New York City Health and Hospitals Corporation is overhauling the way it purchases services and supplies, and the effort is projected to save $50 million in its first year, according to HHC.
Now, instead of each of the 11 hospitals, five long-term care facilities and dozens of community health centers purchasing supplies independently, teams of nurses, physicians and other healthcare providers are pooling their knowledge, experience and buying power to make evidence-based, standardized purchases systemwide.
Marie Torell-Alverio, MSN, RN, CNS, WCC, assistant director of wound care at Coney Island Hospital, Brooklyn, saw success in the first weeks of change, and it came from an item as simple as an underpad used for incontinent patients.
At Coney Island, nurses had been using several pads for a single patient, stacking them together for maximum coverage. When the procurement overhaul came about, Torell-Alverio was part of a team that evaluated products presented by vendors and found a more efficient pad that, depending on the patients condition, often would reduce the need to one pad per patient per shift.
The pad was slightly more expensive, but much less costly than using multiple pads per shift, she said. The savings will ripple through the system for this commonly used item, not just for the cost of the pads but for better protection against costly pressure ulcers, which can be almost $100,000 [in total] to treat, Torell-Alverio said,
She next will research medical-grade honey for wound debridement as an alternative to the commonly used chemical debrider.
If you can think of $166 [per tube] versus $12 per tube, think of the cost savings alone in that, she said.
Standardizing IV start equipmentCathy Norton Lind, RN
Cathy Norton Lind, MSN, RN, NP, associate executive director of emergency services at Elmhurst Hospital Center, Queens, is part of a team looking at standardizing the IV line insertion equipment systemwide.
The exciting part for her, she said, is the end users [nurses] who actually do the work are making the decision as to what products they need to safely perform the procedure and minimize patient complications.
That choice is empowering for nurses and likely will lead to better outcomes when choices are based on best practices, she said.
The team, which includes nurses and infection prevention specialists, were asked to bring all the devices they use for IV insertions to a meeting, and the variation was eye opening, Lind said. Now vendors will present their products and the team will test them and select one kit. The system will be able to leverage its buying power to order them systemwide at substantial cost savings, she said.
Effort wins national award
HHCs initiative was one of 12 recognized this year by the ECRI Institute in Pennsylvania with its 2014 Supply Chain Achievement Award.
The changes are part of an effort to reduce costs as HHC is projecting deficits that are expected to reach $1 billion annually as early as fiscal year 2016.
HHC has been affected by cuts in federal aid, including cuts in Disproportionate Share hospital payments under Medicare and Medicaid designed to help safety-net hospitals that treat large numbers of low-income and uninsured patients. The products have to be equally or more effective than the previous product. Its about improving the quality and keeping our patients safe, Torell-Alverio said.
Marcia Frellick is a freelance writer.