The solution allows surgery orders to be managed across a series of events, from an initial consult through the day of surgery. Charge Router functionality within the product provides a single processing point for all chargeable events in the Operating Room — technical and professional. Barcode entry of implants and supplies also reduces time spent searching for and documenting items. Using extensive scheduling rules and conflict-checking functionality, OpTime coordinates surgeons, staff, inventory, and equipment to automatically identify the best times for a procedure.
OpTime ensures that required staff and resources are available and enforces surgeon-specific preferences and restrictions. Status Boards display all of the patients scheduled for surgery on a given day and track their case progress in real time. The cards assist nurses with the setup of surgical instruments and supplies and provide data to track costs and patient charges.
Legacy systems are a challenge for all companies, especially those who grow through acquisition or need to focus on immediate profitability after a merger. Modernizing and consolidating systems is often left out of acquisition timelines. Unfortunately, this often leaves IT with a patchwork of legacy systems to manage and a lack of partnership between IT […].
Organizations are trying to do everything they can to reduce […]. The evidence of thousands of HIT implementations shows that those who effectively organize prior to kicking off a large HIT project have demonstrable improvement in the project success. The preparation […]. You May Also Like. Legacy System Support Decisions Require Collaboration Legacy systems are a challenge for all companies, especially those who grow through acquisition or need to focus on immediate profitability after a merger.Efficiency and cost management — the metrics by which OR Directors live and breathe.
Data on First Case On Time Starts, cut to close times, room turnover, supply usage help administrators keep a close eye on how efficiently their perioperative suites are running. Preference cards contain clear and concise procedural instructions that, when combined with an accurate record of needed supplies and equipment, prevent unnecessary delays and procedure interruptions.
More importantly, they positively impact patient safety and quality by enabling the surgeon, nurses and technicians to focus exclusively on the patient. Preference cards improve surgeon satisfaction, instrumentation and supply inventory management, as well as staff orientation and training. Physician preference cards provide another significant benefit.
Taken together with supply usage data, preference card information becomes a vital source of data for uncovering valuable supply savings opportunities in the operating room. With surgical costs increasing and reimbursements decreasing, hospitals and physicians need to partner to find ways to contain and reduce costs — and a close-up inspection of supplies may deliver big rewards. The key to this effort begins with information — information that can transform simple data into an effective, actionable tool for driving practice change and cost reductions in the OR.
The majority of hospital surgery departments utilize electronic preference cards generated from their clinical information systems and all feature a catalog of surgical supplies and implants needed during a procedure. Hospital leaders at times make the assumption that those preference cards accurately reflect the supplies the surgeon will use during a case.
Our experience tells us otherwise. Often we find supplies — sometimes a few, sometimes several — on each preference card that surgeons rarely if ever use. Inaccurate and out-of-date preference cards result in real costs: Hundreds of thousands of dollars in wasted supplies and labor jeopardize already thin contribution margins.
Fortunately, corrective measures exist to solve this issue, but they require the combined efforts and commitment of OR Directors and surgeons. Relevant, actionable data enables staff and surgeons to quickly identify and evaluate efficiency and cost-savings opportunities.
Unfortunately, we frequently hear surgeons say that throughout their years of practice, they have not received empirical data they can use to drive more efficient and cost-effective supply utilization practices.
Information drawn from physician preference cards and historical supply usage data supports surgeon-specific and comparative supply usage analysis. Table 1 shows a partial list of supplies used by Dr. A in laparoscopic appendectomy cases. The highlighted items include supplies provided for the case but never used, or picked in insufficient quantities and requiring the staff to leave the OR to retrieve them during the case.
Both represent opportunities for workflow efficiency and supply cost reduction. OR Directors can show surgeons this data and point out how poor preference card management results in case delays, supply waste, and lost time and effort moving unused supplies between the OR and storeroom. In doing so, they will likely gain allies in refining a more selective and efficient case cart build process.
Table 2 shows comparative supply usage data across multiple surgeons for a common procedure. A supply analytic tool like this identifies opportunities to convert a surgeon to a clinically equivalent, lower-cost supply that his colleagues use to achieve similar outcomes. It also identifies opportunities to convert an entire group of surgeons to the same supply, enabling the organization to leverage volume purchasing as well as standardize products and reduce inventory variability.
OR Directors can partner with their Supply Chain VP to include not only surgeon supply usage statistics, but also the average cost of supply expense per case for each of the surgeons in the analysis. This approach grabs attention and often motivates surgeons to dig deeper into the data to better understand the reasons behind the cost differences. Our clients have discovered that presenting supply utilization data in this straight-forward and concise fashion invites surgeons to open a dialogue with the OR staff and with each other — leading to a renewed desire to pursue more efficient supply selection and consumption.
