After the recent merger of Mercy Health and Bon Secours to establish one of the largest Catholic health systems in the country, clinicians, infection preventionists and supply chain teams came together for the company’s first clinical standardization summit.
The one-week April meeting looked to reduce supply spending and to drive improvements in quality and patient safety throughout the newly formed health system. Organized by supply partner Medline at its headquarters in Northfield, Illinois, the summit resulted in $2 million in savings for the organization in the way of reducing overlap and unnecessary products.
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FierceHealthcare spoke with Medline Market Director Kyle Hoffmann along with Amy Whitaker, vice president of supply chain integration, and Anne Macy, system director of infection prevention of Bon Secours Mercy Health (BSMH), to learn more about what happened in that first summit and how it paved a way for better patient outcomes.
The clinical standardization included BSMH representatives from 41 locations throughout the Atlantic, mid-Atlantic and Great Lakes regions. Also, two or three clinical representatives from wound care and infection prevention specialties attended, as nominated by BSMH’s clinical leadership.
“We wanted to bring together like-minded specialists within the ministry to discuss clinical needs within specific categories. Understanding the clinical requirements helps supply chain bid the category correctly,” Whitaker said. “Post-merger, it was very important to understand the ‘way forward’ in several categories.”
BSMH had identified 21 categories that were ideal for creating a standardization. Using a request for proposal process, the company narrowed down the search to a few vendors, and, during the summit, were able to make immediate decisions on systemwide standardizations.
The first step in this process was to break wound care and infection prevention representatives into separate groups. Thirteen wound care clinicians from the system met in the first half of the week, and the 13 infection prevention clinicians met later in the week.
“Each team reviewed samples of products category by category and evaluated each individually, so the clinicians could decide which ones they liked best,” Hoffmann said. “The hands-on approach and access to both Medline clinical and product teams provided the summit with great momentum.”
Whitaker notes that the infection prevention team is an important part of any provider supply chain. Infection prevention acts to support the supply chain in meeting organizational goals and evaluating products for efficacy and safety. The goals of product evaluations include choosing products to meet clinical needs, meeting regulatory requirements and supporting patient and employee safety.
During each clinical breakout session at the summit, BSMH’s supply chain team was in attendance to run the numbers and provide a great deal of analysis and pre-work documents that allowed for on-site decisions. Also on hand at the summit were product designers, product managers, clinical teams and quality assurance teams who presented on the categories and products being evaluated. This way teams could ask questions about development, get feedback and see firsthand the outcomes of the clinical programs behind the solutions.
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Hoffmann gave as an example the evaluation of the system’s hand sanitizers. At the meeting, clinicians were squirting them out, rubbing them on their hands, going through the ingredients and looking at pricing. And for the gowns, the team was able to try them on, test them and throw water on them.
“They really put the products they evaluated through a rigorous review,” Hoffmann said. “This was very necessary, as their various regions used different products. As they were all together in one place, the summit allowed the participants to explain how they used specific products, why they felt what they used was the best for the job, and what they use the items for.”
When a product category was introduced, the team asked questions about ingredients, research backing, product designers and whether improvements could be made. Ultimately, the group was able to eliminate some duplication. For example, over 150 different types of lotion were being used throughout the health system before the summit. The committee narrowed it down to nine that covered everyone’s needs.
Macy said that the meeting was an invaluable way to bring together subject matter experts in order to align products and processes to improve patient outcomes—without compromising safety or cost.
“This meeting allowed the infection prevention team to evaluate products more efficiently. They were able to thoroughly evaluate products, verify product claims, evaluate product performance, assess quality and determine overall ease of use to assure safety for our patients and employees,” Macy said.
For example, Macy notes some of the important standardizations that came out of the meeting:
• Central line dressing standardization
• Central line dressing kit standardization
• Hand hygiene product standardization
• Cleaning product standardization
• Urologic product line standardization
• Chlorohexidine skin prep product standardization
• Oral care kit standardization
Hoffmann said that systemwide changes, created at headquarters without regional buy-in, can create adoption challenges or result in clinicians looking for ways to work around using items they feel they are being forced to use or do not do the job adequately. By involving clinicians early on, it gives them a voice in the process, which leads to improved patient outcomes and reduced variability in care.
After each evaluation day ended, the group recapped discussions and decisions and mapped out a plan to bring the information back to their regional sites.
There are many challenges to overcome when uniting the supply chains of two companies. According to Whitaker, one of the biggest issues to address pre-merger was the different enterprise resource planning systems. Data analytics was labor-intensive, as there wasn't one source to pull all data. Plus, different companies can have different cultures and different ways of evaluating analytics.
“Having an interdisciplinary team making the sourcing decisions can be a shift in culture,” Whitaker added.
There were also the challenges associated with prioritizing patient outcomes over cost. In some cases, BSMH chose products that were more expensive because they believe they will provide better patient outcomes. The system knows to consider savings through the lens of reduced infections and reduced readmissions, which are more costly and have a deeper negative impact on their operations.
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“As the industry moves to value-based care, it’s not just about money for products and programs. It’s about patient care and the patient experience. Savings can come from other areas that are not seen in procurement or supply chain budgets,” Hoffmann said. “Health systems need to take a holistic approach when considering what items they use because savings that do not enhance patient outcomes can have a negative impact on other areas. Beyond the supply chain and products, a holistic approach and a long-term view improves patient outcomes.”
When it comes to making decisions about the supply chain, BSMH has an interdisciplinary team comprised of nurses, physicians and chief financial officers along with infectious disease, quality and sourcing staff.
“The clinicians always drive the discussion, but all inputs are considered by the team prior to making a decision,” Whitaker said.
Overall, the teams found great value in the meeting and intend to have at least two meetings similar to this a year.
“Coming together as one voice, Bon Secours Mercy, in a united way towards several very hard contracting categories,” Whitaker said. “It was wonderful to have clinicians actually meet one another. There is so much value in face-to-face encounters.”
There were several top priorities that came to the forefront at the conclusion of the summit.
For the infection prevention team, healthcare association infections such as urinary tract infections and bloodstream infections were a major focus. The health system is moving forward with programs built around clinical infection prevention solutions, which begin with on-site assessments, data sharing, analysis of current infection rates and work to reduce them.
Another priority coming out of the summit was implementing clinical education and training programs for the system’s clinical teams.
“Standardization remains a priority and we are working hand in hand to identify other practice areas where we can continue to drive standardization and cost savings while enhancing patient care,” Hoffmann said.
He noted that a number of changes have already been rolled out. For example, Medline’s divisions and clinicians are executing product launches across the BSMH system so that old products can be switched out quickly and efficiently. And education is underway for any products that need new clinical training.
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Other longer-term actions include bringing in clinical programs such as ERASE BSI—Medline’s bloodstream infections solution—and ERASE CAUTI—Medline’s catheter-associated urinary tract infection solution—which are slated to be fully implemented by the end of the year. The team will gather one year of data to measure the impact and make any necessary adjustments.
Hoffmann said that this was Medline’s first clinical standardization summit built around the more traditional customer visit model. From the feedback they received, the BSMH team loved it and wants to do it again and in other areas, such as for respiratory products.
“Standardization is so important for health systems,” he added. “Calls and meetings work, but take longer, so getting all stakeholders in one room is very beneficial.”