Medical/surgical and critical care units in our hospitals sometimes
must rent beds and other equipment. A poorly designed process caused
significant overpayment of rental charges for several reasons:
effective tracking of rental orders placed directly with vendors
(after hours) by patient units.
Rented equipment was not promptly returned upon discharge of patient.
to tie vendor invoices back to purchase orders, making it impossible
to ensure accuracy of charges.
The fundamental problem was a lack of communication:
the inpatient unit and the nursing manager; and,
nursing and purchasing.
needed an automated process that allowed nursing to easily rent
equipment when needed, while ensuring that information flowed to
the nursing manager and to/from purchasing.
first step in the new process collects the information from the
nursing unit (shown below):
the patient unit and click the "Get" button, which populates
the Patient field with a list of current patients in that unit
(from ADT Event Alerts).
patient who needs the rental bed.
type of bed.
any comments and select the nursing manager who should approve
off-hours (16:00 08:00 M-F, and Sat/Sun/holidays) the nursing
unit may call the vendor without waiting for approval. During
these hours, "Vendor call placed" is displayed (shown
the request is submitted, a confirmation screen is displayed for
the requestor (shown below).
approver is automatically notified by e-mail and pager. The e-mail
message includes a direct link to the request (shown below).
approving nursing manager is shown the screen below:
an approver does not have access to the e-mail message with the
link to a specific request, a list of pending requests is available.
First the patient unit is selected (shown below).
pending requests for that unit are displayed, and selecting any
request (shown below) displays the same approval page (shown above).
the request is approved, an automatic e-mail is sent to the purchasing
department. This e-mail contains all the information necessary for
purchasing to create a purchase order and place the order with the
vendor (shown below).
e-mail message for purchasing contains a direct link to the equipment
request (shown above). Using that link, purchasing updates the request
with the purchase order number. This directly connects the request
with the purchase order number, ensuring that invoices can be verified
when the patient is discharged, ADT
alerting data trigger an automated e-mail to the purchasing
department (shown below). This e-mail serves two purposes:
purchasing to contact the vendor to arrange immediate pickup of
rented equipment; and,
all necessary data (dates, patient units and cost centers) for
purchasing to charge the rental cost to the correct cost center(s).
the image above to see the full size image]
This application was implemented quite recently, so it is too soon
to have data about its use. However, it already seems clear that
more effective tracking of equipment and requests will:
reduce expenses by eliminating overcharges.
expenses by ensuring immediate pickup of equipment by vendor.
rework with purchase orders and invoices by nursing staff, nursing
managers and purchasing staff.
the flexibility for nursing staff to immediately obtain equipment
after hours without degrading the tracking process.
was enthusiastic enough about this application to request another
module for tracking Wound Vac rentals and supplies (about to go
pays. Other priorities distracted the nursing and purchasing managers
who initially suggested this application, but we kept nudging
and nagging until the application was fully tested and implemented.
can be found in some obscure corners of an organization. I had
no idea this process existed until line managers requested that
it be automated.
Posted 21 November 2008