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  1. 1. Product Selection Based on Criteria and Standards Pat Solkshinitz, R.N. Product Facilitator Product Standardization Calgary Health Region Calgary, Alberta, Canada
  2. 2. Calgary Health Region <ul><li>Calgary has 4 acute care hospitals </li></ul><ul><ul><li>Foothills Medical Centre </li></ul></ul><ul><ul><li>Alberta Children’s Hospital </li></ul></ul><ul><ul><li>Rockyview General Hospital </li></ul></ul><ul><ul><li>Peter Lougheed </li></ul></ul><ul><li>Care in the Community </li></ul><ul><li>Healthy Communities </li></ul><ul><li>Regional Warehouse for Inventory Products </li></ul><ul><li>Regional Surgical Specialties Assembly Centre </li></ul>
  3. 3. Regionalization of Health Care Systems in Calgary: <ul><li>Standardization of Practices has led to standardization of products and medical equipment. (see handout #1 “ Definition and Process for Product Standardization and Evaluation”) </li></ul><ul><li>Standardization of products/equipment has resulted in decreased costs and improved quality of patient care. </li></ul>
  4. 4. Standardization of Medical Products and Equipment Recommendations prior to Tender/Purchase <ul><ul><li>Research Technology </li></ul></ul><ul><ul><ul><li>Utilize Clinical Specialists in Product Review </li></ul></ul></ul><ul><ul><ul><li>Research Government Guidelines </li></ul></ul></ul><ul><ul><ul><li>Utilize ECRI Product Reports/Testing Data </li></ul></ul></ul><ul><ul><ul><li>Benchmark with other Institutions or Regions </li></ul></ul></ul><ul><ul><li>Identify current products being used (numbers used, types, brands, specifications) </li></ul></ul><ul><ul><li>Identify Practice (Current and Changing) </li></ul></ul>
  5. 5. Identify Current Products <ul><li>Initial Information Gathering </li></ul><ul><ul><li>how many products are used annually </li></ul></ul><ul><ul><li>who uses the product </li></ul></ul><ul><ul><li>how many products have similar characteristics/specifications </li></ul></ul><ul><ul><li>how many variations/sizes of the product are used </li></ul></ul><ul><li>what is the cost of each product </li></ul><ul><li>obtain samples of all current products </li></ul>
  6. 6. Identify Current Practice <ul><li>Current Practice </li></ul><ul><ul><li>identify steps in practice where the product is utilized </li></ul></ul><ul><ul><li>identify the group of staff/patients that are dedicated to this practice </li></ul></ul><ul><li>Change in Practice </li></ul><ul><ul><li>identify where steps could be streamlined </li></ul></ul><ul><ul><li>incorporate emerging technology that will improve patient outcomes </li></ul></ul>
  7. 7. Research Product Information <ul><li>Benchmark </li></ul><ul><ul><li>with other health facilities/regions </li></ul></ul><ul><li>Research technology using: </li></ul><ul><ul><li>clinical staff members </li></ul></ul><ul><ul><li>clinical publications </li></ul></ul><ul><ul><li>Government Regulations/Standards/Guidelines </li></ul></ul><ul><ul><li>ECRI Testing and Reports </li></ul></ul>
  8. 8. Therapeutic Products Program <ul><li>Health Canada’s Therapeutic Products Program is the national authority which regulates drugs, medical devices and other therapeutic products used in Canada. </li></ul><ul><ul><li>Medical Device Problem Reporting </li></ul></ul><ul><ul><li>Medical Devices Bureau </li></ul></ul>
  9. 9. Medical Devices Bureau Regulations <ul><li>This is a branch of the TPP which monitors and evaluates the safety, effectiveness and quality of diagnostic and therapeutic medical devices in Canada. </li></ul><ul><li>Web Site: (New Medical Devices Regulations - May 27, 1998) </li></ul><ul><ul><li>Medical Device Licence Classifications (see handout #2 “Medical Device Classifications”) </li></ul></ul><ul><ul><ul><li>Class I </li></ul></ul></ul><ul><ul><ul><li>Class II </li></ul></ul></ul><ul><ul><ul><li>Class III </li></ul></ul></ul><ul><ul><ul><li>Class IV </li></ul></ul></ul>
  10. 10. Selection of Criteria <ul><li>Criteria for Tendering Purposes </li></ul><ul><ul><li>current product information/specifications </li></ul></ul><ul><ul><ul><li>size, shape, function, material, packaging </li></ul></ul></ul><ul><ul><ul><li>(See handout #3 “Product Specifications Profile”) </li></ul></ul></ul><ul><ul><li>staff members agreed upon “new” specifications </li></ul></ul><ul><ul><ul><li>may use new/emerging technology specifications </li></ul></ul></ul><ul><ul><ul><li>may use current product specifications chosen as “standardized” product by staff members </li></ul></ul></ul><ul><li>Note any changes to practice with new product criteria </li></ul><ul><li>Note any change in usage related to new product criteria and/or practice </li></ul>
