Driving Out Waste and Inefficient Use with Value Analysis

by Shaneka N. Demps, RN, BSN, MHSc, CIC, CVAHP

Manager, Value Analysis, BayCare Purchasing Partners LLC

Big Savings and Quality Improvements with Inflatable Patient Positioning and Transfer Devices

It is amazing how value analysis works as a great tool and process to drive positive change in our healthcare organizations. This case study was first presented at AHVAP’s 2022 Annual Conference as a best practice which got great feedback from the AHVAP VA community and was shared on LinkedIn to help spread the educational points further. That is where Healthcare Value Analysis & Utilization Management Magazine reached out to me to ask me to write an article about this best practice to share with the entire supply chain world. There are many take-aways from this article as well as value analysis and utilization challenges that are addressed here.

Inflatable Patient Positioning Devices – BayCare Health System, Clearwater Florida – Value Analysis Department

Like so many value analysis departments, we handle the efficacy and value reviews on new product requests (NPRs) for BayCare Health System. One major project that went through our VA process in 2017 was inflatable positioning/transfer devices. The primary function of the devices was to reduce a major issue going on in the health system which was back injuries to the clinical team members during patient positioning events. The secondary function we identified was to position the patients and reduce sacral pressure injuries, reduce shearing, and offload pressure on patients. Given the fact that an injury to clinical colleagues is a very serious issue and knowing there was a better way to ensure that patients are positioned properly, we set to the task.

The value analysis team set the target scope for the use of this product and the need for the use and the optimal outcomes that we were looking to achieve during the review and efficacy value analysis process. The new systems were trialed and deployed but there did not seem to be any change in the outcomes with clinical team injuries or with patients having improper positioning issues. However, we did see the costs skyrocket on these products.

Retrospective VA Reviews are Necessary Components to Have in Your Toolbox

Given that the cost of these inflatable positioning/transfer devices had climbed to over $5.2 million after two years of use, things clearly had gone awry with the utilization of these devices and the value analysis department was now tasked to address it. It just goes to show that you can do everything right in your value analysis process, but it is the end clinical customers who use these products and that is where challenges occur. The issue was that the costs were climbing exponentially but there was little or no reduction in clinical team or patient positioning issues. A retrospective value analysis review was required by the value analysis team.

Winning Value Analysis Steps to Save 64% or $3.4 Million Annually

We were a bit taken aback by the amount of overspend that had occurred on a value analysis project, although since this is a big system, overspend tends to be higher than most which is why there is a value analysis department to address these very issues. These products continued to be used while the value analysis review was performed which allowed the value analysis team to analyze the use patterns and outcomes of the products much better than we had with a new product request back in 2017.

• Gained C-Suite Support and Engagement?– The product was used system-wide, and many clinical staff really liked using this product, which necessitated the support of senior leadership as this project could have easily been shut down. Given the dollar figure of waste, it was most important to have executive leadership’s backing.
• Knowing the Eye-Opening Facts?– We needed to know how effective the current product mix was with relation to clinical injuries as well as patient positioning issues within the health system. Interestingly, it was found that the current patient transfer devices did not perform as originally intended.
• Engaging Wound Care Clinicians and Nurse Leaders?– When we did the first value analysis review on the inflatable transfer devices when they were new product requests, we were not as astute as we are today with regard to decubitus care at the patient bedside. We identified the correct patient population and developed an action plan for use of these devices.
• Educated the Key Clinical Staff?– Hospital nursing units are unique in that each shift holds a quick huddle to go over safety measures, important protocols, and alike every day that are key to optimal patient outcomes. The VA team set up the huddles on the nursing units for success by providing them with new criteria and preferred alternative tools for patient transfer.
• Supply Chain Participation was Vital?– Once we knew what we were dealing with, the supply chain department jumped into action and adjusted par levels on lower-level units to zero on units that should not be using patient transfer devices at all. They then centralized the product location so they would be available with approval only or emergency use. Only ICU units were able to have a small supply of the patient transfer devices on hand.

Game-Changing Results with This VA Review

As a result of this value analysis review, the health system was able to save $3.4 million on a previous $5.29 million spend for a 64% annual savings which was huge. The bottom line here was that the patient positioning devices were significantly and inappropriately being over utilized. They were not reducing clinical team injuries nor were there any measurable patient improvements with the use of the devices. It took a retrospective value analysis review to uncover these cost, quality, and outcome game changers.

This Was a Team Win for Value Analysis

I am very proud of our team who worked on this value analysis review which included Ronald Colaguori and Rich Frankenfield in our Executive Leadership Team that trusted the VA process to make this successfully happen. We could not have done this work without the assistance of our Senior Analyst, Mark Warden, and his impeccable data throughout this project. Lastly, thank you to Rosaline Parsons, RN, for instilling it all.

This was a study that had every element of value analysis, functional analysis, and outcomes review that helped the health system to achieve so much. BayCare now has $3.4 million added back to their bottom line and a lot less waste of inflatable patient device products and associated products that are used with them. Tons of landfill waste was avoided in this process. Lastly, the BayCare team members saved time by not having to inventory and coordinate so many products throughout the health system. Everyone wins with this one!

About BayCare

BayCare is a leading not-for-profit health care system that connects individuals and families to a wide range of services at 15 hospitals and hundreds of other convenient locations throughout the Tampa Bay and central Florida regions. Inpatient and outpatient services include acute care, primary care, imaging, laboratory, behavioral health, home care, and wellness. Its mission is to improve the health of all it serves through community-owned health care services that set the standard for high-quality, compassionate care. For more information visit?BayCare.org .

See the Article in the Magazine Format here

View all the articles from this issue at www.ValueAnalysisMag.com