1. “ If Logisticians Can Cook” Logistics Assist Visit Concepts
Edlouie S. Ortega, MSM, CDFM, CPFM
Equipment and Technology Management
Medical Equipment and Logistics Solutions
Naval Medical Logistics Command

2. How do you measure success?
Do you believe in key performance indicators (KPI)?
How do you know which KPI to track?
Should all KPI measureable?

3. Who do you agree with?
“Tell me how you measure me, and I'll tell you how I will behave.”
- Eli Goldratt
" Tell me how you’ll measure me, and I’ll tell what damn fool things I’ll do to make the measurement look good."
- Tony Rizzo

4. Restaurant Industry…What we measure
Cash flow. Restaurants are very cash-intensive, forking over money for fresh inventory and tipping out servers and other staff on a daily basis.
Percentage of repeat customers. The National Restaurant Association estimates that three-quarters of most restaurants' sales come from repeat customers.
Staff turnover. On average, management turnover rates run around 20% annually for table-service restaurants, while hourly workers turn over at roughly a 150% clip
Forbes.com

5. Other KPIs we measure
Table-turn over rate. How many times table is filled with customer. How fast tables empty and fill during a shift.
Order-throughput time. How long before a meal goes out to the customer. Drinks – appetizer – main course – dessert.
Table-turn time. How long did the table remain empty and how long did it stayed filled.

6. Restaurants Does Logistics Too and More…
Contracts
Outlays
Budget
Regulations
Overall Strategy
Competition
Staff Development
Procure materials
Move materials
Produce materials
Monitor
Assess
Control

7. What we can learn from a Cook
It’s all about the…
food
presentation
timing
customer service
dish washer
work flow
And sometimes it’s not all about measurable KPI…

8. What we can learn from a Cook
Front of the House – Back of the House - Expedite!!!
Assurance: The act of giving confidence, the state of being certain or the act of making certain.
Control: An evaluation to indicate needed corrective responses; the act of guiding a process in which variability is attributable to a constant system of chance causes.

9. What we can learn from a Cook
Quality Assurance: The planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled.
Quality Control: The observation techniques and activities used to fulfill requirements for quality.
Standard processes/quality products…
not to make measurements look good.

10. What we can learn from a Cook
Outputs
Defined as the goods or services produced (e.g., patient admissions, bed days, work orders, receipts).
Outcomes
Defined as the impacts on indicators arising from the delivery of outputs (e.g., fill rate, turn-over ratio, SOS Due-in rate, maintenance completions rate, unable to locate).
“More focused on Effectiveness than Efficiency”

11. Define Logistics Logistics Medical Logistics
The planning, implementation, and coordination of the
details of a business or other material operations.
Medical Logistics
Is the logistic of pharmaceuticals, medical and surgical
supplies, medical devices and equipment, and other
products needed to support doctors, nurses, and other
health and dental care providers. Because its final
customers are responsible for the lives and health of their
patients, medical logistics is unique in that it seeks to
optimize effectiveness rather than efficiency.

12. Logistics Assist Visit
Purpose:
Assist Logisticians to achieve Total Asset Management (TAM) and improve internal management control of accountable equipment.
Evaluate the effectiveness of the Equipment, Technology Material Management (ETM) processes from materiel procurement planning to eventual property disposal
Evaluate the effectiveness of the Purchasing Management, Acquisition Planning and Requirements Development, and Contracting Officer’s Representative (COR) Programs
The Logistics Assist Visit is NOT an inspection, this is strictly an assist visit to help your staff identify strengths and weaknesses and to provide them with the tools that they need to successfully carry out their mission.

