Becker's ASC Review

58 Supply Chain R educing costs is vital for ensuring the financial health of an ambula- tory surgery center. Managing supply chain effectively can go a long way in reducing costs, and one of the keys to success is standardizing supplies. "Standardization is critically important because we are in an era where we are getting reduced reimbursement from the government, so we have to become efficient," says Mike Lipomi, president and CEO of Surgical Management Professionals. "We don't have the luxury to not be efficient." According to Provista's 2011 Report of ASC Survey Findings, product stan- dardization is the most utilized supply chain management strategy in ASCs, with 34 percent of surgery centers using it. Limiting vendors as possible allows ASCs to leverage the total amount they spend with the vendor to negotiate better per-unit price. Thus, standardizing supplies can lead to greater discounts as well as an ease of control over inven- tory and better materials management at ASCs, according to Amanda Frith, senior director of field operations for supply chain at Surgical Care Affiliates. However, there are challenges standing in the way of achieving standardiza- tion, particularly when dealing with physician preference items. "Physicians often have different products they trained with or become famil- iar with," says Joshua Billstein, a board member of the Washington Ambula- tory Surgery Association and practice manager at The Polyclinic in Seattle. "Also, the administrator is often not a clinical person and it can be difficult for the physician to agree to product changes based on the administrator's request. The physician can feel like an administrator is telling him or her how to practice." Here are seven ways to achieve standardization of supplies at an ASC and not lose physicians on their preference items: 1. Gather data. "Prepare the initial analysis of a product properly and back up your claim with clinical evidence," says Mr. Lipomi. "Otherwise you will lose the confidence of the physicians because then they will think you are just trying to save money and that you aren't thinking about quality or patient outcomes. They will shut down." It is essential that physicians understand that administrators are not merely interested in improving the bottom line, but are also working to ensure that high-quality care is consistently delivered at the center. Administrators armed with a good amount of product data are more success- ful in showing physicians the product isn't inferior. 2. Compare costs. It's important for physicians to know ASC administra- tors have chosen a product that is not only a high-quality product but also makes financial sense for a surgery center. "In a discreet manner, try and identify the cases in which high cost implants may have been used, and then compare it to similar cases using a lower cost implant with a resultant lower cost per case," says Mr. Billstein. By collecting this type of data on cases and comparing them, physicians see how their product choice affects the surgery center finances. This may per- suade physicians to consider different products and think about switching, says Mr. Billstein. 3. Engage physicians in decision-making. How ASC administrators approach the conversation regarding standardization with them is extremely important. "The most successful physician pref- erence standardization projects are those where the physicians are involved in setting the strat- egy for the center," says Ms. Frith. Remind the physicians their approval is neces- sary for any changes and patient care and sat- isfaction is always the first priority. Ultimately, physicians need to help decide the appropriate strategy to create alignment. "Administrators also have to understand that not all physicians are created equal. Not all of them will be comfortable with all techniques and technologies," says Mr. Lipomi. "So you have to be patient and understanding and get the physicians to take the lead." 4. Choose a physician champion. A phy- sician who already uses the product can help administrators talk to other physicians at the center as this will help allay doubts about its ef- ficacy. "If appropriate, [administrators should] ac- knowledge that they do not come from a posi- tion of clinical expertise and are simply providing information and oppor- tunities that can help their centers continue to be financially successful," says Ms. Frith. 5. Facilitate peer-to-peer conversations. If an administrator isn't able to convince some of the surgeons to make the switch, coordinate a peer-to- peer meeting between center physicians. "I try and facilitate peer-to-peer conversations, so that it isn't just me and the physician," Mr. Billstein says. "I keep outcomes and financial data on-hand so that the physicians can look at that as well. And by including another physician, it turns into a clinician-to- clinician conversation." 6. Take a critical look at inventory. "Look into the items that the sur- gery center spends the most on," says Mr. Lipomi. "Single out the ones for which there may be more cost-effective alternatives." This examination can also help ASC leaders find ways to plug waste. For ex- ample, identify items that could be reused. Involve physicians in this process, says Mr. Lipomi, as seeing the number of high-cost products used at a center could spark other ideas for cost-savings. "Once they are in a cost-saving mindset, physicians may be encouraged to standardize their processes," says Mr. Billstein. "This often leads to greater savings on supplies." 7. Ask for feedback. Continue to engage physicians after the changes have taken place for constant improvement. "Don't forget to check in with your physicians once the standardization has occurred and make sure they are happy with the products," says Ms. Frith. Periodically reporting back the actual savings achieved keeps physicians excited about their efforts. Ultimately, standardizing supplies at an ASC translates to bringing about change. "Physicians, like all human beings, don't like change," says Mr. Lipo- mi. "However, change can be exciting if presented properly, and in the case of standardizing supplies, with the appropriate amount of research and tact." n Supply Standardization: 7 Ways to Achieve ASC Physician Buy-In By Anuja Vaidya Joshua Billstein Mike Lipomi

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