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Linens, Patient Apparel, And Hospital Acquired Scrubs And Uniforms
 

Linens, Patient Apparel, And Hospital Acquired Scrubs And Uniforms

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    Linens, Patient Apparel, And Hospital Acquired Scrubs And Uniforms Linens, Patient Apparel, And Hospital Acquired Scrubs And Uniforms Presentation Transcript

    • Translating Your Hospital’s Data into SCMetrix™ Format Vicki Smith-Daniels, Ph.D. Department of Supply Chain Management Contact Us: [email_address]
    • Agenda
      • How to translate data into the required SCMetrix™ format
      • Strategies for making informed decisions on which level of benchmarking is most appropriate for your hospital
      • How to make an informed decision on whether to estimate a data field or insert a missing value indicator.
      • Specific procedures for estimations; common conversion problems will be covered through illustrative examples
      • Suggestions on how to collect additional data in the future
    • Benchmarking Participation Total Supply Expense Total Purchased Services Revenue Total Non-Labor Expense Adj Operating Exp Rebates Surgical Pharmacy Diagnostic Radiology Outpatient Oncology Clinical Laboratory Emergency Obstetrics Dietary Orthopedic Cardiac Cath Interventional Radiology Surgical: Joints, Implants, Stents, etc. Medical: Respiratory, Infections, etc. 1 Facility 2 Departments & Service Lines 3 High Supply Intensity, High Volume DRGs (Optional)
    • SCMetrix TM Data Collection Toolkit Review all tabs from left to right Record data in spreadsheet Online submission of hospital profile Online submission of financial, operational, and supply chain structure Data Definitions Provided in Spreadsheet
    • Guidelines
      • Follow AHRMM-HFMA supply expense definition
      • Include all supply expenses for which your hospital receives revenues
        • Inpatient, Outpatient, and Emergency
      • Allocate supply expenses in the department in which they were used
      • If actual data is not collected for a specific department /service line
        • Estimate data fields when departments/services lines are either significant revenue drivers and/or high supply expenses areas.
        • Input missing value when some department/service line data is not available and/or cannot be estimated
    • Adoption of the Industry Standard Standard Supply Expense Definition The net cost of all tangible items that are expensed including freight, standard distribution cost, and sales and use tax minus rebates. This would exclude labor, labor related expenses, and services as well as some tangible items that are frequently provided as part of service costs. SCMetrix™ benchmarks Total Delivered Cost
    • Customizing Your Hospital
      • Every hospital has these departments in SCMetrix™
      • Clinical Laboratory
      • Housekeeping
      • Inpatient Pharmaceutical
      • Inpatient Surgical
      Identify only departments/service lines for which you will be providing data
    • Questions Continue to send your questions through the chat feature Questions will be answered throughout the webinar or Responses sent after the webinar session
    • Case Studies
      • Community Hospital of Spartanland
      • Valley of the Sun Hospital
      • Napa Valley Medical Center
      • Hypothetical Case Studies
      • General Ledger Codes
      • Different Data Types
      • Frequently Asked Questions
    • Case Study Community Hospital of Spartanland
    • Hospital Profile
      • 63 Bed General Medical-Surgical Hospital
      • Top 5 Service Lines By Revenue
        • Obstetrics
        • Cardiovascular
        • General Medicine
        • Orthopedics
        • Respiratory
      • Departments/Services Offered at the Hospital
        • Emergency
        • Obstetrics
        • Orthopedic
        • Outpatient Services
        • In-house Dietary
    • Thoughts and Questions I’m entering a maze with no end in sight Can I benchmark with SCMetrix™? My hospital does not: Allocate rebates to the actual spend Allocate freight to departments Collect inventory data in all departments Level 1 Appears to be the Right Level of Participation
    • Spartanland’s Information Sources Product Category Supply Expense Reports Financial Statements DRG Reports Procedure Data AHA Annual Survey Rebate Reports Department Managers SCM Manager Distributor Representative Financial Operational Supply Chain Structure Hospital Profile
    • Total Facility Supply Expense: Components
      • Components
        • Surgical Supplies
        • General Medical
        • Drugs/Pharmaceutical
        • Lab Supplies
        • Oxygen and Related Medical Gases
        • Radiologic Films and Chemicals
        • Dialysis Supplies and Fluids
        • Linens, Patient Apparel, and Hospital-Acquired Scrubs and Uniforms
        • Dietary Products
        • Housekeeping/Cleaning Supplies
        • Office Supplies
        • Freight Associated with Any Supply Item
        • Standard Distribution Fees
        • Supply Component of Outsourced Contracts
        • Supply Component of any Equipment Rental or Lease
        • Sales Tax
        • MINUS: Rebates
      • Make Total Facility Supply Expense as accurate as possible
        • Exclude specific supply expenses
        • Input Actual or Estimate for each component
        • SCMetrix™ automatically calculates total supply expense based on the data fields
      Goal Supply Definition from AHRMM/HFMA Total Facility Supply Expense
    • Translating Into Supply Components
      • Guidelines:
      • All product supply/price data should be allocated into a supply expense category
      • If appropriate category cannot be identified, assign to General Medical Supplies
      • If product supply data includes acquisition price, freight, and distribution fees, then record total amount in category
    • Computing Total Delivered Cost
      • Guidelines:
      • Provide total freight and distribution fees if not included in product supply/price data.
