A question of supply
Town Meeting held on Tuesday, June 20, brought a number of important questions and problems to the attention of BWH’s top management. One question in particular, posed by Ruth Muller, MSRN, nurse educator, raised the issue of how the patient floors are not receiving necessary supplies. In addition to asking her question, Muller also made several suggestions of how this problem can best be dealt with. The following is the discussion she had with hospital leaders at the Town Meeting:
Q: Ruth Muller, MSRN: My question relates to our Owens and Meyer contract, and what my nurses and I see as a critical problem with supply. As an example, for the last three weeks, we have had a critical problem getting blood tubing, with 100% occupancy and patients that are actively bleeding and have nonexistent platelet counts. When my nurses have to send the PCA or the facilitator off the floor to go either downstairs to get the supply because it’s not stocked, or go to another pod to borrow supplies, we’re losing facilitator and PCA time. The nurses are literally at some points having to prioritize who’s going to get their blood first based on what kind of tubing they have on hand. If it were an isolated incident, that would be one thing. But I had a personal incident last week in which a surgeon had to wait for more than an hour while I went to both ICUs on the 8th floor, 9C, the 11th floor (a cardio-thorassic ICU), only to find that there were no thorochotamy sets available. I then called the OR and the PACU, and lost more nurse educator time. I’m wondering—as we look to things like Owens and Meyer for a more or less stockless system, do we have some kind of quality monitor of how well we’re doing?
A: Anthony Whittemore, MD, chief medical officer: Again, I want to emphasize the generic issues that we’re all facing here. The acuity is up and average length of stay is only 5.2 days, very short for an acute care hospital. We have a 6 percent increase in volume every year and over 100 nurses positions that are available and funded and that we’re actively recruiting for, and there are no signs that things will slow down. We’re having growing pains, and we rely on your input and listen to it to make improvements.
Art Mombourquette, vice president, Support Services: We’re starting to look at how we can better measure how our vendors are doing. In terms of a partnership with them, I don’t think we’ve done all we can to maximize our relationship with them. Part of what we pay them for is our access to their expertise and distribution systems, in helping us set par levels, in helping us manage supplies on the floor, and we’ve challenged them to come to the table and give us the full value for the premium we pay.
Muller: My concern is the frontline folks who are having to do the deliveries. What I would challenge you to do is set up a new system in which Owens and Meyer would use their expertise with distribution to educate the employees who are going to stock the floors with patient populations, and teach them that these supplies are critical products that need to be stocked regardless of what time it is. I’ve found that employees, regardless of whether they’re nurses or physicians or housekeepers, are invested in this place; and if they have a sense and understanding of what they’re trying to do and why it’s important, they will do it differently.