Kevin Downs, Director of Finance and Performance, Derby Teaching Hospitals NHS Foundation Trust

1. Kevin Downs, Director of Finance and Performance, Derby Teaching Hospitals NHS Foundation Trust
Implementing GS1 standards in theatres:
Improving patient outcomes, efficiency and finance benefits
12 April 2016

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Implementing GS1 standards in theatres:
Improving patient outcomes, efficiency and finance benefits
Derby Teaching Hospitals NHS Foundation Trust

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Derby Teaching Hospitals NHS FT –
Facts About Our Hospital
• The Royal Derby Hospital is the newest hospital in the East Midlands
- £334 million has been invested in the development
- Annual budget of around £475million
• Officially opened in April 2010 by Her Majesty The Queen and His Royal Highness The Duke of
Edinburgh
• We now care for more than 180,000people as inpatients, outpatients, emergency patientsand
day cases
• This equates to around 625,000visits from patients each year
• There are 1,159 bedsin our 50 wards (incl. 4 wards from our London Road site)
- 200 of them are in single rooms with en-suite facilities
- Over 8,000 employees
• We have 35 operating theatres

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https://youtu.be/9RsZwoQesqg

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The Stock Room – Original Objective
The Stock Room – Original Objective

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Master Data Catalogue Management
• Contract based item & price data
• Validated catalogue item data
• Consistent contract based item &
price data
• Controlled ordering
• Standardisation of item choice
Reduced Cost of Procurement
Eliminated PO Supplier queries
385 HL Catalogues, resulting in
145,000 items in catalogues
HL
hTrak

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Scanning Via hTrak
Will scan high value items (includingHIBCC)
Low value items will be put in packs
E.g. on next slide
Scan Surgical Trays (traceability & cost)
Scan Scopes for (traceability & cost)

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Lap Chole Scanning Sheet
‘Mr Leeder’ – SELF MADE
OPEN TRAYS: NEW LAP PREP TRAY
WOLF TRAY
PHARMACY: PREP – RED CHLORHEXIDINE WITH DYE, 20mls 0.5% MARCAIN
HAVE AVAILABLE: SUCTION/IRRIGATION MEDIUM & LARGE LAPRO CLIPS
RANFAC MEDIUM & LARGE LIGA CLIPS

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Kit and Anaesthetic Procedure Packs

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Kit and Anaesthetic Procedure Packs

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Wall Mounted Barcodes

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Integrated Processes – GS1/PEPPOL Compliant
eCat
Catalogue &
Contract
Cleansing
hTrak
Stock Take
Point of Care Consumption
& Inventory Management
Solution
Trust
PO/AP
System
eConnect
PO & Invoice
Transfer
PLICS Coding

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Roll Out Plan
Implementation Plan and Timescale
• Initial Planning stages – Commenced November 2013
• Roll out to General Theatres – April 2014
9 theatres – multiple specialties
• General Day case Theatres – December 2014
3 theatres – multiple specialties
• Radiology – January 2015 – 2 suites
• Cardio Catheter Labs – May 2015 – 2 labs
• Urology day case – August 2015 – 2 theatres
• Ophthalmology – Sept 2015 – 3 theatres
• Hand Theatres – November 2015 – 2 theatres
• Gynae and Children's January 2016 – 4 theatres
• Other day case theatres - September 2015 – 6 theatres (exc Prosthesis and Implants)
• Trauma and Orthopaedics – First qtr 2016 – 8 theatres
• Wards/Outpatients – 2016

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Current Status
Implementation:
• Operational in 9 General Theatres, 7 General Day Case Theatres and 2
Radiology Suites, 2 Cardio Cath Labs, 3 Eyes Theatres, 4 Gynae, 2 Paeds
and 2 Urology Theatres (27Theatres& 4 Suites)
• Rolling out to final 8 Ortho Theatres
• Tracked theatre & stock room consumption
Loan Sets & Surgical trays tracked
Prevented expiry wastage
• Automated replenishment
• Streamlined ordering
Direct via NHS Supply Chain
Knowledge leads to reductions in overall stock levels

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Information Capture
• Patient Scanned and Checked
• Staff Scanned and Tracked
• Track scopes/Instrumentation to patients
- CJD & AIDS
• Tracked theatre & stock room consumption
- Loan sets & Surgical trays tracked
• Lot number captured – Product Recalls
• Prevented expiry wastage & Warning Flag
• Attribute cost to Scope/Instrumentation use
• Track planned maintenance e.g. 100 uses

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Further Value
• Detailed and Accurate data for PLICS
• Automated replenishment of stock
• Clinical Teams Time Saved (Ordering)
• Stock takes halved from 1 day to ½ day
• Reduced stock holding (£’s)
• Direct NHS Supply Chain ordering
• Driving down delivery charges
Information Capture

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Cost Reduction
Since April 2014 Derby have seen business process efficiencies equating to approximately £25k per month after costs
(This figure is relating to General Surgery, Imaging and Cath Labs) – Annual Impact £300k – 30% of Theatres.
Through a combination of factors:
• The non-stock spend has reduced by at least 5-7% since go live
• Culture change in terms of waste, opening and using only what’s needed
• Auto-replenishment of stock, clinician time diverted back to patient care (Stock Take efficiency) 2 days to 1/2 day
• Reductions in the stock holding – Visibility of consumption (Adjusted Min / Max)
• Driving down delivery charges by grouping orders
• Released stock storage space which can be relocated for other uses
Key Data:
Over 400 electronic catalogues feeding validated consumable pricing, enabling detailed analysis of non–pay spend.
We are fully ready to benchmark our pricing…
Income Improvement
• Increased accuracy of OPCS codes due to data capture at point of care.
• Coding of all uncoded patients - £850k
Quantifiable Results

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SLM – Capability and Improvement Trajectory
ImprovementImpact
Time
1
Positive
Negative Challenge – We can’t do
anything with this
inaccurate data; the Execs
will always interfere
Status Quo, current
reporting and
engagement
We need to try and
maximise or increase
income to improve our
financial performance
We need to transform our health
economy services to improve care
understanding how to align clinical
and financial value and the right
commissioning currency, with right
commissioner engagement
We need to try and transform
our own services within our
own organisation to improve
care
1
2
5
3
4
6
We need to try and influence
our costs/approach to ensure
we are delivering the best value

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hTrak Procedure Report – “Crude Data”

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hTrak Procedure Report – “Crude Data”

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hTrak Procedure Report – “Crude Data”

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hTrak Procedure Report – “Crude Data”

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hTrak Procedure Report – “Crude Data”

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hTrak Procedure Report – “Crude Data”

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Point of Use Scanning
• Tray and Consumable Usage
• Automatic Stock
• Identify Static Stock

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Stock Management and Product Selection

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The Now: UDI - Product Code/Lot Number Recall

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UDI - Product Code/Lot Number Recall

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UDI - Product Code/Lot Number Recall

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GS1 standards
The Department of Health’s eProcurement Strategy mandates the use of GS1 standards in
every NHS Acute Trust
GS1 – Basic Building Block
Derby Can Show What Can Be Achieved – “The Vision”
To increase efficiencies and significantly improve the quality and safety of care:
• Patient Safety is enhanced!
• GS1 gives you a common language to identify, capture and share supply chain data
• Ensuring important information is accessible, accurate and easy to understand

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The Next Steps
Medical Gas Outlets
Global Location Number (GLN)
Room Identification and Associated Installed Equipment/Use