“When we waste dollars through inefficient practices, we are not being good stewards to our patients, our taxpayers or to our EMS mission,” writes Jonathan D. Washko. A reliable, effective and efficient inventory management system can help an organization reduce costs, limit waste, improve employee relations and limit liability.
Learn more in the ESO-sponsored eBook, “Achieving operational efficiency”
EMS agencies – big and small – receive countless boxes of supplies, medications and other disposable goods each month, week or even day. For some, there’s a seemingly revolving door of supplies coming in and going out within any workweek process. For others, you can almost see the dust collect and the expiration date gloomily near as yet another 24-gauge angiocath meets its expiration date.
While some expiration dates might be inevitable (like with your cricothyrotomy kits), and that’s not necessarily bad, it begs us to ask the question of whether or not our logistics process is efficient. Are we minimizing an item’s ability to become expired by tracking its shelf life and rotating it around to busier units before the panic of expiration sets in? Are you overstocking – which, financially, equates to overspending? How much is too much? How much is “too little?”
Thinking about our processes from the field crews’ perspective – the end user – it makes sense to think backwards, using the patient care report (PCR) to track an items’ use.
For busy agencies and systems that aren’t able to do a weekly physical tally in their supply room (or warehouse), it’s imperative to utilize software tools to help you manage your equipment and supply (logistics) stocks in order to maintain any form of efficiency. Once again, boxes come in regularly, but how do you determine what gets shipped in those boxes?
2 scenarios for product rotation
Put yourself in the crews’ boots.
You respond to a call for a respiratory distress patient. In the residence, you don your gloves and medical mask (items #1 and #2), assess the patient and apply a nasal cannula with carbon dioxide collection capabilities (item #3), and then begin treating him with a nebulizer (item #4) with aerosolized albuterol (item #5) and ipratropium bromide (item #6). The patient gets loaded into the ambulance, where you obtain IV access using a catheter (item #7) start kit with included extension set and saline flush (item #8). You upgrade the patient to continuous positive airway pressure (CPAP) (item #9) and acquire a 12-lead ECG for interpretation (patches – item #10). You draw and administer methylprednisolone (item #11) (3 mL syringe – item #12; blunt needle or 18-gauge needle – item #13; alcohol wipe – item #14; saline flush – item #15).
When you think about it, that’s a lot of items – and data. Now, how do you keep track of all of this?
Tracking expiration dates and the usage of supplies, equipment and medications, either immediately upon use, or at the beginning of the next shift, can populate reports indicating which items no longer exist within your system.
While in most cases, it’s the crews’ responsibility to restock the unit, let’s talk about the people behind the curtain – those tracking supply use and placing new orders. With all this information captured in the PCR, it only makes sense for one of two things to happen: the PCR communicates with your supply ordering software, or your PCR generates a report that is your supply ordering list.
The first scenario is quite seamless, as the PCR software immediately notifies your vendor of supply use as soon as the complete button is selected so that a weekly order can be automatically submitted. The second option involves a few more hands-on steps, but nonetheless, it’s still quite an efficient process, as your logistics folks receive an automatic report highlighting all of the consumed equipment for a given time period. From here, your logistics team can verify that what was used has been sent back out to the crews (thus, creating a vacancy to be re-filled on the next supply order). All of this depends upon data. If your crews don’t enter the correct data, then the system can’t analyze the right data (and produce accurate results).
Efficiency is the key to minimizing waste. Yes, some medications and equipment items will still reach their expiration dates, but through an efficient system of tracking and rotating these items, you’re much more likely to reduce the quantity wasted by keeping a more fluid and dynamic (rather than static) system in place.
