1. Supply Chain to Docs: Let’s Talk
Pre Suzette Bouchard-Isackson MSN, RN, NEA-BC
System Director Perioperative Services, Trinity Health
Stephanie Falconer, MHA, BSN, CNOR
Contract Portfolio Director Perioperative Services, Beaumont Health
This is the Title slide
Please do not alter the Track Name

2. FACULTY DISCLOSURE
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:
Stephanie Falconer -- None
Suzette Bouchard-Isackson -- None
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3. LEARNING OBJECTIVES:
Identify techniques for better physician-supply chain collaboration.
Evaluate the unique role of physicians in the healthcare supply chain.
Analyze how to best implement and leverage physician engagement in supply chain.
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4. A call to action!
If clinicians and physicians work together with supply chain experts in reducing health technology and care variation, will health systems see improvements in care delivery and the cost of care?

5. Concentrating on health technology & clinical variation aligns clinical objectives with fiscal realities
The US health care delivery system is experiencing an unprecedented rate of change
CEOs of health systems are expecting clinical leaders to devote time to reducing the cost of care
©2017 Trinity Health

6. Health Systems have variation in health technology, care delivery models, & care processes
Lack of consistent approach directly increases the number and variety of health technologies purchased
Variation in health technology selection is rarely based upon evidence of clinical superiority, more often based upon personal preference
©2017 Trinity Health

7. Reducing the spend on variation is key to margin preservation
Health technology is among the fastest growing category in hospital spending
Deeper level of physician integration is required to meet the changing demands to improve cost, quality, and outcomes of care
Are physicians ready for this challenge?
©2017 Trinity Health

8. Variation in care & health technology increases waste & cost of care
Three areas are emphasized when aligning care delivery and supply chain goals
Variation in care & health technology increases waste & cost of care
Reduce cost of care,
& at the same time improve quality, efficiency, & care
Hayes eBook; Value-Based_Purchasing. downloaded on 5/16/17

9. Inter-Professional Team Improves the Care Experience
Aligned teams provide high quality, safe, efficient care to every patient, every time, at every location
Aligned Care Model
Clinical Team
Supply Chain Team
"It's more than pricing!"
Patient- Centered
Relationship
Collaborative
Partnership
Inter-Professional Team
Improves the Care Experience

10. New models, co-lead by physicians in a dyad/triad model emphasize shared leadership accountability
co-led
supply chain leaders
clinicians
C-Suite
partnership
Finance team support
©2017 Trinity Health

11. CDSC Model intersects with " Clinical Models"
Orthopedics Services Care Team
Heart & Vascular Services Care Team
Surgical Services Care Team
Clinically Driven
Supply Chain
Clinically Driven
Supply Chain
Clinically Driven
Supply Chain
example
©2017 Trinity Health

12. Establishing key tactics & principles supports success with physicians
Assess current state and design future state
Create Structure, determine Processes to achieve goals, develop expected Outcomes with clear accountability
Develop relationships and trust

13. Establishing key tactics and principles supports success with physicians
Recruit key physician leaders to co-lead team
Craft solutions they can implement
Address WIFM
Data, data, data
Develop education and training for all
team members

14. Aligned Care Delivery Model physician leadership & partnership
Aligning with physicians for health technology reform supports use of products that optimize & reduce care variation
Aligned Care Delivery Model
physician leadership & partnership
supply chain leadership & partnership
administrative collaboration
"The challenge for hospitals is to align the supply chain to the care delivery model.”
"Today, health systems must be willing to take risk. They have to be willing to hand over the keys and allow physicians to co-lead these strategies. Physicians will engage when they understand the issues, and it is very important to let them help craft a solution that they can stick to.” (3)
©2017 Trinity Health

15. Testing the premise shows promising results
When clinicians and physicians work together with supply chain experts in reducing health technology and care variation, health systems see improvements in care delivery and the cost of care.

