2Purpose Why Am I Here? Why am I here? To some, it’s because we are new in this business and want to learn what its all about. Want to find out that one best way.To some of us - I know about material management. We are all here to learn. Last time attended an educational session on the basics (Examples of negotiation techniques)In times of change, the learners will inherit the organization. Those who refuse to learn will find themselves well equipped for an organization that no longer exists ‑ dinosaursNo one best way, no one Industry leader to point the way.We’re here to learn together. My job is not so much to teach as it is to facilitate, there are people in this room who could a much better job of presenting these topics than I, who are much more qualified. My goal is to lead all of us through this session and to attempt to touch on as many topics as you want or need to discuss.We are looking at this session as a basics course. To some of us we’ve heard it all before. This is a good chance to review and possibly challenge some of your basic ideas and beliefs. To others this may be the first time we’ve covered some of these topics. This will give you a basis for your future learning and hopefully a track to follow for the remainder of this conferenceDivided into 6 sections: Purchasing, Inventory & Distribution Management, Support Services, Information Systems, Finance and LeadershipPurpose Why Am I Here?
4Purchasing/Product Value Analysis: Organizational structure - understand all aspects and divisions included in the structure responsible for the purchase of materials, supplies and capital equipmentIs there one definition? Finance, x-ray, housekeeping all have specific definitions associated with their name or image. What about MM. What are your divisions? Responsibilities? Give examples.Understand process and techniques of Purchasing, Receiving, Inventorying.These are basic concepts that are joined together in the legal procedure of forming and acting on contract , a legal document. We’ll go into these concepts a little later in the presentation and show their interrelation.Understand concepts of Planned capital replenishment and retirement as part of the capital purchasing processThe difference between being reactive and proactive. Reactive - someone else is in control of your life. Proactive - you are in control. This planned capital replenishment is based on the useful life of an asset. The idea is to replenish the item at the same time that it reaches the end of its useful life. This concept is based on the replacement of technological equipment on a planned, cyclical basis. In standardizing and grouping the replacement of these items, benefits arise in negotiating better price discounts, standardizing for repairs and supplies, simplified training and use of equipment. Usually this program is for high tech, portable equipment that meets a certain dollar limit established by the hospital.Organizational structureHospital purchasing processPlanned capital replenishment
5Budgets Material Management Role in the Operating Budget Process. Material Management Role in the Capital Purchasing ProcessBudgetingEvaluating & SelectingNegotiatingTools
6Purchasing Techniques Understand Purchasing Techniques:Contract Negotiationold skills (examples), new skills - win/win requires proper planning and preparation. Identify objectives - both yours as well as the other parties - open relationship, know your partners. The ineffective negotiator is one who becomes locked into a set style, who cannot remain open to new options and who cannot break out of this pattern of inflexibility. Negotiation is a dynamic activity. Each event is unique as it brings together a new combination of people and circumstances. Therefore, plan and then adjust performance to meet the particular circumstances.Competitive Biddingapples to apples; determine when it is best to use this technique based on the cost of the item compared to the expense to conduct the bidding. Alternatives.Material Use Evaluationthe difference between what the hospital needs and what would be nice to haveComparative Costingcost analysis of the total acquisition - total not jus the lowest price, the best price.Multi-facility Product Standardizationmost difficult because of the increased factors involved: number of egos involved, specific institutional needs, area product availabilityContract NegotiationCompetitive BiddingMaterial Use EvaluationComparative CostingMulti-facility Product Standardization
7Purchase Agreements Product Quality & Patient Care. Understand various purchase agreements including the following:product quality consistent with standards for patient care.lowest possible total procurement cost.Total cost evaluationcost protection for extended periods of time.beneficial for both parties, guaranteed purchase in exchange for price protectioncost increase ceilings.In volatile markets or with products that are raw material market driven such as textiles, paper goods, rubber products develop cost ceiling.consignment agreements with competitive prices.Don’t own the product until it is used. Inventory on had belongs to the vendor; hospital has physical possession and responsibility but not ownership. Advantage is cash flow because the material is paid for only when it is used. Not when it is sitting in your warehouse. The vendor becomes a partner in your efforts to reduce inventory. It is no longer to the supplier’s advantage to have a great deal of inventory on hand at the hospital and at the hospitals expense. Rather it is now to the vendors advantage to keep inventories lean, which is what you wanted to do all along.extended payment terms.Negotiate terms improve cash flow by allowing your money to draw interest longer. Or negotiate discounts based on early payment.stockless purchasing agreements.All stocks are held by the vendor - none on hand in the hospital. Tailored catalogs, orders placed directly with vendor and delivered directly to users. Advantages: minimum paperwork, handling of items, consolidated billing and elimination of inventory. Dangers: no emergency stocks, tied to one vendor, vendor must be accurate or increase in return paperwork, hospital must have good budget and expense controls to control overordering.Product Quality & Patient Care.Lowest Possible Total Procurement Cost.Cost Protection & Cost Ceilings.Consignment Agreements.Value of Extended Payment Terms.Stockless Purchasing Agreements.
