Getting Past the Efficiency-Expert-Lingo
While the OHS white paper describes the process in efficiency-expert-lingo, what is most marvelous is how well it seems to work, in language anyone can understand. For example, these lowest-costsurgeons were wasting 76% of the surgical trays they ordered. OHS was able to cut their orders of surgical trays down from seven per TKA to two, with no adverse impact on patients, the white paper says.
“On a typical day, where three surgeons perform four cases each, the new process will save central sterile 60 trays. Furthermore, the risk of loss and breakage is reduced. OHS avoids surgical case delays by owning and keeping instruments at the facility, whereas in the traditional model, instruments are often shipped overnight from all over the country to match schedules,” the white paper says.
Overall savings for the surgeons in the test group came to 22%. The savings rose to 29% when factoring in post-process costs and applying that to the entire group of OHS surgeons doing TKAs.
The Cost of Chewing the Fat With Sales People
The OHS white paper implies, but doesn’t precisely say, that a major cause of waste is letting device and supply salespeople chew the fat with physicians. It does say of these vendor sales people that “Preoperatively, intra-operatively, and postoperatively,” they were found to be deeply involved in:
- Product training/education
- Scheduling coordination/communication
- Surgeon case review
- Instrument trays assembly
- Room/cart setup
- Guidance of OR staff
- Instrument cleanup coordination
- Reassembly of used/clean instruments
- Inventory management
OHS took the vendor sales people entirely out of the loop for the surgeons involved in the study and assigned some of the tasks above (after training) to surgical technicians, elevating their job titles to “surgical specialists.” These specialists did some of their work using the SIGHT Medical software in the surgical suite.
“It should also be noted that while the new surgical specialist role produced new responsibilities, it was not necessary to add additional full-time equivalents (FTEs),” the white paper says.
“With the ability to remove the sales representative from the process, OHS could leverage and negotiate a hospital direct price point for knee implants, resulting in significant savings for each case,” the white paper says. The software also allows OHS to see inventory on hand using the software.
As an orthopedic implant representative for better than 30 years, I feel it necessary to reply to the above study, specifically; The Cost of Chewing the Fat with Sales People. After listing all the many functions the company representative performs, and then attempting to eliminate that one person, to me makes no sense. What appears to be completely ignored, is; most, if not all company reps are well trained professionals, providing an invaluable service to not only the surgeon, but also the hospital staff, whether it be in the operating room, central sterile supply, or wherever they are needed. Its then stated that the surgical techs, whom I’ve found to be excellent, are assigned some of the reps tasks. Its important to know; what training, and by whom? Most likely, not the in depth training provided by the implant companies to their reps, but I could be wrong, I believe this to be a serious omission. Now, I’m fully aware of the need to look at all costs associated with joint replacement, however in my opinion,value needs to be part of the equation also.