Our work with clients has shown us that achieving improved operational and financial results in the OR through effective physician preference cards requires significant effort and focus. Get up-to-date healthcare industry insights, news, and articles delivered right to your inbox.They just completed a project where they helped an organization enhance its EHR and ERP integration in the perioperative areas.
Listen in as our experts make a compelling case for driving functionality between your systems to realize these improvements in the OR and beyond. Also, if your organization is looking to upgrade your ERP system in the future, they outline a few steps you can take right now to make the transition easier in the long-run.
Brian Beinborn: Hello everyone. I'm Brian Beinborn, vice president of strategic solutions at Nordic. For the last 15 years I've worked primarily in the clinical EMR space. I started at Epic and the perioperative applications, which introduced me to the integration supply chain and EMR.
Today we hope to discuss the benefits of a well-integrated ERP to EMR foundation as well as the planning you can begin now for your eventual transition to your cloud. I'm joined by Michael and Munaf from our strategic solutions team. Guys, please introduce yourselves. Michael Malecha: Hi, my name is Michael Malecha. I'm senior director of the ERP practice here at Nordic. So I've been in your shoes.
I'm a manager on our optimization team. Brian: Great. Thanks guys. The focus on this has increased a lot in the last few years. For most of the last decade or so, healthcare organizations have focused their time, energy, and resources on implementing EMRs. This means for many, the ERP system has remained stagnant in terms of functionality.
With the impending upgrade to the cloud and the new attention ERP systems functional abilities, the timing is right to take a look at your current integration between ERP and EMR to maximize the benefits you set up for long-term successful transition.
Munaf, you recently completed an engagement with a partner focused on improving this integration in the perioperative areas. They came to us saying they were potentially losing over a million dollars a month in their perioperative supply chain.
Could you give us a little bit of an overview of that project and the benefits that organization is seeing? Munaf : Sure. So this organization came to us knowing they had a problem and that problem really nested within a database that they had sitting in between Lawson and Epic.
They were requiring two users to manually update this interface on a daily basis to get information from the ERP system to the EHR. And this resulted in lags in authorization and pricing information getting to Epic, resulting in them not charging appropriately or knowing what they actually had on hand. Brian : And Munaf, this is something we don't typically see in an Epic to Lawson environment, correct?
Munaf : Correct. It's a little unusual, but I think the downstream impact and the work that we did once we had gotten that interface fixed is something that we see in other organizations. Brian : And we started to understand their problems by starting that project with a quick assessment. We did a very rapid assessment to be able to understand what those problems were and come up with the solution that included four parts, right? So we had four waves.
The first included that interface piece to get the database out of there and set up a direct interface from Lawson to Epic.OR preference cards are designed to help nurses prepare for procedures. But what happens when a glut of cards flood the system? Cleveland Clinic nurses tackled the task of standardizing OR preference cards.
Operating room preference cards are designed to assist nurses with the setup of instruments and supplies and provide data to track costs and patient charges.
But sometimes they fall short of their intended purpose. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services Policy. In addition, the front-end purpose of the cards — usefulness in the OR — was taking a back seat to the cost-tracking function. Runion and Shahamat are part of a six-person committee that oversees the preference card project.
Because the project is so vast, the committee has three working groups that tackle separate elements and report to the committee:. Most of the work to date has been done by the first two teams. The piece handled by the Chargemaster Team is not operational for nurses and affects the patient after discharge, so it has been temporarily put on hold.
They considered what components were helpful and what could be left off. Nurses can access maps of supply rooms so they can easily find everything from drains and gloves to gowns and pneumatic antiembolism stockings. In addition, nurses can click on photos of the supply table setup for various surgeons and procedures. This is particularly helpful for nurses who float from hospital to hospital, says Shahamat.
The primary accomplishment of the Supply Team has been to create custom pack supplies for high-volume procedures.
Physician Preference Cards: An OR Director’s Key to Efficiency
The team began with a pack for laparoscopic cholecystectomy—or lap chole. They reviewed every item that each hospital uses for lap choles, then agreed on which ones should be included in the new standard lap chole pack.Heightened cost pressures continue to force hospitals to look for ways to reduce wasted spend.
In fact, in a recent surveyhospital executives said finding cost savings to meet their current-year objectives is one of their top challenges. The supply chain—more specifically, inventory and order management processes—is a natural place to look for savings. Charles Poirier, author of Diagnosing Greatness: Ten Traits of the Best Supply Chains, provides a compelling synopsis of the enormity of the opportunity.
As Poirier notes, "That is a lot of new free cash flow. Arguably the biggest driver of over-budget inventory spend are medical-surgical supplies—the disposable or implantable items used in the operating room that include high-cost physician preference items.