8Procedural & Operational Techniques and Systems That: Understand the various procedural and operational techniques that minimize customer cost of ordering, storing, and using supplies, services, and equipment.Order cost is the expense of placing an order for a given item. Receiving, dispatch, inventorying, storage, accounting,. Grouping orders spreads the cost of each order over many items.Storing costs: insurance, obsolescence, theft, dispatch, space.Techniques: standardization, par level/exchange carts reduce overstocking, consignment inventories, JIT, stocklessMinimize Customer Cost of Ordering, Storing and Utilization of:SuppliesServicesEquipment
9On Time Order Placement Expediting Supplier Performance Analysis Ensure that timely order placement, expediting, and supplier performance analysis take place.In order to assess the effectiveness of supply chain operations, it is necessary to develop a series of continuous measurements. These will assist the material management professional in designing, implementing, measuring and, where necessary, re-designing the supply chain process. The four measurements include: customer satisfaction, service quality, timeliness of service and supply chain activity-based costing.In keeping with the basics, customer satisfaction can best be measured against the standard seven R’s of material management: the right product, place, time, condition, quantity, cost and customer. These measures are basic but often overlooked for more complicated and diverse factors. The use of customer feedback questionnaires, based on these seven R’s, allows the manager to hear what service as well as service levels are required by their customers. This involvement of the customer in the design of continuous quality improvement results in a pro-active approach to service levels.It is important for the successful health care material and resource manager to have a renewal process of performance measures. With change occurring so rapidly in our profession, it is essential that we constantly renew our operations. We can not wait for change and then react. We must be proactive change agents. And we must start in our own operations. This change process must be driven by accurate performance measures. Remember: results do matter.Order PlacementExpeditingSupplier Performance AnalysisContinuous Review
10Audits Review of Discrepancies Purchase Orders Invoice Price Understand the various audit activities, including the review of discrepancies, purchase orders, invoice price, payment terms, lost rebates, performance criteria, contract terms and conditions.Many hospitals have developed sophisticated measurements of their customer delivery performance. Although these attempts are a step in the right direction, they are all too often complex and cumbersome to use. As such, they are not effective measurement tools. Whatever device is developed for use in your institution must ask in a very simple manner, “Was my customer satisfied 100 percent of the time?” Most customers never complain directly to the area that provided the unsatisfactory product or service. They may complain to others, which diminishes your image, but you will never hear the about the problem. This is why whatever vehicle you develop, must be simple and easy for your customers to use.Constant evaluation and tracking throughout the process to ensure contract and performance compliance. Build a history of information about vendor performance and ability to comply with your requirements.Review of DiscrepanciesPurchase OrdersInvoice PricePayment TermsLost RebatesPerformance CriteriaContract Terms and Conditions.
11Supply Chain Analysis and Cost Benefit Analysis Techniques Negotiate competitive pricing, terms, and service levels.Translate your goals into ranges for settlementplan to reach agreement not to argueUse competitive proposals as support documentsDetermine the other parties range of settlement as well as compromise.Develop quantitative data to support each facility positionnot just price:warrantiesdeliveriesmanualsacceptability of productstrade-in equipmentlimitations of liabilityautomatic renewal clauseequipment loans & costinstallationpenaltiesservice contractstraining classespayment termsdiscounts - early delivery, volume purchase, manufacturers promotions, piggy-back pricingProductsService Levels.