  11. 11. Steps in Product Selection <ul><li>Identify Problem or Need (see handout #4 “Needs Assessment Worksheet”) </li></ul><ul><li>Establish Product Specifications </li></ul><ul><li>Tender Process </li></ul><ul><li>Decision to Evaluate pre or post tender </li></ul><ul><li>Review Evaluation results </li></ul><ul><li>Award Product </li></ul><ul><li>Implement Product </li></ul><ul><li>Re-assess product in 6-12 months post-implementation </li></ul>
  12. 12. Mandatory versus Non-Mandatory Weighted Criteria <ul><li>Establish what the product must do </li></ul><ul><ul><li>if the product does not contain this property - you cannot use it) </li></ul></ul><ul><li>Establish what you would like the product to do that is not mandatory </li></ul><ul><ul><li>these are specifications that are “nice to have” </li></ul></ul><ul><li>Weigh the non-mandatory criteria according to its importance (scale of 1-10) </li></ul><ul><li>Include all mandatory and non-mandatory criteria in the RFP document (see handout #5 and #6 “Mandatory and Non-Mandatory Criteria Sample) </li></ul>
  13. 13. Mandatory Criteria <ul><li>Do not make the mandatory criteria so rigid that there is only once choice of product that could ever meet your needs </li></ul><ul><ul><li>costs can be affected if choice is removed </li></ul></ul><ul><ul><li>supply of product could be limited and sporadic </li></ul></ul><ul><ul><li>potentially you could have no bid responses from vendors (re-tendering time and costs would be involved) </li></ul></ul><ul><li>Ensure that criteria is simple and fully defined </li></ul>
  14. 14. Non-Mandatory Criteria <ul><li>Weigh the specific function so that it best meets your needs and offers you more than one choice of product </li></ul><ul><li>Use a simple scale of 1-10 to keep the results workable </li></ul><ul><li>Ensure that not all criteria is weighted “10” - this will allow for easier identification of “best” product once results are tabulated </li></ul>
  15. 15. Tendering Process <ul><li>Outline specific products, usage, specifications </li></ul><ul><li>Prepare Request for Proposal (RFP) Document based on hospital purchasing standards (see handout #7 “Calgary Health Region RFP” ) </li></ul><ul><li>Ensure timelines are appropriate: </li></ul><ul><ul><li>Responding Vendors have enough time to organize an appropriate bid </li></ul></ul><ul><ul><li>Your Purchasing Department has enough time to organize all of the bids and samples received </li></ul></ul><ul><ul><li>Time is allowed for staff members to review bids and move to evaluation if required </li></ul></ul><ul><ul><li>Time to allow for ease of transition from old to new product </li></ul></ul>
  16. 16. Product Selection Weighting <ul><li>Inform vendors in the RFP that product will be selected based on varying % of the following: </li></ul><ul><ul><li>Clinical Acceptability </li></ul></ul><ul><ul><li>Latex-free Product </li></ul></ul><ul><ul><li>Price and Price Protection </li></ul></ul><ul><ul><li>Value Added Content </li></ul></ul><ul><ul><li>Overall Best Value </li></ul></ul><ul><ul><li>Acceptance of Standard Terms and Conditions </li></ul></ul><ul><li>Percentage used to award product varies - Price is usually 30-50% of equation - clinical can be 50-70% depending on the clinical needs </li></ul>
  17. 17. Organizing Bids <ul><li>Review bids on all levels (i.e. grouping certain products or analyze each single item) </li></ul><ul><li>Analyze current costs versus potential costs related to “grouping” and “single” </li></ul><ul><li>Organize products for review by staff members on a low cost to high cost basis </li></ul><ul><li>Organize and ensure samples of all products are available for staff members to review </li></ul><ul><li>Ensure that all requested “product specification” material has been received by the bidding company (i.e. data relating to product performance, third party research material) </li></ul>
  18. 18. Review of Product Bids <ul><li>Use Staff Member “group” established to assist with this process </li></ul><ul><ul><li>include high use areas, specialty use areas </li></ul></ul><ul><ul><li>Ensure no conflict of interest issues with group members (see handout #8 “Statement of Full Disclosure”) </li></ul></ul><ul><li>Ensure samples of products are available for review and discussion </li></ul><ul><ul><li>hands on review of products is required to make informed decision </li></ul></ul><ul><ul><li>have current product samples available to compare </li></ul></ul>