      • Include sales tax based on state policies for goods and service purchases.
      • Include rebates for all purchases made during the benchmark period.
    • Calculating Rebates 1/1/07 7/1/07 1/1/08 Goods Purchased Rebate Received Rebate Received Rebate Received Guideline: Report rebates associated with the spend during the benchmarking period Estimation: Sum actual rebates received during the benchmarking period plus pending/projected rebates or Estimate total rebates using actual average rebate rate of your total spend on contract for 2007
    • Department Supply Expense Data Collection Total Delivered Cost For Dept Supply Usage Including Dept Specific Supplies General Medical Supplies Office Supplies Freight Standard Distribution Fees Supply Component of Rentals/Leases Sales Tax Rebates
    • Department Freight Example: Clinical Lab
      • Available Data
      • Spartanland does not collect freight at the department /service line level
      • All other clinical lab supply expense data available
      • Estimating Freight Expense
      • Estimate facility freight as a percentage of total supply expense : Freight/Total Supply Expense = 1.2%
      • Clinical Lab Supply Expense Without Freight: $200,460
      • Compute Freight Using the Following Equation
          • Total Clinical Lab Supply Expense = Freight + $200,460
          • Clinical Lab Freight = .012*Total Clinical Lab Supply Expense
          • Total Clinical Lab Supply Expense = $202,895
          • Clinical Lab Freight = $2,435
    • Product Delivery Data
      • Insert missing value 99999999999 (11-9’s)
      • Cannot benchmark these metrics
      Inventory Turns Central Stores Central Supply Clinical Lab Pharmacy Inpatient Surgical Inventory Value Central Stores Central Supply Clinical Lab Pharmacy Inpatient Surgical Consignment Inventory Clinical Lab Pharmacy Inpatient Surgical On-Time Orders Central Stores Central Supply Clinical Lab Pharmacy Inpatient Surgical
    • Revisiting Level of Participation
      • Top 5 Service Lines By Revenue
        • Obstetrics
        • Cardiovascular
        • General Medicine
        • Orthopedics
        • Respiratory
      • Departments/Services
      • Offered at the Hospital
        • Emergency
        • Obstetrics
        • Orthopedic
        • Outpatient Services
        • In-house Dietary
      Benchmark Obstetrics
      • Service line supply expenses available for
        • Surgical supplies
        • General medical supplies
        • Drug/ Pharmaceuticals?
      Yes, Include in the Hospital Profile Total supply expenses for obstetrics INCLUDES surgical supplies, general medical supplies, drugs/pharmaceuticals, office supplies, freight, standard distribution fees, supply component of any rental or lease, sales tax MINUS rebates.