16. Example Shoulder Sourcing Event
Orthopedic Joint and Trauma Sourcing Advisory Team
Subgroup: Shoulder Surgeons
Co-Chairs Dr. Mark Pinto, Marissa Rumble/Kelley Young
Spend: $21 Million
Original Target Sourcing Event Standard Advisory Team: Savings $1 Million
OUTCOME
Sourcing Event with Voluntary Physician Advisory Team: Savings $3.8 Million
CDSCM Structure could have supported achievement of additional potential bid not awarded: $2 Million based on elimination of Vendors

17. Putting the Premise into Motion
Michigan’s largest health system with
$4.5b in net revenue
8 hospitals, 168 outpatient sites
3,400 licensed beds
87 accredited residency and fellowship programs
5,000 staff physicians
35,000 employees
Service Statistics
177,508 discharges
567,658 emergency visits
17,536 births
129,837 surgeries

18. Taking the premise from concept to implementation
Steering Committee
Leadership
Charter
Executive Value Analysis Steering Committee -Create structure Medical Supply Chain Lead -Provide clinical oversight Charter Creation -Develop purpose and guiding principles
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19. Creating the Teams
Using a phased approach, decide what teams should be prioritized for creation and implementation. Criteria for selection must include high spend areas that create the most opportunity to realize early savings.
Surgery
Orthopedics
Cardiology
Laboratory

20. Team Structure
Physician and Hospital Executive Co-Chairs Portfolio Director Supply Chain Support Team Members -Contract Administrators, coordinators, analysts Finance Infection Control Clinical Engineering Quality and Safety Physicians Nurses Inventory Control

21. Guiding Principles Clinically Led Main Drivers System Focused
Evidence Based
Best Practice
Main Drivers
Quality/Safety
Cost
System Focused
Membership
Executive Approvals

22. Physician/Hospital Partnership
Physician leader responsibility
Campus leader commitment
Savings targets
Savings tracking
Confidentiality
Conflicts of interest

23. Goals and Processes
Standardization
New Products
Communication

24. Aligning Physicians Successfully
Shared savings
Program Support
Resident
Support
Capital Equipment

25. Measure of Success
Three program examples: -Total Joint -Spine -Orthopedic Trauma Strategies Awarded vs Non-awarded Compliance savings achieved $7.1M

26. Q&A Slide

27. References
Health Sector Supply Chain Research Consortium Trends, 2014.
Barlow, Rick, Dana; Physician Push vs Pull. Healthcare Purchasing News, January p. 4
Belliveau, Jacqueline; Exploring the Role of Supply Chain Management in Healthcare. Healthcare supply chain management is the regulation of the flow of medical goods and services from manufacturer to patient. RevCycleIntellegence.com/news retrieved 2/14/17
Donatelli, D; Clinically integrated supply chains should surpass evidenced-based design. Healthcare Purchasing News, December 2015, volume 39, No.12.
Advisory Board Company; Enfranchising Physicians in Supply Chain Reform, Best Practices to Achieve Procedural Cost Reduction
Advisory Board Company; Achieving Cost-Savings Goals Through Care Variation Reduction. 2017
Advisory Board Company; Next-Generation Supply Cost Savings
Advisory Board Company; Engaging Surgeons in Cost Control
Advisory Board Company; Partnering with Physicians for Supply Chain Reform
Advisory Board Company; Untapped Opportunities for Saving Millions
Zak, PJ, The Neuroscience of Trust. Harvard Business Review. Jan-Feb p84-90.
©2017 Trinity Health

28. References
12. Donatelli, Dee; Taking Hospital Cost‐Reduction Efforts to the Next Level: Clinically Driven Processes Proven to Improve Utilization and Reduce Costs , Hayes Whitepaper 2013, downloaded on 5/15/ Hayes, Winifred; Evidenced-Value Analysis: Using Scientific Evidence to Drive Quality and Reduce Cost. Practical strategies to simultaneous achieve world-class healthcare quality, improve patient outcomes, and realize cost savings. Hayes Whitepaper 2012 downloaded on 5/15/ Advisory Board Company; Playbook for Consumer-Focused Health System. 2016
©2017 Trinity Health