357 - Implant Management – Leveraging Online Collaboration and Automation to Expedite Inventory Replenishment
Clinical Issue: In July 2018 Cardiovascular Surgery (CVOR) began a pilot program and implemented a perpetual inventory management system for all sterile and non-sterile supplies including implants and allografts. The pilot program goals: drive consistent supply availability, minimize excess inventory, and realize true cost accounting. April 2019 CVOR canceled a cardiac surgery because an implant was not available.Description of Team: CVOR Nursing Staff, Cardiac Procedural Clinical Director, and Procedural Supply Chain Coordinator (PSCC)Preparation and Planning: The PSCC and CVOR nursing staff conducted a root cause analysis in May 2019 to identify causes which directly and indirectly lead to the cancellation of a surgery in April 2019 due to an implant not being available for the procedure.
Assessment: The PSCC and CVOR nursing staff assessed the implant management system and created a value stream map. The team highlighted two key areas for improvement: 1) increase transparency and accessibility of the implant inventory, and 2) reduction in the replenishment timeframe of greater than forty-eight hours to twenty-four hours.Implementation: The PSCC created a list of all cardiac implants and validated the implant list against the organization’s unique device identification (UDI) management system. The PSCC developed an online collaborative spreadsheet program in cooperation with the CVOR Nurse Coordinator and Cardiac Procedural Clinical Director. All CVOR nursing staff, cardiac surgeons, and other members of the Procedural Supply Chain department were provided training and full read-write access to the online implant inventory. The PSCC created multiple automation features to notify departments of key changes made to the implant inventory including but not limited to use during a procedure signaling the need to reorder, implant expiration, and implant backorder.Outcome: Implementation of the online implant inventory immediately changed the level of transparency in implant availability going from one to two staff members having first-hand knowledge of what implants are available to the entire value stream knowing at any given moment what implants are available. Surgeons are able to effectively pre-plan for implant procedures and can pre-select the exact implant(s) needed for their case. The replenishment timeframe from the point the implant is used intraoperatively to the point it is restocked to the shelf has decreased from greater than forty-eight hours to less than twenty-four hours.Implications for Perioperative Nursing: Online collaboration and automation are rapidly becoming the norm in patient care environments such as the Cardiac Surgery Operating Room. This project highlighted the need for on-going partnership between interdisciplinary teams such as Cardiac Surgery and Supply Chain to leverage online collaborative tools and automation in order to achieve success in a high risk patient care environment.