Hospital efficiency is, of course, about boosting productivity while reducing workloads and costs, but it is also about delivering better patient care. Inefficient workflows, inaccessible equipment and supplies, unnecessary expenditures and waste all lead to poorer patient outcomes. They can also lead to low staff satisfaction. With over 30 percent of hospitals operating on negative operating margins, the need for operational efficiency has never been greater.
For hospitals and healthcare facilities, optimizing efficiencies across the board is a constant challenge. The traditional hospital ecosystem wasn’t set up to be lean as its number one priority. With rising costs, nurse and physician shortages, and increasing patient admissions, however, these organizations must determine where efficiencies can be gained, even with something as small as a medical storage cabinet on wheels, a.k.a. Medcarts.
The Electronic Health Reporter posted an article about the importance of equipment management in the healthcare setting, citing the need for hospitals to make their equipment and supplies readily available and organized so caregivers can work efficiently to deliver quality care to every patient. Their recommendation is based on an authoritative article by GE Healthcare.
The GE Healthcare report, “Out of Control: How Clinical Asset Proliferation and Low Utilization Are Draining Healthcare Budgets”, found while the number of mobile clinical assets is growing rapidly, their utilization hovers only at around 50 percent. This means healthcare facilities are purchasing assets that are simply wasted, perhaps not because they aren’t needed, but because they aren’t accessible. As a case in point, the article goes on to discuss reasons for this discrepancy, using an example of a nurse manager who reports difficulty in locating telemetry monitors on his or her unit and 10 more are leased, rather than investigating why ones that should be available can’t be found. In this scenario, it’s less about reducing inventory and more about optimizing workflow processes, then stocking levels.
The report also found that nurses spent around 21 minutes per shift searching for what they needed to deliver quality patient care at a loss of $500k in non-productive work time. This is where the medical storage cabinet on wheels makes a difference. Storing needed equipment and supplies on a mobile cart makes those items visible and accessible, and ultimately, utilized. Where can hospitals begin with their efforts to gain efficiencies? Let’s take a closer look.
The most obvious need for attention is with equipment and supplies. With so much documented waste and underutilization, hospitals need to do a thorough assessment of the equipment and supplies they keep in stock. From there, they need an accurate picture of whether those items are, in fact, being utilized and to what capacity.
Once this data is gathered, the real investigation begins. This is the step GE Healthcare alluded to: determining why equipment and supplies are stocked and then not used. Is it a matter of inaccessibility alone? Or, is it more because the hospital lacks a specified protocol as to how these items are to be procured. If there are no checks and balances, items can be requested, ordered, and fulfilled without anyone verifying they were actually needed.
Hospitals and healthcare facilities can greatly reduce costs and inventory space through this analysis, but this is only part of the journey. In order to translate these findings into efficiency improvements, organizations must decide how to make their equipment and supply inventory more transparent and accessible.
Medical storage cabinets on wheels is a relatively inexpensive option, where equipment and supplies can be stocked and delivered to specific hospital units and patient floors. By doing so, the items are visible, accessible and convenient. The mobile carts are highly customizable, containing items that units most uses, such as surgical instruments and anesthesia in the surgery unit, crash cart supplies in the emergency room, and wound care supplies on patient floors. The medical cabinets may also house various pieces of equipment, including a glucometer, a heart monitor and defibrillator, an oxygen tank, and various blood pressure cuffs.
There are many different kinds of medical storage cabinets on wheels, some requiring locking mechanisms to prevent theft or unauthorized access. Medical facilities often purchase a combination of cabinets to fit their specific needs. The key is to make these cabinets the go-to for supplies and equipment. If the item the nurses or physicians seek is not in the cabinet, they can initiate the request.
The next area for efficiency improvement is in hospital workflows. Nurses, in particular, must operate under an efficient workflow to reduce waste, optimize their time with patients and deliver quality patient care. In the scenario presented by IBM, the nurse manager requested a telemetry monitor as his or her first step after assuming a shortage. There was no specified protocol for the nurse to follow in determining if there were monitors in storage somewhere on-premise. It’s not the nurse’s fault, mind you. According to National Nurses United, 49 states have no cap on how many patients they are assigned and more than half their time is spent on documentation and care coordination, leaving little time to locate equipment and supplies. Nurses need help.
Hospitals and healthcare facilities can make a real difference in patient care and nurse satisfaction by establishing workflows that facilitate efficiency and productivity. Nurses don’t want to spend their time searching for what they need to do their job. By placing those common items in mobile medical storage cabinets, they gain precious minutes to their day to do the very things they entered the profession to do.
The procurement workflow must also be evaluated. As stated before, checks and balances should be present, enabling nurses to make a request, but establishing an inventory check before the item is procured. By making it easy for nurses to see what equipment and supplies are on premise, such as a digital inventory system accessible via their mobile device, they can easily request that item be delivered without purchasing a new one.
This type of transparent inventory application is similar to a retail store or grocery store. A customer can’t find an item on the floor and may ask a store associate if the item is in stock in the back warehouse. Most stores enable their employees to access a database or app to quickly see if the item exists in store before they offer to order the item for the customer. This same capability should be implemented in the hospital environment.
Of course, this will require the medical facility to keep digitized records of every piece of equipment and all supplies in their storage warehouse or room, as well as those items stocked in the medical storage cabinets on wheels, in-room storage cabinets, and storage cabinets located in specific hospital units and floors. When an item is taken from these cabinets, there should be a workflow established for restocking those items and documenting the subsequent reduction of inventory in the supply warehouse.
Call it a medical storage cabinet on wheels or a Medcart, these are, of course, not the only solution for reducing inefficiencies. Hospitals must take a hard look at where they are spending their resources, including budgets, time and staff. As patient admissions increase and costs escalate, any efficiency opportunity, however small, is worth the effort to find.
McKinsey suggests improving efficiencies by first walking a mile in the patient’s shoes. By identifying the main stages in a typical patient visit, hospital managers can, “analyze the demand for services, the system’s ability to supply them, and the variation associated with both, measured in the number of patients per unit of time.” After this practice, managers can then more accurately predict the maximum patient flow each day and identify where inefficiencies are occurring.