Donada J. Reimer, BSN, RN Manager, Clinical Support Services Mayo Clinic Supply Chain Management

1. Donada J. Reimer, BSN, RNManager, Clinical Support ServicesMayo ClinicSupply Chain Management Repositioning Clinical Expertise to Deliver Supply Chain Excellence

2. General Premises & Challenges • Health Care Costs • New Techniques & Technologies • Inventory Expense Management

3. Where’s the Money?

4. Historical Model:Decentralized Supply Chain support and expertise

5. Our Approach:People, Processes & Technology

6. Our Approach: People • Repositioned Clinicians from Procedural Areas to Supply Chain Management • Created a partnership between SCM and the Procedural Areas • Surgical Services • Radiology • GI/Endo

7. Clinical Support Services: PEOPLE • LOGISTIC SPECIALISTS • Leverage batch reports for inventory management • Conduct daily reconciliation of inventory • Create barcodes for products • Perform all restocking activities • Place orders for non-stock items in the ERP system • Manage equipment repairs and returns

8. Clinical Support Services:Coordinators • Coordinators • Recruited the Necessary Talent • Patient Billing • Systems Background • Strong Analytic Skills • Focused Training & Staff Development • Required Medical Terminology Classes • Surgical Procedure Observation

9. Coordinator Responsibilities • Patient Billing • Audit charges • Debit and Credit • Medicare Denials • Read Surgical Dictation • Capture lost charges • Correct procedure names • Manage and Maintain Systems and Data • SIMS • PYXIS

10. Responsibilities (Continued) • Provide Data Analysis • Monitor contract compliance • Provide inventory valuation • Cost/Case Analysis • Project Management • Lean Six Sigma projects • Pyxis Implementation for Surgical Services

11. People • Specialty Trained RN Manager • Rationale: • Clinical Experience • Knowledgeable • Procedures • Supplies/Substitutes • Credibility • Clinician to Clinician vs. SCM to Clinician

12. Enterprise Strategy:Process • ERP System - Lawson • Billing System - HealthQuest • Inventory System - SIMS

13. Our Approach: Technology • Surgical Supplies Technology Team (SSTT) • Physician Led • Managing New Technology • Supports product conversions • Supports the Value Analysis Process – Enterprise • Management team member for SCM & SS

14. On Line Request Form • Inventory Criteria: Item MUST • Reduce net Episode of Care Cost • Improve Patient Care by a measure degree • Improve patient or staff safety • Fill a critical need for which no existing product/equipment is serving

16. Reproducible Results

17. Managing to Medicare • Waste Reporting • Supply Usage • Expiration Reporting Utilization Management

18. The Cost Challenge • For 2009 at MCH: • for primary hip replacement, costs for surgical • supplies alone consumed 46% of MS-DRG 470. • for primary knee replacement, costs for surgical • supplies alone consumed 35% of MS-DRG 470 • Just to recover the cost of an MS-DRG 470 admission, a 40% reduction in surgical supply cost was needed.

19. Managing to Medicare

20. Supply Cost as a % of DRG Reimbursement

21. Contract Compliance

22. Eliminating Waste

23. Key Concepts Increased pressures for Surgical Services personnel to do more with less require out of the box problem solving Repositioning and retooling Supply Chain Management can return clinicians to patient care Aligning subject matter expertise within Supply Chain can better position the organization to meet future challenges

24. Clinically Focused Management for Surgical Services Services Provided: New Value Proposition

25. People, Processes, and Technology • The combination of the People, the processes and technology help the Enterprise to meet strategic goals

26. Questions or Comments