13. Logistics Assist Visit
Focus:
Assessment of continued suitability as it applies to aging technology.
Assessment of effective use of the logistics information system as a tool for improving materials management operations.
Collect information to develop technical criteria for use as basis for acquisition actions across BSO-18.
Assessment of accountable equipment records with an acquisition cost of $25,000 and greater.
Assessment of Material Management
Assessment of Acquisition Management

14. Logistics Assist Visit
Assessment Methodology
Use of existing data and focus on establishing the baseline between the site and the "Best Practices" in BSO-18 claimancy and in the industry.
Incorporate training, database management, material management, technology management and acquisition management site visits.
Provide feedback to the site regarding LAV findings and recommendations that will help the site focus on its strengths and immediate improvement.

15. Logistics Assist Visit
Assessment Elements
1. Evaluate synchronization of the Navy business practices,
policies, and logistics and acquisition information systems.
2. Validation Processes (Management Assertion)
3. Evaluate training requirements and provide just-in-time
training as needed.

16. Logistics Assist Visit
Assessment Elements
Evaluate synchronization of business practices, policies and systems.
Review current policies.
Analyze data; focus on trends.
Evaluate site’s business practice.
Evaluate site’s appropriate use of business systems.
Identify processes requiring BUMED-wide standardization.
Identify change requirements to the logistics information systems.
Identify change requirements to the policies.

17. Logistics Assist Visit
Assessment Elements
2. Validation Process (Management Assertion):
Valuation. Test all contributing factors (device code, life expectancy, useful life, acceptance date, acquisition cost, etc).
Completeness. Test to ensure that maintenance significant equipment and personal properties are entered in DMLSS.
Accountability. Test if the equipment found on site belongs to the entity.
Replacement Plan. Test for proper equipment selection and requisition process.
Due-in Receipt. Test to ensure that due-in materials are properly receipted and properly recorded.

18. Logistics Assist Visit
Assessment Elements
3. Evaluate training requirements and provide just-in-time
training as needed.
Identify functionality gaps.
Identify execution gaps.
Identify process gaps.
Identify current workload and productivity.
Identify additional training requirements.

19. Assessment Candidates
Equipment Receipt
Inventory Management/UID
Five Year Equipment Replacement Plan
Device Code Assignment
Property/Item Decrease/Loss
Document Control
Maintenance Plan and Procedures
Repair Parts Request and Issue
Service Contracts
Material Due-ins
Emergency Management Plan/CBRNE/IPP
COR Appointment, Training and Management
ECAT Orders

20. Performance Metrics Analysis
SWO Workload/Metrics
June (Before LAV)
July 2010
August
2010
YTD as of JUNE 2010
Mean
Beginning Work Order Balance Qty 34 90 29
1477
123
New Work Order Qty
403
372
522
4974
414
Reopened WO Qty 12 25 2
Completed Work Order Qty
321
363
405
4317
360
Cancelled Work Order Qty 38 70
122
812 68
Ending Work Order Balance Qty 24
1347
112
Carryover 56
-61 5
-130
-11
Completion Rate
79.96%
93.72%
95.6%
79.20%
Relative Inventory Accuracy
90.57%
81.18%
70%
83.68%

21. Imaging Equipment Portfolio
Total Items: 729
Total Acq Cost: $114M
Total Items: 550
Total Acq Cost: $96M
Total Items: 181
Total Acq Cost: $42M
Total Items: 124
Total Acq Cost: $15M

22. Potential Throughput₄
Capacity Utility Rate
Modality
Qty₁
Total Procedures₂
Actual Throughput₃
Potential Throughput₄
Procedures /Day₅
CUR₆
Bone Densitometer 1 3  - -
Radiographic System, Mammography 2
4,916
2,458
4,000 20
61.4%
Radiographic System, Mobile
2,376
792 -  9
Radiographic System, Urologic
236 79
2,000
3.9%
Radiographic Unit
26,154
8,718
15,000
104
58.1%
Radiographic/Fluoroscopic
1,357
452
1,200 5
37.7%
Radiographic/Fluoroscopic, Mobile, C-Arm
115 58
Scanning System, Computed Tomography
7,330
8,000 29
91.6%
Scanning System, Gamma Camera, (SPECT)
730
365
18.2%
Scanning System, Magnetic Resonance Imaging
3,341 13
83.5%
Scanning System, Ultrasound 4
9,577
2,394 38

