The Ohio State University Wexner Medical Center

Note: This article first appeared on March 29th, 2018 on Becker’s Hospital Review as Best guesses don’t cut it in healthcare: OSUWMC’s supply chain transformation.

The OSU-WMC continues to realize the value of 2-Bin Kanban and BlueBin is a proud supplier of these innovations and continually supports them on their Lean Supply Chain journey.

Overview

The Ohio State University Wexner Medical Center is an academic medical center with more than 20 centers and institutes across central Ohio. The nationally-ranked organization has more than 1,300 beds and saw more than 1.7 million outpatient visits last year, as well as over 130,000 emergency department visits.

Not having the correct supplies at the right time has a clear and direct impact on patient care. In recent Press Ganey surveys at The Ohio State University-Wexner Medical Center (OSUWMC), nurses responded to the statement “I have the supplies I need to do my job,” as one of the top 10 areas of dissatisfaction. The issue was assumed to be either a management problem or an issue with the employees known as supply coordinators, who are responsible for replenishing supplies for individual nursing units. Frustrated with their inability to easily access the supplies they needed, nursing leadership went to the organization’s new chief supply chain officer Hal Mueller to find a solution, which is where Patricia Hoch became involved.

Fixing a Process Problem in Supply Chain

A 12-year veteran at OSUWMC with a background in the Six Sigma method of business process improvement, Hoch now serves as the director of distribution and logistics for the organization. She knew that the issues being faced by OSUWMC couldn’t be solved with just another supply chain technology or shelving solution.

Hoch started process mapping, interviewing employees, and conducting time studies, where she discovered that the organization didn’t have a people problem but rather a process problem.

The root causes of the process problem were manifold. For one, OSUWMC’s supply coordinators were utilizing a par-cart push inventory system and spending huge amounts of timing estimating inventory levels. This healthcare traditional replenishment process is problematic and can lead to stock-outs and excess. “We had an entire inventory system based on how good a guesser you were,” Hoch said.

We had an entire inventory system based on how good a guesser you were

Further, supplies were often disorganized or hidden because there wasn’t a standard for supply room design, which frequently led to confusion and re-work.

Hoch evaluated several options ranging from supply chain technology to hardware and custom cabinetry, but those solutions would only fill the gaps in the short term and not help with facilitating a holistic process and lean transformation. This led Hoch to a discussion with BlueBin’s founder CEO Charles Hodge and CMO Robb Swan about BlueBin’s lean-replenishment system.

A Simple Solution to a Complex Problem

Though the deployment is still at its early stage, Hoch notes that BlueBin was selected because it “drives accountability and standard work so that clinicians have what they need when they need it.”

BlueBin’s Hodge notes that the system allows nurses to “stay focused on what matters. Nurses shouldn’t have to know how supply chain works; they should just have what they need, without failure.”

It asks very fundamental questions and provides what you need to do your job. I can look at these metrics and know at-a-glance what I need to know.

BlueBin leverages Kanban supply management processes that have been around for more than 70 years; the company is the first commercial provider of a standardized Kanban replenishment system tailored for the healthcare industry. The lean and visual nature of BlueBin’s solution made it easy for Hoch to pitch the solution to her teams. “Technology is great at solving some things, but other things we don’t need to make that complicated.” ”

“What we’re building is racks and plastic bins and plastic pipes and stickers – all these things are so simple, but they make so much sense,” Hoch said. “Even the dashboard, although it’s a technology component, is very straightforward. It asks very fundamental questions and provides what you need to do your job. I can look at these metrics and know at-a-glance what I need to know.”

Hoch introduced the program first in three floors of the new Brain and Spine Hospital, and then in the medical/surgical area of the hospital.

It first began with a beta test in a 4,600-square-foot supply room – a good location to begin with since it didn’t impact clinical activity. With the new lean system, OSUWMC was able to consolidate the supply stock and reduce inventory by more than half, taking up only 2,000 square feet and creating room for a staging area.

Having the supply room serve as an initial test environment allowed Hoch and her team to gain credibility by leading by example. Being able to demonstrate the BlueBin system hands-on and educate clinicians about its potential helped alleviate concerns associated with change and risk, making it easier for Hoch to expand the system into other specialty areas not traditionally managed by supply chain.

Some additional benefits of the early deployment with BlueBin:

• Clinical staff members are removed from all supply chain management activities – they simply have what they need, when they need it.
• Hoarded supplies are eliminated, since the program delivers supplies where they are needed to optimize clinical workflow.
• Stocking levels are analyzed daily to ensure supply standards are maintained, and there are never excess or expired products.
• Stock-outs and rush orders are virtually eliminated. The Daily Management System refines the program and drives continuous improvement.

Seeing Results

Hoch’s efforts centered on changing the process and the culture around supply replenishment. Part of that involved changing the titles for supply coordinators to Supply Chain Coordinators. This relatively minor change had big implications for the employees. “The title change says that those team members are part of a larger process – I’m not just a person that puts stuff away, for example,” said Hoch. “At the core of it, you’re an integral part of the supply chain. It doesn’t just end when the supplies hit the loading dock.”

The Kanban processes that are integral to the BlueBin system provide the supply chain coordinators with information and transparency. Hoch and her team expanded the Daily Management System beyond supply areas to other areas within the organization, including linen management, equipment management, and kitchen and nutrition areas, where (for example) refrigerated items within the nourishment stations are part of the new process.

BlueBin’s system is currently deployed in approximately half of the organization’s inpatient facilities and the Center is already seeing significant savings in terms of costs, space utilization, and clinical workflow optimization process improvements. Specifically:

What Patricia and her team are doing is truly unifying the supply chain. This is a perfect example of how a large academic medical center can track and manage everything that’s consumed in the hospital through one flexible system…

• 7.8 percent in medical supply cost savings
• 7 percent reduction in recurring medical supply costs
• Ability to take on other areas of the facility previously managed by clinical staff because of efficiency gains, all while remaining FTE neutral
• Reduction in supply stock-outs (99.5% fill-rate)

The overall deployment is about one-third complete and Hoch and her team are planning for continued expansion into specialty areas of the large academic medical center. The savings are anticipated to further increase as the deployment grows, around recurrent medical supply costs.

“Implementing a culture change in any organization can be a challenge,” said Hoch. “It’s important not to lose momentum and to continue building on your success in order to further your progress, and keep achieving those milestones.”

“What Patricia and her team are doing is truly unifying the supply chain,” said BlueBin’s Charles Hodge. “This is a perfect example of how a large academic medical center can track and manage everything that’s consumed in the hospital through one flexible system, whether it’s to track and manage surgical and medical supplies or refrigerated pudding cups.”

About Bluebin

BlueBin specializes in lean supply chain solutions for healthcare organizations. BlueBin has perfected this approach in a way never before thought possible in healthcare. Most customers experience ROI within 12 months of implementation.

BlueBin’s system is currently deployed in approximately half of the organization’s inpatient facilities and the Center is already seeing significant savings in terms of costs, space utilization, and clinical workflow optimization process improvements. Specifically:

• 7.8% in medical supply cost savings
• 7% reduction in recurring medical supply costs
• Ability to take on other areas of the facility previously managed by clinical staff because of efficiency gains, all while remaining FTE neutral
• Reduction in supply stock-outs (99.5% fill-rate)
• The overall deployment is about one-third complete and the OSU team is planning for continued expansion into specialty areas of the large academic medical center.

The savings are anticipated to further increase as the deployment grows, around recurrent medical supply costs.