Centralized distribution cuts costs, boosts service
Staff cross-trained to handle supplies, equipment
A centralized distribution system for equipment, linen, and medical-surgical supplies at Spaulding Rehabilitation Hospital in Boston has dramatically increased services to the treatment floors while keeping the same number of staff.
When David Walsh joined the Spaulding staff as operations manager a year ago, one of his first projects was to centralize distribution services to provide one-stop shopping for the jobs his department covers. At the time, there were 19.9 full-time-equivalent (FTE) employees who worked eight hours a day, Monday through Friday. Nursing supervisors took care of distributing supplies and equipment when the distribution staff weren't working.
Now there are 15 FTEs in the centralized department, five who work on the nursing floors, and service to the hospital has been increased to 24 hours a day, seven days a week. Here are the steps Walsh took to accomplish the change:
o Cross-trained staff. Employees who formerly handled only supplies now can handle linen and equipment as well.
o Created a central tracking database for equipment. When a patient is discharged, operations staff are automatically alerted to pick up the equipment. That means there's always enough equipment on hand, and rentals are unnecessary. The change has reduced the average monthly rental for wheelchairs from $7,000 to $1,100.
o Established a central location for all equipment and supplies. This saves time staff might have spent searching several floors for needed equipment. It also saves money on capital expenses. For instance, the hospital has 70 infusion pumps within a central pool. In the past, each floor had 10 pumps in a supply room. If there were 15 patients who needed pumps, staff would have to borrow five from other floors or rent them.
o Eliminated the on-site stock room for medical and surgical supplies. When Walsh arrived at Spaulding, he found $39,000 in dead inventory sitting in the stock room. By shifting to an adjusted time delivery system, he was able to make a one-time cost savings of $39,000 on inventory.
Now an operations employee assesses each unit daily and transmits an order for supplies by computer to a vendor. The vendor stocks the hospital every day. "We have an arrangement with our vendor. We transmit the order by 7 p.m., the vendor delivers between 12 and 1, and the floors are stocked by 7 a.m.," he says.
The hospital has negotiated a five-year contract with a local vendor for a large percentage of the supplies it buys. Of 472 stock items the hospital uses regularly, it buys 460 from that supplier. "We have a partnership that's a win-win situation for both of us. They know they're going to get our business for five years. We are able to buy in small units at a time for a good price," he says.
Leigh JP, Miller TM. Ranking occupations based upon the costs of job-related injuries and disease. J Occup Environ Med 1997; 40: 1,170-1,179.
Timber cutting and logging operations top the list of occupations with the highest costs for job-related injuries and diseases, according to these researchers. The data are drawn from large nationally representative data sets, using information on occupation categories and workers' compensation costs.
The researchers describe the per-worker cost of job-related injuries and illnesses for six broad categories and 223 specific occupations. "Operators and laborers" is the broad category responsible for the highest total and average cost. Some specific occupations that contributed the most to total costs include truck drivers, nonconstruction laborers, assemblers, retail workers, carpenters, mechanics, press apprentices, welders, stone cutters, and warehouse workers.
Cost and injury data are broken down in several ways, providing different lists of high-injury and high-cost workers. Among white collar workers, for instance, the highest costs are associated with retail sales workers, managers and administrators, sales supervisors, registered nurses, shipping and receiving clerks, secretaries, teachers, and licensed practical nurses.
Information on the relative costs of injuries among different employee groups can be useful when determining the potential need for occupationsl health and vocational rehab services with particular employers, the researchers suggest.
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