HC Value Analysis and Utilization Management Magazine_Volume 12 Issue 2

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Volume 12/Issue 2

Healthcare

Leading Cost and Quality Strategies for the Healthcare Supply Chain

Magazine

Featured Article: Innovative Needle-Free Device Drives Evolution in Standard of Care for Inpatient Blood Draws

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Volume 12/Issue 2

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Contents

Healthcare Value Analysis & Utilization Management Magazine

4 FROM THE PUBLISHER’S DESK By Robert T. Yokl

Unlocking the Power of Value Analysis with Artificial Intelligence

6 FROM THE MANAGING EDITOR’S DESK

Healthcare Value Analysis & Utilization Management Magazine is published Bi-monthly by SVAH Solutions® P.O. Box 939, Skippack, Pa 19474

By Robert W. Yokl

What Should Your Priorities Be Going Into 2024?

Phone: 610-327-4820 bobpres@ValueAnalysisMagazine.com

www.ValueAnalysisMagazine.com

9 AHVAP

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By J. Hudson Garrett Jr. and Karen Niven

The Imperative of Being a Partner, Not Just a Vendor, in Healthcare

Editorial Staff

12 VALUEKPI

Publisher

By Robert T. Yokl

Robert T. Yokl

The Importance of Measuring Value Analysis Success with KPIs

bobpres@ValueAnalysisMagazine.com

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17 FEATURED ARTICLE By Joy Selchow, Kimberly Alsbrooks, and Shanna Salmon

Innovative Needle-Free Device Drives Evolution in Standard of Care for Inpatient Blood Draws

Managing Editor Robert W. Yokl ryokl@ValueAnalysisMagazine.com

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30 CLINICAL VALUE ANALYSIS By Anne Marie Orlando

Senior Editor

Enhancing Your Contracting Strategy

Patricia A. Yokl

34 VALUE ANALYSIS ADVISOR (FOR SALES REPS) By Robert T. Yokl

How to Develop and Effective Sales Mindset

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Editor and Graphic Design Danielle K. Miller

36 VALUE ANALYSIS 101 By Robert T. Yokl

Why You Should Adopt a Value Analysis Policy and How to Develop One

39 UTILIZATION MANAGEMENT By Robert W. Yokl

3 Steps to Fast Tracking Clinical Supply Utilization Savings

43 PERSPECTIVE By Robert T. Yokl

Are Manual Systems Holding Back Value Analysis Decision Making?

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Copyright 2023 SVAH Solutions. All rights reserved. Reproduction, translation, or usage of any part of this work beyond that permitted by Section 107 or 108 of the 1976 United States Copyright Act without permission of the copyright owner is unlawful. For permission, call, fax, or e-mail Robert W. Yokl, Managing Editor. Phone: 610-327-4820 E-Mail: ryokl@valueanalysismagazine.com for approval to reprint, excerpt, or translate articles. 3


From the Publisher's Desk Unlocking the Power of Value Analysis with Artificial Intelligence Robert T. Yokl, President/CEO, SVAH Solutions Robert T. Yokl

Value analysis is already a powerful tool to identify savings opportunities at your healthcare organization through functional analysis, life cycle analysis, and supply utilization management. Now, with artificial intelligence (AI), a whole new world of savings, quality, and safety gains can be achieved. This is why 68% of business executives believe the benefits of generating AI outweigh the risks, according to Gartner.

“68% of business executives believe the benefits of generating AI outweigh the risks.”

One of the advantages of AI for value analysis practitioners is that you will be able to gain insights into your data without human intervention. This will enable you and your value analysis teams to have better, more accurate data-based decisions. For instance, AI will enable you to scan all of your expenses in light speed to determine where there are supply utilization misalignments in your supply streams that are now hidden from your view. Another important gain from AI is greater efficiency and productivity gains by removing timeconsuming manual work. You will be able to delegate tasks such as generating savings reports, project management oversight, and ongoing communication with stakeholders without human involvement, thereby freeing up your time to perform more important work (e.g., training, planning, educating department heads, surveying customers etc.). As you become more familiar with AI, it will help you move into the digital age without hassle or loss of productivity since it will perform like your automobile’s cruise control. One major benefit from AI for value analysis practitioners, as I see it, is AI’s ability to automatically sift through vast data, create custom analytics, and search out intelligence to uncover unseen savings or quality and safety issues that have been concealed from your view in the past. This will ensure that no savings or quality and safety issues are lost in a data maze. These opinions I share with you today are based on SVAH’s own investigation, tests, and business models created by AI for our clients’ benefit. I can say without reservation that we at SVAH are blown away by AI’s possibilities in the future of value analysis and supply chain management.

