HEALTHCARE SELF-STUDY SERIES N


PURCHASING EWS


January 2020 The self-study lesson on this central service topic was developed by STERIS. The lessons are admin- istered by Endeavor Healthcare Media.


Earn CEUs After careful study of the lesson, complete the examination at the end of this section. Mail the completed test and scoring fee to Healthcare Purchasing News for grading. We will notify you if you have a passing score of 70 percent or higher, and you will receive a certifi cate of completion within 30 days. Previous lessons are available at www.hpnonline.com.


Certifi cation The CBSPD (Certification Board for Sterile Processing and Distribution) has pre-approved this in-service for one (1) contact hour for a period of fi ve (5) years from the date of original publication. Successful


completion of the lesson and post test must be documented by facility management and those records maintained by the individual until re- certifi cation is required. DO NOT SEND LESSON OR TEST TO CBSPD. For additional informa- tion regarding certification contact CBSPD - 148 Main Street, Suite C-1, Lebanon, NJ 08833 • www.sterileprocessing.org.


IAHCSMM (International Association of Health- care Central Service Materiel Management)


has pre-approved this in-service for 1.0 Continuing Education Credits for a period of three years, until November 26, 2022. The approval number for this lesson is STERIS-HPN 192611. For more information, direct any questions to


Healthcare Purchasing News (941) 927-9345, ext. 202.


LEARNING OBJECTIVES


1. Identify the key elements assessed by change committees


2. Defi ne the contents required for a change proposal


3. Calculate the return on investment by Heide Ames and Karen Owens


change, inspections and audits happen, and new infectious outbreaks raise ques- tions about existing policies and proce- dures. These events provide opportunities to make changes that achieve optimal processes. However, gaining the approval to implement changes can be challenging, even if those changes could result in a higher standard of care. Process improvement requires formal written proposals. To gain approval, it’s important to include all the necessary elements.


A


Change approval elements Any change in device processing, no mat- ter how necessary, must be reviewed and approved before being implemented. Each facility’s policies and procedures dictate the approval process. While some changes may only require manager approval, oth- ers require approval from a change control committee.


Change control committees can consist


of cross-departmental representatives from within the healthcare facility. Members may include infection control, risk management, fi nance, surgery, device processing, facili- ties, and strategic planning representation. Though each functional group reviews the proposal from its specifi c perspective, the committee as a whole looks for three key elements: necessity, benefi t and cost.


Necessity


The higher the necessity for change to assure the function and wellbeing of the patients and healthcare facility, the more likely the proposal will be approved. High necessity changes are driven by federal or state law, results of credentialing inspections, or actions to stop current facility healthcare- acquired infection (HAI) outbreaks. Low necessity changes typically include pro- posals offering small improvements. For example, proposals that provide a minor process improvement or waste reduction may have a low necessity.


Sponsored by:


Benefi t C hanges can be benefi cial in many ways. Some changes directly improve patient care.


36 January 2020 • HEALTHCARE PURCHASING NEWS • hpnonline.com


s we all know, change is constant in the workplace. In healthcare en- vironments, regulatory guidelines


Other changes reduce spend. Some changes may improve quality while others increase productivity. Each type of benefi t carries a different weight based on the healthcare facility’s needs and goals. Those with the most importance to the facility carry the highest weight and will be approved over those that don’t align with their goals. Typi- cally, the highest weighted changes include those that directly impact patient care. This is normally followed in importance by cost savings. Changes that indirectly improve patient care or increase department produc- tivity usually fall into third place. Finally, changes that prevent minor inconveniences, such as having to reclean a device found dirty during inspection, would have the lowest weight. I t’s also important to note that a ben-


efi t may not be a tangible improvement in performance. Some benefi ts involve the prevention/avoidance of a possible event that could negatively impact a patient or the facility. Changes that may prevent medical errors, unseen contamination and outbreaks can be highly desirable even when none of these events have been documented at the healthcare facility.


Cost Cost is divided into two buckets; short-term and long-term. Short-term costs include one-time spends associated with imple- menting the change. Short-term costs may include such things as new equipment, installation, room modifi cation and associ- ated labor. Long-term costs are those costs that reoccur after installation is complete, such as disposables, service, maintenance, and limited reuse items associated with the new process.


Deciding what to work on The change control committee receives more proposals than the facility can implement. They are responsible for reviewing all proposals and selecting the ones to imple- ment. Although each facility has its own set of requirements, the decision process is similar for all. The fi rst projects to be reviewed and ap- proved are those that are legally necessary. These include state mandates, national rulings, and proposals that are intended to


Writing a winning process change proposal


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