NCAHRMM Spring conference The Implementation of a Value Analysis Committee and the Impact from the Clinical Perspective May 2017 NCAHRMM Spring conference

Health System Introduction 62-bed hospital in Oxford, NC 2 primary care clinics 3 specialty clinics 1 ExpressCare clinic 1 long-term care facility NCAHRMM Spring conference

Prior to Implementation…….. No defined process for reviewing/approving technology or products for clinical efficacy prior to purchase Sales representatives were not required to make appointments and “just showed up” in the OR. Clinicians/Surgeons were approved/given whatever they asked for. No documentation or formal process was in place for trials. Standardization was not a organizationally driven concept. NCAHRMM Spring conference

Steps Taken to Implement…….. The Sales Pitch  We had to get buy in first from The Administrative Council, which is comprised of the CEO, CFO, COO, and two Senior Administrative Directors. By-Laws Granville is a county-owned facility that reports into a Board of Trustees and thus has to follow a set of By-laws so to ensure this committee carried all the weight and backing of the Medical Executive Committee our CEO wrote it into the By-Laws. The Committee Structure  We actually had a little help from Children’s Health System of Texas so we looked at their committee structures and came up with a version that would best fit Granville. Committee Scope  New Item/Evaluation Requests; Clinical Capital Equipment; Standardization or Savings Initiatives Policy & Procedure  In order to role any new Committee or process out in a Hospital you have to have a P&P to go with it! CHST was able to help us out again here with providing us a copy of their policy so we didn’t have to re-invent the wheel and we modified it to fit Granville’s needs. Committee Appointments NCAHRMM Spring conference

Medical Executive Committee Value Analysis Committee (VAC) Value Analysis Process Overview Medical Executive Committee Participants Scope Med Exec Committee Members Physicians (as needed) Materials Management (as needed) Review, approve, or reject decisions recommended by lower-level committees, after clinical, financial and operational impacts are reviewed Provide Oversight and controls on the addition of proposed new services, products, and equipment as well as replacement products/equipment within Granville Health System and to ensure the following is achieved Clinical acceptance and positive outcomes Financial impact analysis and planning Operational impact analysis and planning Regulatory guideline compliance Patient, employee and visitor safety and satisfaction Set policies and procedures for the evaluation of proposed new services, products, and equipment, as well as replacement products/equipment, to examine effectiveness and financial viability, to improve quality outcomes, and to ensure that there is a consistent approach. Recommendations Decisions Value Analysis Committee (VAC) Participants Scope Chief of Surgery CNO CFO (2) Representatives from the Medical Staff Director of Materials Management Clinical Value Analysis Specialist (M/M) All supplies , equipment and services used within Granville Health System with emphasis upon rigorous review of new products prior to use to improve patient outcomes. Chair: Chief of Surgery Facilitator: Director of Materials Management NCAHRMM Spring conference

NCAHRMM Spring conference Lessons Learned…. Communication is KEY!!! There can never be too much communication especially during a conversion, shortage, or stock-out. Watch your patient flow and case schedules during house-wide conversions for units that will be impacted!!! Ex. SCD change out that requires the change out of the disposable sleeves When scheduling education for the units always ask for multiple days (day and night shift) to ensure largest impact for successful implementation during conversions. Ask for visual aids to post on the units as well as any online tutorials that can be posted on the Intranet to refer back to. It is important to have your Nurse Managers and Clinical Leads on board at all times!!! Be well organized and prepared to answer any questions during committee meetings. There should be no down-time during the meetings. You want the physicians/clinical staff to leave feeling that the committee is having a positive impact on your facility and that they are playing an important role in it. Keep them engaged!! NCAHRMM Spring conference

Goals Accomplished by VA Committee Promoted Standardization  Direct impact on Safety and Competencies for Staff Used Cost Accounting Model when reviewing new supplies requested by clinicians Collected adequate physician and clinical input when making decisions on capital purchases Engaged physicians, nurses, c-suite, IC, risk, and supply chain in making the most informed decisions around cost, quality and outcomes for our patient population. Saved money and reduce waste!!!!! NCAHRMM Spring conference

Milestones & Achievements FY2016 Created FTE for the Value Analysis Specialist Position Launched the Value Analysis Committee Reduced inventory in the Central Storeroom by $20K Completed initiatives including standardization of pulse oximetry yielding $43K in savings FY2017 Participated in a Capstone/Premier Physician required Pacer Program (First for GHS!) Completed initiatives including standardization of exam & surgeon gloves yielding $83K in savings NCAHRMM Spring conference

NCAHRMM Spring conference Education……. NCAHRMM Spring conference