  19. 19. Review of Product Bids (continued) <ul><li>Systematically review all clinical requirements and how well those are met by the vendors ( do not include pricing during this phase - “best product” to be chosen based on meeting clinical needs first) </li></ul><ul><li>Total up non-mandatory scores </li></ul><ul><li>Establish which product best meets clinical needs based on criteria </li></ul><ul><li>Apply % weighting to this product from RFP document </li></ul><ul><li>Evaluate product selection if required </li></ul>
  20. 20. Evaluation Process <ul><li>Select Appropriate Products for Evaluation (based on need, tender) (see handout #9 and #10 “Evaluation Process Model” and “Product and Equipment Review Questions”) </li></ul><ul><li>Write reasonable, obtainable product criteria </li></ul><ul><li>Target appropriate areas in which to try a new product (include them in the criteria development) </li></ul><ul><li>Write Evaluation Criteria that thoroughly encompasses the important points of the product and its function </li></ul><ul><li>Write Evaluation Forms that are easy to utilize and analyze (see handout #11 “Central Venous Catheter Kit Criteria”) </li></ul>
  21. 21. Forming Evaluation Criteria <ul><li>Obtain information from staff members as to the most important factor/function of the desired product </li></ul><ul><li>Organize the product evaluation criteria from start to finish (turning the machine on to turning the machine off - and include everything in between) (see handout #12 and #13 “Neonatal Cardiac Monitor Evaluation” and “Vital Signs Monitor”) </li></ul><ul><li>Ensure that specific considerations related to its use are evaluated (i.e. the acceptable weight of the product if it has to be carried) </li></ul>
  22. 22. Evaluation Criteria Weighting <ul><li>Add weighting factors to those items that are not considered mandatory but are more important than others </li></ul><ul><li>Weigh the specific criteria/function in relation to its importance (scale of 1-10 with 10 being the most important) </li></ul><ul><li>Allow for “comments” to be made in addition to answering specific questions </li></ul><ul><li>Keep questions as simple and low in number as possible to maintain ease of use/completion </li></ul>
  23. 23. Analyzing Evaluation Results <ul><li>Tabulate all answers and number of responses (see handout #14 “Summary Central Venous Catheter Kit”) </li></ul><ul><li>“ Comments” need to be reviewed and added to final analysis as they will many times verify the “numbers” results (see handout #15 Summary Epidural Tray”) </li></ul><ul><li>Apply weighting factor to those questions that have been pre-selected (see handout #16 “Summary Cardiac Electrodes”) </li></ul>
  24. 24. Analyzing Evaluation Results (continued) <ul><li>Organize summary for presentation to staff members involved in the process (keep it simple) </li></ul><ul><li>Allow staff members to review and make a recommendation/decision based on the results </li></ul><ul><li>Document summary and outcome for review with bidding companies </li></ul>
  25. 25. Award of Product <ul><li>Product awarded based on tender results or evaluation process (see handout #17 “Product Award Sheet”) </li></ul><ul><li>Notify companies and allow for ample lead time to stock product </li></ul><ul><li>Education requirement related to product implementation must be addressed before product is implemented </li></ul><ul><li>Changes to policy/practice must be in place </li></ul><ul><li>Important to use up old product before implementing the new (as time will allow) </li></ul>
  26. 26. Award of Product (continued) <ul><li>Communicate decision of product award to all users of current products involved </li></ul><ul><li>Ensure all necessary “parts” have been awarded for use with the product (i.e. disposable associated with equipment) </li></ul><ul><li>Prepare cost analysis related to product award for period of contract term </li></ul><ul><li>Ensure that “alternate” products have also been chosen by this group (i.e. acceptable substitute products if required for backorder situations, manufacturing problems, etc.) </li></ul>
  27. 27. Follow-Up Post Implementation/Award <ul><li>Assemble updated usage and cost information data on products 6 to 12 months post-award </li></ul><ul><li>Communicate with departments using new product/equipment as to satisfaction level </li></ul><ul><li>Clinical Engineering review of awarded equipment (repairs, etc.) </li></ul><ul><li>Review findings with Vendor - make any changes as necessary (i.e. number of supplied products/equipment needs to increase) </li></ul>