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Grasp the worth of the value analysis/utilization management connection

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Volume 12/Issue 2

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From the Managing Editor’s Desk

What Should Your Priorities Be Going Into 2024? By Robert W. Yokl, Sr. VP, Supply Chain & Value Analysis — SVAH Solutions

A new year is just around the corner which will no doubt challenge many in our supply chain industry to up our game to new levels that we never thought possible. Let’s face it, there is a heck of a lot of change going on and higher demands from our Chief Financial Officers to optimize costs to mitigate the budgetary shortfalls that all health systems are seeing. All this on top of the new product requests, contract conversions, recall facilitation, and managing teams and projects. Next year can be a daunting year if you don’t have some form of strategic plan with clear-cut goals and objectives.

You Can Just Let the Future Happen or You Can Control Your Own Future What should you be focusing on that you are not already focusing on in 2023? This is a great question to ask yourself, your leaders, and your teams as most don’t ask these questions and tend to get caught up in the ongoing grind of the value analysis job. I am not discounting the good work you and your organization are putting in but at some point we need to look to control our future or the future will control us. The strategy is simple, we must try to foresee, project, and envision the future of our value analysis programs and fit ourselves nicely into that future as well as optimize costs, quality, and outcomes at a high level with the least amount of work and stress on us and our organizations.

Envisioning the Future is Key to Your Success – But You Don’t Need a Crystal Ball! Ask Your Leaders - A system CFO said to me, “Financially, we are doing good for the next three years but after that we are going to have challenges and I want our people to have the systems in place to address these challenges before they hurt our bottom line.” Why did he give me that bold statement? Because I asked him questions during a strategic planning session for a new cost optimization modality that they were rolling out. We must ask our leaders where we stand from a financial standpoint and from quality and outcomes, and they should include our end customers’ satisfaction as well. Ask the CFO about the finances, ask the CNO about the patient outcomes and

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From the Managing Editor’s Desk

Robert W. Yokl

quality, ask the Director of Infection Control about the infection rates, etc. Keep your finger on the pulse of what your organization is in need of before it comes down to corporate edicts that you will have no control of. Figure Out What Is Missing – The only people that really know what is missing are those who are actually aware of what else can be done. I see this often after speaking at a conference or regional meeting on things like Clinical Supply Utilization Management (CSUM) when a Value Analysis Manager comes up to me afterwards to talk. They always say, in one way or another, “I am responsible for CSUM, that’s my job.” I totally agree that that is their job but then with a question or two I find out that they are only following up after the clinical utilization of the new products they are evaluating. I then explain that the biggest savings opportunity is sitting untouched, which is going back over all your major categories of purchase. I have a saying, “The more you know about value analysis, the more you know you don’t know.” So, you really have to be on top of your game and learn what others are doing as far as new modalities, best practices, and the like. What Fixes Do You Need – Every value analysis program has areas that could be improved. It could be as simple as members not participating or not showing up to meetings. If you need to move team members along and recruit new members, then having an annual review of your program is a good time to do it and most bosses understand this. Other things could be workflow bottlenecks or missing data that creates more work for supply chain. Take the time to plan out the fixes for your value analysis programs and use an annual VA review as the reason for these changes.