12Value of Contracts Definition of a Contract Laws of Agency Understand the legal considerations included in the definition of a contract, laws of agency, and express and implied warranties that maximize value to the hospital.UCCContract is an exchange of promises between two or more persons that is enforceable in a court of law. It may be verbal, written or implied by conduct. It may be set forth in a letter, an order form, or a specifically titles “contract” or “Agreement”. The form does not determine the enforceability.Conditions must be met:Define a contract: passing of title for a price.Requires: offer and acceptance, intent -consideration - something of value, not necessarily equal, must be exchangedlegal purpose,capacity - minors, insane, intoxicated, legal aliens (OK), married women (under common law, married women could not enter into contracts, only single women) and corporations, therefore agentscompliance with statute of fraudsagency: express, implied,Guaranteed (implied) unless given away:Warranty of merchantability - quality goods fit for ordinary intended uses, adequately packaged, contained or labeledWarranty of implied fitness for a particular purpose - buyer communicates the purpose; buyer relies on seller’s expertise; seller selects goods; seller knows purposeWarranty of title - seller guaranties title free of liens and encumbrancesWarranty against infringements - seller delivers goods free form all 3rd party claims (patents, trademarks, copyrights)Definition of a ContractLaws of AgencyExpress and Implied Warranties
13Supplier Performance Standards Understand the various supplier performance standards the following:product quality - is quality consistentpricing - is pricing kept within the negotiated guidelinesdiscounts - are discounts offered and honoredrebates - are you made aware of manufacturer rebates and are they passed onservice charges - are they reasonable and within the contract guidelinesinvoicing - are invoices accurateservice levels - value addedyou must remain vigilant, part of you job, part of your value added service to your customersProduct QualityPricingDiscountsRebatesService ChargesInvoicingService Levels
14Value Analysis Process Evaluate purchasing reports (e.g. cost savings, price index, order processing time, purchase order error rates, work load volume, freight expenditures).Many hospitals have developed sophisticated measurements of their customer delivery performance. Although these attempts are a step in the right direction, they are all too often complex and cumbersome to use. As such, they are not effective measurement tools. Whatever device is developed for use in your institution must ask in a very simple manner, “Was my customer satisfied 100 percent of the time?” Most customers never complain directly to the area that provided the unsatisfactory product or service. They may complain to others, which diminishes your image, but you will never hear the about the problem. This is why whatever vehicle you develop, must be simple and easy for your customers to use.
15Change Management Standardization Consolidation Re-engineering Change Management: Understand the concepts of standardization, consolidation and/or re-engineering processes as they pertain to Materials Management.New ways to do your job. No longer acceptable for the good old days.Determine what your job is, not just the functions, get tot he root of the job. Now create a support system that will enable you to achieve your jobstandardization, consolidation and reengineering are only three of the tools available for the progressive mm professionalStandardizationConsolidationRe-engineering
16Product Utilization Process Interact with physicians and clinicians to coordinate and integrate cost and quality management programs into existing departmental services by assisting with: program development, data collection and analysis, implementation , monitoring, measurement and evaluationyou can’t do your job in a vacuum. Get out of the basement. Enlist herosDefinitionImplementationMM Role
17Resource Analysis Process Review Clinical Applications Provide consultation to departments requiring assistance in resource allocation. Identify opportunities for reduction in resource consumption.Remember you are to manager resources and to be a resource as well.Process ReviewClinical Applications
18Code of Ethics High personal standards Agent of the hospital Obey the spirit and letter of the law of the land, the articles of incorporation, the bylaws and the regulations of the corporation.Demonstrate the highest standards of personal integrity, truthfulness and honesty in all hospital activities; administer the Hospital’s affairs with impartiality, efficiency and effectiveness in a manner that enhances its good name and mission.Be certain that information is accurate when speaking on behalf of the hospital; disclose when stating personal opinions; and be scrupulous in the representation of authority and avoid misleading those with whom we deal.Approach organizational and operational duties with a positive attitude and constructively support open communication, creativity, dedication and compassion; bring credit to the Hospital through public demeanor; accept as a