    • Questions Continue to send your questions through the chat feature Questions will be answered throughout the webinar or Responses sent after the webinar session
    • Case Study Valley of the Sun Hospital
    • Two Critical Estimation Issues Valley of the Sun Hospital provides extensive outpatient services Problem: Supply expenses for inpatient and outpatient services combined together in supply reports Valley of the Sun Hospital receives sizeable rebates Problem: Rebates tracked at facility level and needs to be allocated to strategic department/services lines
    • Estimating Outpatient Supply Expense
      • Estimation Procedure:
      • Estimate the outpatient adjustment factor as the % of revenue from outpatient services
        • Outpatient Revenue/Total Revenue
      • Compute the adjusted supply expense facility
        • Remove oxygen, linens, dietary, and housekeeping supply expenses
      • Calculate Outpatient Supply Expense
        • Adjusted Supply Expense * Outpatient Adjustment Factor
      Total supply expenses for outpatient services INCLUDES surgical supplies, general medical supplies, lab supplies, drugs/pharmaceuticals, dialysis supplies and fluids, office supplies, radiological films and chemicals, freight, standard distribution fees, supply component of any rental or lease, sales tax MINUS rebates. Outpatient Supply Expense
    • Other Methods: Inpatient and Outpatient Estimate outpatient if greater than 40% of revenue
      • Facility Metrics
      • Supply Expense Per Adjusted Patient Day
      • Supply Expense Per Adjusted Discharge
      Facility Revenue Metrics Net Inpatient Revenue Per Inpatient Days Outpatient Revenue as a % of Patient Revenue Outpatient Revenue per Total Outpatient Visits
    • Allocating Rebates Across Departments: Inpatient Surgical Example
      • Available Data
      • Facility rebates = $146,000
      • Product category acquisition prices
        • Supply expenses minus freight, distribution, sales tax, and rebates
      • Estimation Procedure
      • Compute total facility acquisition spend for all categories
          • Sum of surgical, general med, pharmaceuticals, lab, oxygen, radiological films, dialysis, dietary, linens, housekeeping and office supplies
      • Estimate inpatient surgical acquisition spend available for rebates
          • Calculations same as (1) but only for rebate-eligible inpatient surgical spend
      • Calculate inpatient surgical rebate estimation factor as % of inpatient surgical acquisition spend/total facility acquisition spend
          • Inpatient surgical acquisition spend/total facility acquisition spend = 13.6%
      • Estimate inpatient surgical rebates
          • Facility Rebates * Inpatient Surgical Rebate Estimation Factor
          • $146,000 * .136 = $19,856
    • Questions Continue to send your questions through the chat feature Questions will be answered throughout the webinar or Responses sent after the webinar session
    • Case Study Napa Valley Medical Center
    • Thoughts and Issues Full Implementation of Level 2
      • Issues:
      • Products used in multiple depts .
      • General Medical products not allocated to all depts.
      • Integrated Information System
      • Service Line Management
    • Issue #1: Assign Based on Where It Is Used
      • Departmental/Service Line Expenses
        • Put specific device cost in one place
          • Cardiac Cath Lab Supply Expense (with Intervention), or
          • Inpatient Surgery Supply Expense
      • Total Cardiac Implant Supply Expense
        • Sum all implants used in Cardiac w/ Intervention and Surgery
        • INCLUDES implant purchase cost, freight, standard distribution fees, sales tax MINUS rebates
      Hospital 3 Surgery Hospital 2 Cardiac w/out Inter Surgery Hospital 1 Cardiac w/ Inter Surgery Example: Pacemaker Implants Assign to location used
    • Issue #2 : Allocate unassigned supply expenses as a percentage of the directly traceable departmental supply costs Example: Assume that the cost of unassigned general medical supplies is $200,000 and that $800,000 in total facility acquisition spend was directly traceable to the following four departments/service areas. General/Medical Supplies Rate = $200,000 / $800,000 = 25% of Direct Supply Cost Facility Level Unallocated Acquisition Spend Allocation Rate Total Facility Acquisition Spend = Include only acquisition spend in the assignable supply expenses. Exclude freight, distribution fees, sales tax, and rebates in the assignable calculations. Inpatient Surgery Assignable = $ 400,000 x 25% Allocated G/M = $100,000 Pharmacy Assignable = $120,000 x 25% Allocated G/M = $30,000 Emergency Assignable = $200,000 x 25% Allocated G/M = $50,000 All Other Depts. Direct Cost = $80,000 x 25% Allocated G/M = $20,000
    • Questions Continue to send your questions through the chat feature Questions will be answered throughout the webinar or Responses sent after the webinar session
    • Take Aways and Going Forward
    • Learning Curve: Data Collection 1st Half 2007 Significant Upfront Investment in Identifying Data Sources 2 nd Half 2007 Incorporate Data Validation Feedback 1 st Half 2008 Anticipate Greater Dept/SL participation 2 nd Half 2008 Processes In Place
    • Take Away 1: Multiple Information Sources Product Category Supply Expense Reports Financial Statements DRG Reports Procedure Data AHA Annual Survey Rebate Reports Department Managers SCM Manager Distributor Representative Financial Operational Supply Chain Structure Hospital Profile
    • Take Away 2: Use Missing Values
      • If you want to benchmark some departments but do not have all data available
        • Financial
        • Volumes
        • Inventory
      • Use the missing value data field
        • 11 – 9’s
      • If you do not have department procedure data, there is little value in benchmarking that department/service line
        • Do not select the department/service line in the Hospital Profile
      • If you are benchmarking at Level 1 and do not have the required department data
        • Insert the missing value data field
    • Take Away 3: Use Estimation Procedures
      • Allocating facility total delivered cost components to departments/service lines
        • Freight
        • Standard distribution fees
        • Sales Tax
    • Take Away 4: Not Included Expenses
      • Review supply expenses not included in the AHRMM-HFMA definition
    • Going Forward
      • Send unanswered questions to
        • [email_address]
      • Record estimation procedures in toolkit and submit to [email_address]
      Good to Go 1st Half 2007 2nd Half 2007