Overcoming Barriers to Cath Lab Inventory Control

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  Between 11 cath labs at two William Beaumont hospitals, physicians perform more than 12,000 procedures annually. Barbara Stevenson, a material coordinator at the Royal Oak, Mich., facility, takes a Cypher drug-eluting stent from the Pyxis inventory control system, an automated, transaction-based, closed system from Cardinal Health.

As multifunctional cardiac catheterization labs see new cardiovascular products constantly arriving and old ones getting pushed to the back shelves, administrators need a well-organized storage space, as well as a sophisticated method for integrated inventory management to control costs and revenue.

As healthcare costs continue to rise, hospitals and facilities are looking to trim costs without compromising the quality of patient care and safety. Supply chain management is a strategy many facilities have incorporated since inventory can represent 20 percent or more of a hospitals’ operating budget. To keep within budgets, control over inventory is a key function within any hospital, but especially in high procedure volume areas like operating rooms, emergency departments and cardiac catheterization labs.

In light of this, the pressure to pinch pennies and reduce costs is fierce for cardiovascular (CV) administrators, particularly given the increasing variety of products that CV administrators and inventory control managers must stock. The trick for inventory teams is to maintain a balance between the latest technology to come online and the products that already stock their shelves. And CV administrators must do this in a way that keeps physicians happy while staying on budget.

Eliminating the guesswork in supply chain management is critical for the cath lab environment because the cost of inventory within the labs is typically higher than other areas of the hospital. “Keeping inventory levels and supply expense low is a main function, but balancing that with enough inventory for physicians to use on hand is the double-edged sword,” says Renee Bouren, assistant director of clinical inventory at William Beaumont Hospitals in Royal Oak, Troy and Grosse Pointe, Mich. The three-hospital system has 1,711 licensed beds and 12 cath labs between them. The volume for the Royal Oak and Troy hospitals (Grosse Pointe’s single cath lab numbers are insignificant) is more than 12,000 procedures annually, including diagnostic caths, interventional cardiology and peripheral vascular procedures.

To control inventory, the cath labs utilize Pyxis, an automated, transaction-based, closed system from Cardinal Health. At Royal Oak, the hospital has installed two Pyxis units in each of the eight labs, and another 20 in an outer core. At Troy, they have two units in each of the three labs, and another eight in an outer core.

When nurses or technologists need an item, they go to a unit and pull up the patient record through the Pyxis computer at the station. Once the patient’s file is chosen, the doors to the supply cabinet are unlocked, the nurse hits the “take” button, the inventory is decremented and the charge applied to the patient’s bill. If a product is not used, the same thing is done in reverse, adding a credit to the patient’s bill and to the inventory.

Challenges do exist, Boren admits, particularly for oversized products, which require the Pyxis cabinets to be customized for them to fit. Having the space to add new products also is a challenge. Because Pyxis is a closed system, new items cannot be added without first depleting items from existing inventory. Bouren and her team are currently preparing for the influx of new drug eluting stents (DES) due to hit the market soon. One option they are considering is to limit the number of DES vendors, rather than carry every type of stent.

Despite theses challenges, Bouren rarely runs out of stock. The cath labs turn inventory about eight times a year, which is high for a cath lab, she says. Her inventory on any given day can be close to $2 million, and sometimes $3 million. They count inventory levels every week, a job easily done with the automated Pyxis system. Bouren also credits her staff, which is 98 percent compliant in keeping in line with inventory control policies.

“We look for expired product once a month during our physical inventory which includes counting asset items located outside of Pyxis,” Bouren adds. “We keep a very low volume here—mostly ‘just-in-time’ inventory, but we do a complete physical inventory and report it to the eight-member