personal duty the responsibility to remain informed on important and critical issues affecting the Hospital; and avoid accepting an assignment that cannot be effectively and completely discharged in a timely manner.Exercise independent judgement in the best interest of the Hospital, and free of compromising influences and loyalties; act responsibly and in good faith, and in a manner not designed or intended to bring personal gain from the discharge of Hospital duties.Give notice, in a manner consistent with the Regulations and as otherwise may be reasonable, of any duality of interest or possible conflict of interest and make it a matter of record;Refrain from: 1) Using funds or assets of the Hospital for personal gain; 2) Soliciting or receiving, directly or indirectly, anything of value from any purveyors or vendors of goods or services to the Hospital, or any person or entity for influencing their actions; or 3) Granting or accepting favors for personal gain.Report the unethical or inappropriate behavior of a person to the Hospital Administration or Board of Governors when informal resolution is not effective.Refrain from using official positions or influence either for or against any candidate for public office.Serve with respect, concern, courtesy and responsiveness, recognizing that service to your institution.High personal standardsAgent of the hospitalPositive attitudeBest interest of the hospitalConflict of interestPersonal gain
20Supply Chain Management Supply Chain Management: Understand how the organization's acquisition and distribution strategies and practices can serve to improve the overall healthcare system supply chain.Supply chain management refers to the art of managing the flow of materials and products from the acquisition of raw materials to the delivery of finished products to the end user. As such it includes the activities of sourcing and purchasing; manufacturing; distribution planning and management; inventory management and inbound and outbound transportation; and the linkage with the customer service.Understand the relationship between receiving, purchasing, and distribution as they pertain to the inventory process.Integrated logistics management can improve both the cost and customer service performance. The acts of ordering, inventory, distribution, storing, receiving and customer service are all interrelated. A change in any one of these activities influences the others, and an attempt to minimize any individual cost element may result in higher total supply cost. (examples of receiving errors and how they effect A/P, Inventory, Purchasing, distribution, manufacturing, raw supply)Acquisition and Distribution Strategies and PracticesImprove the Overall Healthcare System Supply Chain.Resource Integration
21Inventory Strategies Consignment Strategy Just-in-time Strategy Understand inventory programs and strategies including: consignment strategy, just-in-time strategy, stockless strategy, consolidation strategyConsignment: a purchasing agreement where the supplier retains ownership of supplies while they are physically stored at the hospital. The hospital pays when the supplies are used. Such supplies are not considered part of the hospital’s inventory or assets.JIT or almost out - Inventory arrives when it is needed and delivered to the point of use. This transfers the stock from your storeroom back to the distributor or manufacturer. However, you also transfer the control. Not work in all situations.Stockless - systems usually cover a wide category of items such as office supplies, plant services parts, etc. These usually involve setting up what amounts to a charge account at the vendor for small orders that are delivered directly to the ordering department. The hospital carries little or no inventory. However, the facility loses detailed control over each order and must depend on after-the-fact review and budgetary controls to prevent overordering.Consolidation - gives more volume to fewer vendors, which drives down costs. This does not mean squeezing suppliers for lower prices; rather it means shifting volume to more efficient suppliers and creating value through greater economies of scale.Consignment StrategyJust-in-time StrategyStockless StrategyConsolidation Strategy
22Inventory ReductionDefining Realistic TargetsHow to achieve
24Facilities Planning Considerations Evaluate warehouse design factors:environment (e.g., inpatient/outpatient mix, length of stay)design for your customers supportflexibility (e.g. ease of expansion and contraction)design for tomorrowemphasis on total, overall system rather than specific subsystemsmanage materiel and resources not just bandaidsautomation of materials management functioncan it be automated as a tool or resource in your distribution systemback-up systems availablewhat happens when the lights go outSpaceOn-site vs. Off-siteWarehouse Design Factors:FlexibilityTotal System DevelopmentBack-up Systems
