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Three ways to cut waste and save money in the ASC

n some ways the ambulatory surgery center (ASC) operates like a standard operating room, and in many ways it doesn’t. There are certain aspects of the ASC that make it unique. Facilities that overlook those differences could be missing out on opportunities to improve patient care, ramp up effi ciencies, and save money. The key is in knowing where to look and how to act.


ASCs and ORs operate at dissimilar paces, with different turn- around times and patient throughput. IT capability may also differ with the ASC often working on a less sophisticated system, which can impact the EMR, inventory management and more. Clinical practice also tends to change due to surgeons who come and go along with their preference for supply usage. In fact, the entire ASC staff can vary dramatically from a hospital OR staff, not just in terms of size but in how it functions.

“ASC staff often wears many hats — the materials manager is also the scrub tech or the clinical director may also scrub and circulate,” said Bilinda Garlock, RN, BSN, Manager of Clinical Operations,

Ambulatory Surgery Centers, Cardinal Health. “Staffi ng is also very tight and there’s a need to cross train between the perioperative departments such as PACU and Pre Op nurses. The PACU nurse may also be cross trained as the Endo suite nurse.” Clearly, running a smooth ASC means keeping the dots connected — and there are a lot of dots to connect. Many ASCs will experience gaps along the way. Sometimes these gaps are easy to overlook or just hard to recognize. Uncovering hidden waste and discovering areas of real savings and positive outcomes can be achieved by reevaluating internal processes. Here are three ways ASCs can cut waste by taking a second look:

1. Improved OR supply utilization

Neglecting to routinely review your pack programs can lead to poorly supplied high volume procedure packs, particularly when new procedures have been added to the case mix and staff are left to “make do” with what they have. “I was in an ASC where they were using a Hand Pack for the majority of their procedures because that was the procedure the pack was created for,” recalled Garlock. “But over time other procedures were added to their case mix without reviewing the supplies needed to start that case. There was approximately $30 of waste each time that pack was opened for a procedure other than a hand procedure.”

2. Reduced SKU count

ASCs often feel they have to keep the doctor happy in order to attract and retain the best surgeons and maintain case volume. So it’s easy to see how a surgeon’s personal preference for specifi c products can drive up SKU counts. “The type of surgeons’ gloves used by ASCs may not be preferred by that surgeon so the ASC orders a different type of glove, often at full retail price, to satisfy that surgeon’s preference,” said Garlock. “Too many SKUs can be just a matter of looking at duplication of supplies from different vendors; do you have the right mix of gloves and surgical gowns, can standardization of suture types be worked on?”

3. Product standardization

Standardizing your ASC products can actually be a simpler task than you might think and, as Garlock suggests, surgical gowns and gloves are just two areas where opportunities are often identi- fi ed. For example, it may be that you’re stocking your ASC with multiple types of gowns, all with the same AAMI rating levels. A careful comparison and product review could help you make more informed decisions as to the types and number of gowns on hand. Surgeon’s gloves are another example. Garlock points out that a typical case mix in an ASC can do well with three to four types of gloves: An overall general use surgical glove, an underglove option, an ortho glove, and a more tactile-sensitive glove depending on the case mix.

By improving your OR supply utilization, reducing SKU count and standardizing your products, your ASC can reduce waste. • HEALTHCARE PURCHASING NEWS • July 2016 31

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