11 cost-saving tips that work from your peers
(Editor’s note: In this final part of a two-part series, we share some of the best cost-saving ideas we picked up at this year’s Same-Day Surgery Conference, held June 8-10 in Atlanta. If you’d like to hear other great ideas, don’t miss the repeat conference, which will be held Nov. 2-4, 1997, at the Ritz-Carlton, Huntington Hotel in Pasadena, CA.)
Want to save money? Get your physicians to standardize the vendors your program uses. Grant Eye and Ear Hospital in Columbus, OH, narrowed its vendors to two. Those two companies made a presentation to physicians at a dinner meeting, says Cheryl A. Sangermano, RN, BSN, CNOR, director of the hospital’s operating room, post-anesthesia care unit, ambulatory surgery center, and laser center.
"Get your docs involved," Sangermano advises. "Once you get their buy-in, you’ll have a much easier process."
One final vendor was selected, and that vendor combined lenses and packs into a bundle. The result was a $350,000 savings over 18 months. For example, lenses that previously sold for $300 and up now could be purchased for $100 or less.
Here are 10 more cost-savings ideas from your peers:
1. Post the cost of items once a week or once a month in a place where your staff can see them. "Keep your staff informed," Sangermano suggests.
Promina Gwinnett Health System in Lawrenceville, GA, has taken that idea one step further. When a staff person drops an item and it can’t be used, it is thrown into a box, says Vangie Paschall, RN, CNOR, laser endoscopic coordinator in the surgical services division. Paschall brings those items to an inservice and hands out products comparable in price, such as eggs and detergent. This simple exercise brings the concept of cost-consciousness to life, she says.
2. Standardize preoperative eye drops and reuse eye drop bottles. Standardizing the number of drops resulted in a savings of $75,000 per year at Sangermano’s facility, with a $14 savings for each patient, she says.
3. Use Autopaks. These large, heavy peel packs with a clear plastic top are available from Ongard Systems in Hauppauge, NY. (See source box, below right.)
"You can see what’s in there instead of opening three or four," says Jocelyn King, RN, MHSA, director of surgical services at Columbia Portsmouth (NH) Regional Hospital and Pavilion. The product resists tearing and cuts down on wrapping time because it is a one-layer wrap, King says.
4. Put your physicians on a rotating schedule to sit down with the staff in the lounge and discuss potential areas for cost savings. Include the recovery room staff and the front desk, suggests Terri Gatton, RN, CNOR, director of surgical services at Columbus (OH) Eye Surgery Center.
"It took six months to get the doctors to show up and help the staff overcome their fear of discussing operational issues," she says. But the payoff has been worth the wait, she says. For example, different lower-cost viscoelastics were added due to staff suggestions.
5. Reduce your draping cost. Gatton reduced her cost per procedure from $65 to $12 by eliminating items in the core pack and eliminating the use of custom eye drapes. Gatton uses the outside packaging from the core pack as a drape that catches fluids under the operative side of patients’ heads. These steps saved $45,000 in one quarter.
6. Reprocess single-use surgical instruments and supplies. Network with companies that reprocess surgical instruments, Gatton advises. (For more on reprocessing single-use instruments, see legislative update, p. 119, and Same-Day Surgery, June 1997, p. 69.)
For example, you can reprocess and reuse a control top component that clips to the syringe, instead of control syringes, which are expen-sive. The cost savings for the last half of 1996 was $5,000, Gatton says.
Columbia Gulf Coast Hospital reduced the cost of its sutures by 50% and saved $4,500 in one year by reprocessing opened but unused sutures, says Angela Marchi, RN, MS, administrative director of business development at Columbia Gulf Coast Medical Center in Panama City, FL.
7. Examine your postoperative and discharge processes. Jan Odom, MS, RN, CPAN, a clinical nurse specialist in surgical services at Forrest General Hospital in Hattiesburg, MS, and president of Nursing Solutions, a perianesthesia education and consulting company, says some patients may be able to be discharged directly into recovery, thereby bypassing the more expensive main postsurgical recovery room. (For more information, see SDS, October 1996, p. 109.)
In addition, voiding may not be necessary for all procedures, she says. Re-examine your discharge criteria, Odom advises. (For more information on voiding before discharge, see SDS, October 1996, p. 111.)
8. Compare the prices of your vendors. Gatton has found good prices with Allergan Medical Optics in Irvine, CA. (See sources, p. 109.)
9. Use reusable supplies, such as washable vinyl pillows, instead of disposable ones. Baptist Regional Medical Center in Corbin, KY, saved $51 per patient with reusable pulse oxi-meters, says Brenda Patterson, LPN, outpatient surgery nurse. The hospitalwide savings was $35,000 to $40,000 per year.
10. To encourage efficiency, offer "service shares" to your staff for steps they achieve. Achievements may include reductions in length of stay, reductions in lost charges, and increases in patient satisfaction, all of which affect the bottom line.
Baptist Regional has a hospitalwide program that rewards employees based on whether their positions are full time or PRN, and the number of hours worked in a year. The program was part of the hospital’s preparation for managed care, says Teresa Hopkins, RN, who works in the medical center’s recovery room.
In addition, staff members are given $100 for submitting ideas that improve efficiency. One suggestion was to substitute the flow meter adapter for aqua packs that many patients use. The savings to patients was more than $1,200 a year ($75 per patient).
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