These items, which can account for 30 percent to 40 percent of a hospital's supply expenses, represent by far the largest percentage of inventory spend. That's not surprising given the high cost of many items in the category. But they also are responsible for a substantial portion of the typical hospital's inventory budget overrun. Why do hospitals struggle so much to contain their medical-surgical inventory spend?
The biggest culprit is the physician preference card. The preference card specifies the supplies a surgeon requires to complete a particular procedure in the OR. It's critical to ensuring the nurse pulls the right supplies from stock and has them at the ready when the surgeon needs them. The problem is, in a typical hospital, preference cards are often outdated or otherwise inaccurate. Of course, preference cards were accurate when nurses created them. But over time, as surgeons change how they execute a procedure or learn about new products, nurses add items to the card—but often don't remove the ones no longer used.
In other words, they're not spending time tweaking and refining preference cards. And that's understandable: Nurses' primary role is caring for patients. They're not materials managers or inventory specialists, and when forced to choose how to juggle demands for their time, the patient always wins.
Yet the end result remains: Preference cards have come to resemble more of a laundry list of all items a nurse thinks a surgeon might require—rather than a reflection of a surgeon's exact supply needs for a given procedure. These inaccurate preference cards lead to substantial supply waste in the OR. For example, at one hospitalsurgeons typically use only about 60 percent of the supplies pulled for a typical procedure.Learn about our expanded patient care options for your health care needs.
Epic trainer Evelyn Chen keeps her instructions simple when she teaches new employees how to navigate the electronic medical record system that spans Johns Hopkins Medicine. There will be plenty of time later for users to tailor the system to their departments and roles. Chen is also leading efforts to update the resources that are available, rolling out new tip sheets to help make time in front of a computer more logical and efficient.
Some of the new information will help users prepare for quarterly upgrades to Epic, which will add features and change the look of the templates. The information is divided by provider and role, so cardiology nurses, for example, can click on their designated portal for updates, while other portals are specific for anesthesiologists, chaplains, pharmacists and others.
Quick start guides QSGswhich provide overviews of Epic use by role, can be found under Additional Resources within the role-specific pages. Skip Navigation. Tips and Tricks for Getting the Most out of Epic. Johns Hopkins' medical concierge services offer complimentary assistance with appointments and travel planning. Request free assistance:. First Name. Last Name. Yes, I would like to receive additional information from Johns Hopkins Medicine.
Related Reading. With new tools and resources, Johns Hopkins Medicine is making it easier for clinicians to conduct precision medicine research and use the results to improve patient care. Dragon voice recognition software is now available in Epic for all Johns Hopkins providers. The software is being deployed as part of the enterprisewide Joy at Hopkins Medicine initiative to improve the quality of life at work for our clinicians, offering a convenient alternative to typing notes on a keyboard or waiting for transcribed dictations.Charles Poirier, author of Diagnosing Greatness: Ten Traits of the Best Supply Chainsprovides a compelling synopsis of the enormity of the opportunity.
As Poirier notes, "That is a lot of new free cash flow. Why do hospitals struggle so much to contain their medical-surgical inventory spend? The biggest culprit is the physician preference card.
A few examples of Digital Preference Card Systems. Traditionally, these have been on paper. And traditionally, they have grown increasingly complex and inefficient as surgeons have introduced and adopted new and improved product innovations, without a systemic focus on either standardization or a policy of consistent iteration.
Thus, many new players have created processes and solutions that try to address the issues above, the consensus being that digital is the way to go. Many new innovative players as well as big, established names have marketed their own solutions, including:. ProcedureCard solves the universal problem of inaccurate cards in the operating room. Surgical preference cards are used globally, and most facilities use an archaic paper system or an inaccessible and inaccurate electronic system.
Bad cards waste time, money, and resources within surgical facilities. ProcedureCard allows the team to access, update and create cards across devices in real time. ProcedureCard fixes your surgical preference card management system. Scrubitthe award-winning app, enables correct surgical set-up, reducing cost, waste and disposal of unnecessary surgical tools, while also minimizing the need for nursing staff to leave the theatre to retrieve missing items.
Overall, this translates to less operating theatre traffic, more efficient surgeries and improved outcomes for patients. Staff can easily maintain up-to-date inventories, manage par-level inventory and make just-in-time supply delivery a reality with easy-to-use tools for managing the perioperative supply chain. Today the DPC tool is used in every operating room across Intermountain.
Users can log in and view any DPC at any Intermountain facility. They can see the costs of supplies, search for comparable products, submit change requests for a DPC, and see the history of changes made for a DPC.
OpTime gives users access to comprehensive patient information throughout the perioperative episode with workflows designed to improve productivity, room utilization and documentation. Barcode entry of implants and supplies also reduces time spent searching for and documenting items.