25Receiving Strategies Centralized vs. Decentralized Understand the receiving process and how it relates to the purchasing contractreceipt is different that acceptance in a legal contract. You must establish that difference. Acceptance it is yours. Receipt you are now responsible.Discuss the importance of the distribution processes and accountability (e.g., accurate reporting to the customer activity, discrepancies between receipts and supplier invoices).Remember that all of the activities throughout the supply chain are interrelated and interdependent including distribution. Products delivered to the right location, all the time, can also be used to measure the operation’s success in performing value-added activities. These activities may include the placing of supplies into a secondary inventory system, rearranging product storage areas and making deliveries in such a way as to assist the customer in how they use the items. The condition of products delivered to your customer must be measured. Damaged merchandise is of little value to your customer. This also creates added expense in all other areas of the supply chain. From handling to purchasing to expediting delivery to receipt and expense reconciliation. The measurement for the timeliness for deliveries must reflect performance based on the expectations and needs of the customers, and in their terms. Any measure of the “right time” that is not based on customer expectations and needs runs the risk of inaccurately measuring supply chain performanceResolve customer concerns by providing a central point of access, and serve as a liaison to customer departments and suppliers.Centralization has several advantages: purchasing personnel are better trained in purchasing skills, inventories are reduced and uniformity of policies and procedures throughout the hospital.Discuss various distribution strategies and systems for products:automatic replenishment systems,scheduled requisitions,travelling requisitions,emergency requisitions,back-order systems,just-in time systems,stockless systemsCentralized vs. Decentralized
26Distribution Strategies Discuss various material transport devices:carts,pneumatic tube systems,automated guided vehicles (AGV),monorail systems,conveyors,tuggers,cart lifts,dumbwaiter,chutesbackup systemsAutomatic Replenishment SystemsScheduled RequisitionsTraveling RequisitionsRandom Request SystemEmergency RequisitionsBack-order SystemsJust-in Time SystemsStockless Systems
30Sterile Processing Decontamination Options and Safety Procedures Understand sterile processing concepts, development, and activities.What is Sterilization? .An Absolute? Destroying all forms of microbial life. Either yes or noDiscuss various decontamination options and safety proceduresSoaking, Manual Washing, Chemical Disinfecting, Ultrasonic Cleaners (Cavitation), Mechanical Washers, PasteurizersSafety in Decontam. Proper protective attire, Training in hand‑washing, Instruction in instrument handlingDiscuss Microbiology 101 and how it pertains to the sterilization processMicrobiology Some harder to kill than others, Regular bacteria, TB (Mycobacterium Tuberculosis),Spores (normal resting stage in the life-cycle of certain groups of organisisms - a phase of bacterial life)- are the most resistant of all living organisms in their capacity to withstand external destructive agentsDiscuss the principles/methods of sterilizationDifferent methods kill in different ways, Steam fries (moist heat), time & temperatureETO breaks down cell structureDiscuss the various types of carts (e.g., surgery case carts, dietary carts, soiled linen and trash carts). discussterminal sterilization (e.g., floor-landing, car and carriage model), including ethylene oxide sterilizers. Types of Sterilizers – Steam, Gravity & Pre-VacTwo Steam Options – Terminal, Items are wrapped, goods are protected, Usually performed in SPD, 2 ‑ 4 hour turn‑aroundFlash - Items are not wrapped, goods are unprotected, Usually performed in OR/L&D, 10 ‑ 20 minute turn‑aroundEthyline Oxide (ETO)More Sterilization Options, Chemical, Radiation, Gas Plasma, AcidDecontamination Options and Safety ProceduresMicrobiology 101Principles/methods of SterilizationCartsDecontamination & Sterilization Equipment:
32Material FlowOptimal LayoutRelated Department LocationsAlternatives
33Quality Management Bowie Dick Tests Biological Tests Process Monitors Perform tasks in cleaning and preventive maintenance to ensure high level of sanitation and infection control.Discuss quality management of the sterilization process, including:Bowie Dick tests,designed for high-vacuum sterilizers to show the pattern of residual air (was a vacuum established)biological tests, designed to confirm the presence or absence of living microorganisms B. Stearothermoplilus or B. Subtilisprocess monitors that show sterilization time, temperature, and pressure inside a sterilizer.Chemical Indicatorsexternal indicators that show whether the item has been processed inside a sterilizer,tapeMaintaining Sterility - Is sterility time or event related?, Traditional time dating use of dust covers, Commercially sterilized goodsBowie Dick TestsBiological TestsProcess MonitorsExternal IndicatorsInternal Indicators
34ETO Work Environment. Discuss ETO gas in the work environment. Discovered and described in Odorless, colorless, carcinogenic, steriliantUsed as a pesticide and fumigant early 1900’s1929 first used as a bactericidetime, temperature ( ), concentration & moistureaerationWork Environment.
