Hospital saves by reusing supplies and linen
Changes also improve quality of patient care
Spaulding Rehabilitation Hospital in Boston is saving nearly $350,000 a year and increasing patient comfort by switching from rental and disposable products to reusable ones the hospital has purchased. By creating a centralized distribution services department, the hospital has increased coverage from eight hours a day, five days a week to 24 hours a day, seven days a week with the same staff. (For details on Spaulding's distribution services, see p. 111.)
"Cost savings are very important to the hospital since reimbursement is fixed on a per-case basis. When we cut costs, we also look at the quality of patient care. The changes we made actually increase the quality of patient care," says David Walsh, operations manager.
Under current Medicare regulations, hospitals may be reimbursed for capital expenditures. This also made it advantageous to purchase the products rather than rent them, Walsh says.
Here's how the hospital achieved its savings:
1. Switching from disposable to reusable incontinence pads, washcloths, and precaution gowns. The initial savings is about $130,000 a year, including the cost of purchasing the products. In addition, patients and staff report the reusable products are more comfortable than the disposable ones. Reusable pads also save nursing time because they are easier to change than disposables, Walsh says. The pads are larger and less likely to leak, which means they require less frequent changes and reduce the risk of soiled bed linens, Walsh says.
Also, because of the absorbency of the reusable incontinence pads, hospital policy no longer calls for diapering incontinent patients at night. This decreases the possibility of skin breakdown and keeps patients more comfortable, Walsh says. Cost savings on diapers have not yet been tallied.
2. Buying instead of renting mattress overlays for patients with stage 3 and 4 decubitus ulcers. This saved $96,000. In the past, the hospital was renting 20 to 35 units a month. It bought 40 units to make sure it has enough on hand for peak demand.
3. Reducing the number of products that require hazardous waste disposal. This saved $94,000 a year. The hospital was spending $9,000 a month of biohazardous waste disposal. Now the costs have dropped to about $1,100 a month. The reusable products go through the universal precautions laundry.
4. Switching to reusable needle boxes. This saved $13,000. In the past, the hospital hired an outside contractor to dispose of the hazardous waste containers located in patient rooms containing used needles and syringes. Now the hospital has purchased reusable containers. The closed containers are taken by a vendor to a processing site, emptied, cleaned, and returned to the hospital.
Spaulding purchased a three-day supply of the boxes, also called sharps containers. At any given time, a third of the boxes are being cleaned, a third are in the patient rooms, and a third are in storage as replacements.
How to do it yourself
Walsh suggests these steps for developing a cost-savings plan at your facility:
o First, consult with your nurses and therapists to find out what products they use and how they think the process can be improved.
o Visit other rehabilitation facilities to see how they cut down on equipment and supply costs.
o Since the acuity of patients in rehab is getting higher, Walsh also suggests visiting referring acute care hospitals to find out their practices for patients who have more acute medical needs.
o Create a partnership with vendors who will work with you on cost-reduction ideas. Talk to equipment, supply, and linen vendors. If they don't want to work with you, look for other suppliers.
o Before making any changes, talk to the nurses and therapists again because they are the end-users. Their support will make the cost- saving process work better.
o Once you come up with a way to save, don't rest on your laurels. Look for ways to save more. By working with his vendors, for example, Walsh has come up with another kind of incontinence pad that will save the hospital an additional $30,000 a year.
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