23. Projected Cost Avoidance
Modality
Section
FY 11
FY 12
FY 13
3YR Total
Radiographic/Fluoroscopic System
4.2.3.
$700 $0
RF Service Contract Cost
$42
$126
Radiographic Unit
4.2.4.
$240
RU Service Contract Cost $6
$14
$34
Radiographic/Fluoroscopic System, Urologic
4.3.5.
$210
RFU Service Contract Cost
$13
$38
Imaging System, Computed Radiography
4.3.7.
$160
$80
Total PCA
$1,371
$149
$69
$1,508
In Thousands

24. Region
UIC
Unit Name
BWO
NWO
RWO
CWO
XWO
EWO
Risk 1 UTL
Risk 2-4 UTL
UTL %
PMCR
NME
N32185
NHC New England
196
191 5
2.55%
100.00%
N39163
USNH Sigonella 1
127 3 4
3.15%
NMW
N68095
NH Bremerton 2
240
234 9
3.75%
N66094
NHC Cherry Point 26 20 6
23.08%
N00232
NH Jacksonville
109
731
847
0.14%
99.88%
N68084
NHC Charleston 35
114
143
3.51%
98.66%
N66097
NH Oak Harbor 95 88 8
8.42%
97.96%
N00211
NHC Great Lakes
153
145 7
4.58%
97.44%
N68292
USNH Yokosuka 16
304
294 21
6.91%
97.22%
N66095
NH Lemoore
128 11
8.59%
96.90%
N66096
USNH Naples
110
0.00%
96.49%
N00183
NMC Portsmouth 63
1064
995 87 47
8.27%
95.84%
N68093
NH Camp Lejeune 18
341
321 24 15
7.04%
95.83%
NCA
N00168
Walter Reed NMMC
188
1542 45
951
685
139 44
47.28%
92.17%
N68096
USNH Guam 33
152
169
0.66%
91.40%
N00285
NHC Corpus Christi
90.91%
N00259
NMC San Diego 85
1109 49
1001
103
9.56%
88.82%
N66101
USNH Rota 22 55 62
10.91%
88.31%
N68470
USNH Okinawa 65
355
315
13.24%
85.27%
N00203
NH Pensacola 48
300
245 50
16.67%
84.29%
N61337
NH Beaufort
317
257 14 51
4.42%
84.16%
N68098
NHC Hawaii 70
100 39 31
39.00%
81.76%
N68094
NH Camp Pendleton
278
362
504
123 12
7.18%
80.81%
N35949
NH Twentynine Palms
172 27
15.70%
70.52%
N00162
NHC Annapolis
198
VALIDATE
N00231
NHC Quantico 38
N66098
NHC PAX River
TOTAL
BUMED-WIDE
1278
8118
7349
1408
766
18.12%
91.96%

25. Navy Medicine Support Command
M42 Logistics Policy
Chief, MedLog
M46 Logistics Execution
-Lead Contracting Executive
-Fleet Hospital Program Office (PML-500)
-Property Management Office
-Medical Logistics Business Systems/Metrics
-FOA Vaccine Management
CO, NAVMEDLOGCOM
Execute Current Mission
NEMSCOM
NOSTRA
Echelon 2
Dual Hatted Position
Echelon 3
Navy Medicine Support Command
Support Functions MOU
Echelon 4

26. Related Sessions
LO-T-3-B Equipment Management Self Assessment - Conduct Your Own LAV
LO-T-3-C Material Management Self Assessment - Conduct Your Own LAV
LO-T-3-D Maintenance Management Self Assessment - Conduct Your Own LAV
LO-W-3-C Automatic Identification Technologies (AIT) /IUID and RTLS
LO-W-3-D Equipment Management Process
LO-W-3-E Annual Inventory Process and Requirements