35Linen Distribution Utilization Pilferage Schedules Monitor the distribution, utilization, and pilferage of linens.Discuss tracking, weighing, scrubsDevelop linen distribution schedules in conjunction with users needsDistributionUtilizationPilferageSchedules
36Linen Processing Equipment Development of procedures and process for the selection, acquisition and maintenance of linen processing equipmentSelectionAcquisitionmaintenance
37Hazardous Waste Disposal Discuss hazardous waste disposal policies and procedures in accordance with regulatory requirements.EPA, JCAHO & DOTEPA defines it: ignites, corrosive, reactivity, toxicJCAHO requires written waste management planDOT controls the transportcradle to graveAlternative – organization-wide salvage programsPolicies and ProceduresRegulatory Requirements.Cradle to GraveSalvage
38Food Service Evaluation and Performance Tools Same as SPD, i.e., take raw material process and distributeFood order processfood preparation and consumption ratiosFood distributionEvaluation and Performance Tools
39Universal Precautions Demonstrate knowledge of universal precaution guidelines.OSHA December 1991According to OSHA, the following is the recommended protective barriers - gloves, gown, mask, and goggles, and should be used when handling any body fluidsgood for all
40Information Systems 201Discuss aspects of an automated, system-wide materials management information system.Define functional requirements for an automated materials management system.Understand various data and analysis to task forces, departmental personnel, administration, and physicians.Automated MM systems support several functions including the requisition of stock, inventory, as well as non-stock items, purchase order and receipt processing, par level or exchange cart replenishment, and inventory management activities.Computer use in MM consists of broad operations management, with the most important function involving support of planning activities, specifically, computers can plan monthly and annual budgets, inventory, distribution, staffing, equipment, and other requirements.Computers can also be used to track demand issues for special types of equipment and medical devices.It is your resource as well as a mechanism to provide resource support to your customers at all levels.Automated, System-wide Materials Management Information System.Functional RequirementsData Analysis
41Finance 201 Capital Equipment Comprehensive Pricing Annual Objectives Review capital requests for compliance with standardization efforts and contract requirementsEnsure the MM system has comprehensive pricing info instruments, supplies & equipmentAnnual objectives and budgetary recommendations including analysis of budgetary data and coordination of departmental expendituresAutomated financial systemsNon-label budgetary expensesImpact of reimbursementsCost saving programs including equipment maintenance, capital equipment selection and the procurement, inventory management, utilization and selection of products and servicesAsset management programsCapital EquipmentComprehensive PricingAnnual ObjectivesFinancial SystemsBudgetary ExpensesReimbursementsCost-Saving ProgramsAsst\et Management
42Strategic Planning & Leadership 201 Understand how the Material management Department fits into the operational plan of the hospital.Fact vs. fictionMaterial Management & Operational Plans
43Management Management Theories Understand various management theories and the key principles of performance improvement in daily operations (e.g., customer driven, key player involvement, continuous improvement).Customer driven with key players involvement (in a vacuum)It is important for the successful health care material and resource manager to have a renewal process of performance measures. With change occurring so rapidly in our profession, it is essential that we constantly renew our operations. We can not wait for change and then react. We must be proactive change agents. And we must start in our own operations. This change process must be driven by accurate performance measures. Remember: results do matter.Participate in efforts to improve processes (e.g., provide assistance in analysis of process flow; provide operational needs assessment of resources required to provide process improvement).Participate in Performance Improvement (PI) and Environment of Care Committees, and Corporate Compliance programs.You are a resourceDevelop position descriptions and employee responsibilities.Contract between you and your employees; what to expect; no secrets; paperworkDevelop department goals and objectives in concert with the organization's mission and strategic plan.Before you can develop the mission statement for your department, you must first find out the mission and strategic plan for your facility. Every organization has one. Find It. Get a copy. Post it in your department. Why? If this is the plan and the direction in which your facility is headed in the near and distant future, don’t you think it wise to make sure you are headed in that same direction? One simple rule: If what your’ department is doing does not support the mission statement, stop doing it. If you continue, you are only wasting time, energy and resources by going off in the