Infection Control Today - 09/2003: Identity Crisis

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Identity Crisis: Tracking Medical Supplies and Inventory

By Becki Harter, CST, RCST, CRCST, FEL

How to properly maintain, track and inventory medical supplies and instrumental inventory has been a key orientation, education and implementation challenge for central service (CS) or sterile processing (SP) departments. Receiving, distribution and returning of supplies can represent a large chunk of the overall budget in lost, broken or otherwise non-retrievable if not managed properly.

With a tracking program in place and a dedicated staff these types of budget losses can be minimized. Orientation, education, dedication and a very important key to a successful tracking program is accountability. The flow of accountability is: CS/CPD to the user department to CS/CPD.

The nomenclature of the past and in some cases the present is that CS/SP departments are solely responsible for all inventories. If there was loss, breakage, need for repair or misplacement, it all surely happened in CS/CPD. However, since no device, instrument or supply remains in CS/SP but traffics back and forth, the responsibility/accountability flow is shared and must be viewed as a shared entity if cost reduction and effective inventory management is to be a part of a healthcare facilities overall quality assurance program. The question now arises, how do you accomplish the task inside a living breathing clinical setting where time and resource are always in demand?

Step One

In every clinical setting the first place to begin is in the recording of all inventories:

(Par levels) on hand
Wrapped supplies
Disposable supplies
Instrumentation (single backup inventory to instrument sets)
Case carts
Equipment (monitors, IV poles, beds...etc)
Support products such as: detergents, disinfectants, indicators, wraps, tape, filters and other processing supplies.

Before you can begin to track your inventory you must know what you have. This may require extensive research, as some supplies may be in departments outside of CS/CPDbut CS/CPD still has domain over those supplies as they are listed as a CS/SP item(s) in your healthcare facility.

Step Two

Who will be the CS/SP staff responsible for distribution? Some facilities are so large that assignment to teams, sections or areas is needed to properly monitor inventory flow. Each designated responsible staff must record, track and receive items in the assigned area or of the assigned inventory. It is common to expect that if there is a name attached to the process on both sides of the accountability flow, the effectiveness of the inventory management program is better than if there is not. Mystery accountability rises to blaming and the Who done it? Who Me? and I dont know, merry-go-round to which a great loss in time, money and resource can and defiantly will result, as well as frustration and the minimization of customer satisfaction on both sides.

Methods on how to identify and track inventory can vary but the standard of tracking practice is pretty much the same formula; quantity, description, receiving department(s) (CS/SP or user department).

Step Three

Choosing the method of tracking is key to the success of any inventory management program. We will explore from the basic to the technology- supported methods. Below there are a few examples of inventory management programs. As it is with all programs, routine inspection and review of the quality management program must be done. A program left unchecked is not a program.

Method Three:

Application of a bar-coding program through one of the many medical tracking systems available, or through the primary provider of your facilitys instrumentation needs is the best choice for inventory management. Through a comprehensive bar-coding system each individual item can be tracked and each compiled item can be tracked. For example: In an instrument tray there may be 50 or more instruments. Each instrument can be tagged and the entire set can be tagged. The individual tags can give you information about that instrument(s) such as:

  • Date of last repair, refurbishing or sharpening
  • Issue date and who issued it
  • Company/catalog and so on

The set tag can tell you:

  • Who processed the set (how long did that take? Were there any problems? Instruments missing damaged or replaced?)
  • Where the set went (user department to the CS/SP; in some programs the patient that the inventory was used on is identifiable) Programs that allow inventory to be tracked to the patient to include sterilization method, load and process indicators are very valuable in cases where infection control is critical (CJD) to protecting the overall patient population. Infectious agents that inventory comes in contact with, may require additional decontamination steps not found in the standard of practice and or quarantine or in some cases destruction of inventory. Comprehensive bar code or other tracking programs allow CS/SP to take control of inventory. These programs address every area of inventory tracking:
  • Etched or identification by bar code labels. This prevents and minimizes the use of tape or dipping of instruments/sets that will have to be replaced intermittently at an additional cost. However, there will may be some cases where taping and dipping are needed to identify doctors specials and so on.
  • Distribution Receiving
  • Inventory on hand or par levels. Use of tracking methods can help identify areas where inventory needs to be decreased /increased or eliminated.
  • Identification of problem areas, so that these process inhibitors can be negated and proper education/training employed. (Repair logs can help identify where additional care and handling information/ education is needed to prevent/minimize future damage and inventory replacement expense.)
  • Reduction in the paper chase. Digital and disc compilation of data, releases valuable storage space otherwise used for storage boxes full of paper. This space can now be used as part of the total operation of the CS/SP unit instead of being dead space. In some cases this means a better departmental workflow.
  • Easy access to vital information can be stored in a database rather than endless searches through handwritten inventory data entries or time-consuming searches for sterilization information (JCAHO inspections immediately become easier).
  • Companies that provide tracking programs will come in and inventory all products for you, thereby increasing effectiveness of productivity management. There are companies that provide instrumentation that also provide tracking programs. In many cases, these companies will offer the program free of charge and provide best pricing on instrumentation if a commitment is made to utilize their company as a primary resource for instrument needs.
  • Reduction in overall cost from inventory on-hand to repairs, damage and loss of needed resources for daily operation of your facility.

Some facilities that cannot afford the best technology; however, an incremental application with potential for growth can always be done and is achievable over a set period of time and as dictated by budget constraints. The facility must choose which segment of the program is most critical. Inventory tracking is commonly chosen first with good reason, as this represents the largest expense to most CS/SP departments/ healthcare facilities. Other areas are added as budget allows.

Proper tracking and identification of all inventories will always mean a more efficiently run CS/CPD and will diminish unnecessary cost related to overstock, loss/displacement and/or damage. Organized CS/SP departments provide the opportunity for excellent customer service and pride in work well done. Cost reduction seems to be the buzz word of this era in healthcare and will continue to be a top priority as insurance reimbursements change and patient populations get sicker and sicker because they are living longer and longer. Tracking programs are not meant to be regimental or time-consuming, but if used as a tool for healthcare management of inventory (whatever form that takes), can be the right arm of your budget allowing you to expand and fully explore new innovative methods of practice. Because you know where your inventory is, what it is doing, and where it will end up, your budget will not suffer from mis-managed inventory. A large percentage of inventory budgets are eroded by replacement of preexisting inventory, whereas by comparison less is spent on new innovative devices/inventory. Proper management, tracking, overall identification and use of inventory can open up new avenues in the budget for new technologies and devices. Materials-management programs can be the catapult to a well-managed inventory and an expandable budget.

Becki Harter, CST, RCST, CRCST, FEL) is the 2003 winner of the AAMI Becton Dickinson Career Achievement Award and is president and CEO of Indianapolis-based consulting firm Sterilization By Design.

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