming year. The company’s press release noted:

“62% of survey respondents say advanced analytics is the most needed skill set to be developed in the financial ranks of health systems in 2019-2020. 95% of CFOs agree that the CFO of the future will require a much more robust data analytics skill set than 2019 CFOs.

91% of CFOs surveyed state their top priorities for 2020 will be managing cost reductions followed by 85% needing to predict the impact of new payment models through enhanced reporting.

76% of all financial leaders from supervisor through CFO levels report needing better performance management dashboards as overall satisfaction with current technology and reporting systems is less than 9%.

92% of survey respondents believe the CFO of the future must be a better job leveraging technology and staff with IT skills for health providers to succeed financially.

As health systems CFOs steam ahead toward digital transformational technology, 83% believe the finance function must provide more advanced analytic support that most current decision support and cost accounting vendors have offered, particularly those attached to enterprise EHRs.

“Financial leaders will need to recruit and retain staff who possess traditional financial expertise, flexibility in adopting new payment models, willingness to accept nontraditional responsibilities such as cybersecurity, patient satisfaction and innovation, but most importantly the eagerness to learn new technologies and process designs,” said Brown. “The technological complexities of transforming financial systems and business integrations across health system units may well hasten the retirement of many old-guard CFOs from the industry.”

In 2020, all respondents concluded the most highly sought leadership skillsets that health system CEOs and boards will see in their financial team executives are:

Technology Acquisition and Implementation (89%)

Data Analytics (85%)

Financial Business Strategy (82%)

Financial Operations Administration Through Technologies (81%)

“To assess whether the digital transformation is having an impact on the health system, the C-Suite needs a strategy that is more transformational and less incremental, thus the evolving role of the CFO taking more technological control is inevitable,” said Brown. “The degree of transformation required to achieve the results of value-based centric provider to align with financial business strategies and digital initiatives is the task at hand for the future CFO.”

Read the full article here: Black Book Charts a Future Course for the Healthcare CFO

Most hospitals are learning to live in the new value-based care environment in real-time and adjusting on the fly. Many hospitals and health systems are looking to achieve significant savings by eliminating waste in their supply chain. As the article mentions, making substantial reductions in organizational spend requires powerful and accurate data about expenses and comprehensive data analytics capabilities. One place that hospitals may find immediate opportunities for reducing their costs is by better managing their implants and supplies, which make up the second biggest component of procedure costs after labor. If your organization lacks the proper tools to provide powerful data around your supply chain spend, consider systems such as iRISupply which can collect real-time data around supply and implant usage using RFID technology and provide actionable insights to help with vendor negotiations, on-hand inventory levels and owned-consigned item mix. Powerful data analytics included with the software will give specific recommendations on which items to reduce or eliminate, and which items should be owned vs. consigned, leading to millions of dollars in cost-savings opportunities. These cost-savings opportunities can help hospitals increase their margins and could contribute tens of millions of dollars to the bottom line.

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