wrong direction. And, you’ll waste even more resources in trying to play catch up. Now, take a look at your own department. Gather all of your employees around the table and ask them, “Based on the facilities mission and goals, what are ours?” Write a simple statement that describes the mission of your department. Make the mission doable and realistic. We’re looking for missions and goals, not dreams and blue smoke. And remember rule number one. If there is a statement in your departmental mission statement that does not support the facility mission statement, it doesn’t belong there. Take it out.Management TheoriesPrinciples of Performance Improvement in Daily OperationsProcess ImprovementCorporate Compliance Programs.Position Descriptions Responsibilities.Department Goals and Objectives
44Human Resource Issues Staffing Requirements Union Compliance Understand the issues connected with the management of staffing requirements and human resource issues (e.g., union compliance, staff training and development).Reengineering the jobUnion shopsTraining and development is your responsibility, part of the job description contractStaffing RequirementsUnion ComplianceStaff Training and Development
45Your Customers Define Customer Satisfaction Plans Communication Links Define customer, Develop customer satisfaction plans, communication ;links, and measurement tools.Who are your customers?Understanding and anticipating customers needs helps the manager to provide service not only to the customer, but eventually to the customers customer. By this I mean that it is necessary to first determine the primary customer level. In most hospital operations, the primary customer of the material manager, is not the patient. It is those clinicians and service personnel who treat the patient. One of the by-products of this recognition is the enabling of the clinician to be more successful with their customer, the patient. In this sense, the right customer may be one or two levels away form the hospital’s primary customer. This is also a good example of proactively responding to the needs and continually improving the performance of the entire supply chain process.DefineCustomer Satisfaction PlansCommunicationLinksMeasurement Tools.
46Do You Know? Uniform Commercial Code Robinson-Patman Act Environmental Protection AgencyDepartment of Transportation (DOT)Hazard Communication StandardContinuous Replenishment ProcessesVendor Managed Inventories (VMI)Safe Harbor RegulationsDemonstrate knowledge of:Uniform Commercial CodediscussRobinson-Patman Acthospital discounts can not be used to compete with retail communityEnvironmental Protection Agency (EPA)Hazardous waste, medical gas (ETO), what others?Department of Transportation (DOT)Waste handlingHazard Communication Standard (HCS)OSHA 1/93 Protection under OSHA's Hazard Communication Standard (HCS) includes all workers exposed to hazardous chemicals in all industrial sectors. This standard is based on a simple concept - that employees have both a need and a right to know the hazards and the identities of the chemicals they are exposed to when working. They also need to know what protective measures are available to prevent adverse effects from occurring.Continuous Replenishment Processes (CRP) & Vendor Managed Inventories (VMI)vendor managed inventory, bar code, automatic, build security up front, used throughout industry, CRP is the process of a supplier managing the inventory of their products in the customer's warehouse(s) based on product movement information provided to the supplier on a daily basis. To accomplish this requires the development of a partnership between the supplier and the customer that is quite different from the traditional approach of customer generated orders.Safe Harbor Regulationsenacted in the 1980’s issued in spells out what a healthcare facility can and can not do regarding purchasing transactions, separation of profit and non-profit transactions, conflict of interests, kickbacks, rebates, referral fees, gifts, etc.. Violations of these federal laws result in major fines and/or prison terms.
47Professional and Regulatory Standards Maintain updated knowledge of relevant professional and regulatory standards and make certain activities conform to these standards and are properly documented:JCAHO, MDPH, OSHA , Title 22all outside influences that impact your job. Know specifics of what impacts you and how it can be an expense driver in your institution.JCAHOMDPHOSHATitle 22
48Your Resources Purchasing/Materials Management Organizations Participate with purchasing/materials management organizations, including GPO affiliationsand local, state, and national purchasing/materials/sterile processing organizations (centralsterile supply organizations).Demonstrate A familiarity with EHCR (Efficient Healthcare Consumer Response).Mission & GoalTo drive the vision for healthcare products supply chain to become:faster more cost-effective more responsive utility basedopen quality-oriented modularized flexible neutralTo have the right product in the right place at the right time in the most cost-effective manner, to efficiently serve the healthcare needs of the end consumer.Purchasing/Materials Management OrganizationsLocal, State, and NationalGPO AffiliationsEHCR