Source: InnerSpace

As electrophysiology (EP) lab volumes in the U.S. continue to rise and as new innovations in EP technologies and devices emerge, hospitals of all sizes are faced with similar supply chain issues—having enough stock on hand, keeping physicians happy and controlling costs.

The field of EP is only just beginning to emerge from the shadow of the cath lab and how EP inventory is managed varies from facility to facility.
Three EP labs across the country tell us how they are tackling inventory management workflow and processes.

Contracting to control costs
For Stanford University Hospital in Palo Alto, Calif., the choice for inventory control was outsourcing. The firm Owens & Minor (O&M) handles the job with its Clinical Supply Solutions program, an internet-based order, inventory, contract, revenue, resource and utilization management service. The contract with O&M includes the services of Shawn A. Owen, a dedicated inventory control coordinator. The monthly fee for the services of O&M varies according to factors such as hospital size, number of contracted staff and how many departments use the service.

Owen oversees ordering and inventory management for the entire hospital, which includes the 13-room, multi-site cath lab suite. Cath lab procedures are divided into five areas: cardiovascular, EP (two dedicated labs), pediatrics, neurology and interventional radiology. “It’s like five different stores with different sets of tools, wants, needs and desires,” Owen says. Each area has a lead inventory technologist, employed by the hospital, who reports to Owen. The inventory tech monitors par levels, which are set on usage and turn-around times and “are constantly being adjusted due to physician preference or procedure volume fluctuations,” says Owen.

What is the benefit? Fernando Cruz, lead EP tech, says having someone like Owen in the hospital eliminates the worry from his daily workload. “We have a busy day already. I have to work with 15 different machines. We have every piece of equipment in an EP lab. If there is a supply problem, I can have Shawn take a look at it,” Cruz says.

Cross-training, smart planning
Mission Hospital, an 800-bed facility in Asheville, N.C., employs a separate inventory coordinators for its cath lab and two EP labs. Inventory is often driven by physician preference, but is kept to a minimum based on the number of procedures averaged per week using the supply chain management system from Lawson. “This works well because we know what cases we do and what needs to be ordered based on the cases we have scheduled,” says Toni Wild, RN, staff nurse in charge of EP inventory.

At Mission Hospital, everyone in the EP lab is cross-trained on the inventory management system, and ordering responsibility is rotated every three months among the nurses. Wild notes that it was “eye-opening to see how the processes work,” even for personnel who have clocked in some years at the facility. Everyone becomes familiar with product delivery processes, including the variances of particular vendors, and how it all impacts forecasting product inventory. “It is good to be able to learn the snags in the workflow,” she says. “Just because you order something doesn’t mean it’s going show up. Sometimes you have to track it down and figure out where the breakdown or process bottleneck occurred.”

Wild notes that the hospital began a strong cost savings initiative last year, looking for ways to improve processes and eliminate waste. As part of that, the EP labs participate in two programs where they recycle the platinum tips from used ablation catheters and purchase idle inventory for sale at a fraction of the cost (see sidebar).

Separate labs, separate everything
The 739-bed Strong Memorial Hospital at the University of Rochester Medical Center has two EP labs, and one Stereotaxis Magnetic lab under construction. The EP labs maintain their own personnel, budget and supply areas, says Michele Prame, administrator for both the cath and EP labs.

Theresa Truitt, information analyst, and two other inventory personnel order and manage inventory for both the EP and cath labs based on the day’s usage and purchase orders generated. Any “unsolvable problems” go to Prame, who oversees budgets, contract negotiations and all large capital equipment purchases. The EP labs divide inventory into ablations, implantables and introducers. Breaking it out this way makes tracking items and par levels “much easier,” Truitt says.

Much of the EP product line is purchased on consignment as an added cost-containment measure. Prame speculates that a smaller program can probably manage EP and cath all on one budget, maybe even a one-person operation for inventory/purchasing. For a high-volume hospital, EP must be separate because there is not a lot of similarity in product, and product cost comparisons can be done easily, she adds. “Partnership between inventory, purchasing and providers ensures effective inventory management with a workable budget,” she notes.