Automate – You will want to automate as much of your value analysis and cost optimization program as possible. Even though you may be highly proficient at working with spreadsheets, that does not mean that you cannot take it up a level with advanced value analysis workflow and analytics solutions. Remember, this is not just for today, this is for the next year, or even three to five years of your program. Figure out what needs to be automated by how much time you spend on spreadsheets. A good example of this is value analysis analytics that are performed by VA or supply chain analysts who spend 90% of their time working up reports on spreadsheets that tend to be repetitive periodoriented tasks. This should be automated, as spending 90% of their time crunching numbers is not ideal. That will free up their time to better interpret and communicate the changes that need to be made. If you have ever interacted with me via email, you would have seen that I have a message below my email signature that reads: “There is always a new way: a new way to solve a problem, a new way of climbing the mountain. The ability to identify that ‘new way’ is a valuable asset because most people won’t see past the way things have always been done. The confidence to pursue that ‘new way’ and look at an issue from a new angle is rare enough because most people will obstinately refuse to change. The desire and drive to execute the ‘new way’ lies at the heart of every great innovation.” This is a quote from a book, but I found it translated into our value analysis and supply chain world. Value analysis and supply chain professionals are experts at finding a new way or a new product or service for our customers and stakeholders, but it is now time for you to look for how you can make your programs better.

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STAY CONNECTED HERE Volume 12/Issue 2

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AHVAP

Garrett and Niven

The Imperative of Being a Partner, Not Just a Vendor, in Healthcare J. Hudson Garrett Jr., Ph.D., MSN, MPH, MBA, FNP-BC, IP-BC, PLNC, VA-BC, BCMSLcert™, MSL-BC, CPHRM, LTC-CIP, CPPS, CPHQ, CVAHPTM, CMRP, CPXP, CDIPC, FACDONA, FAAPM, FACHDM, FNAP, FACHE, FSHEA, FIDSA, FAHVAP Karen Niven, MS, BSN, RN, CVAHPTM, FACHDM, FAHVAP

In today's rapidly evolving healthcare landscape, the traditional model of healthcare suppliers merely acting as vendors has become increasingly insufficient. Instead, healthcare organizations are seeking partners who can collaborate, share their goals, and actively contribute to improving patient outcomes. This shift from a vendor-centric to a partnership-centric approach is not merely a trend; it's a fundamental necessity. In this article, we'll explore the importance of being an industry partner rather than just a vendor in the healthcare industry.

Building Trust Through Collaboration One of the most compelling reasons for healthcare suppliers to embrace a partnership mentality is the trust it builds. Healthcare is not just a transactional business; it's a matter of life and death. Patients and healthcare providers depend on suppliers to deliver quality products and services consistently. When suppliers become partners, they share in the responsibility for patient well-being.

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AHVAP

Garrett and Niven

Collaborative partnerships establish trust between suppliers and healthcare organizations. These partnerships involve open communication, mutual respect, and shared objectives. Suppliers who actively engage in the healthcare ecosystem, understand their customers' needs, and work hand-inhand to address challenges become invaluable allies. This trust leads to stronger, more enduring relationships and ultimately benefits patient care.

Aligning Goals for Better Outcomes In the healthcare sector, the ultimate goal is to improve patient outcomes. A vendor may provide products or services that meet a basic need, but a partner goes beyond this by aligning their goals with the healthcare organization's objectives. Partners actively seek to enhance patient care, reduce costs, and improve operational efficiency. Partnerships in healthcare involve a commitment to innovation and continuous improvement. Partners work together to find innovative solutions to complex healthcare challenges. This can involve customizing products or services, conducting joint research and development, and participating in quality improvement initiatives. By aligning goals and actively contributing to better outcomes, partners become integral to the healthcare team.

Reducing Costs and Increasing Efficiency Cost containment is a critical concern in healthcare, and partners play a significant role in achieving this goal. A vendor may focus solely on selling products, often at a fixed price. In contrast, a partner looks for ways to reduce costs throughout the supply chain, from product design to delivery. Partnerships allow healthcare organizations to tap into the expertise of their suppliers to identify cost-saving opportunities. Suppliers who are partners actively seek out ways to improve efficiency, reduce waste, and enhance the value of their offerings. This not only benefits the healthcare organization's bottom line but also ensures that resources are allocated where they are needed most – patient care.

Adapting to Changing Needs The healthcare landscape is constantly evolving, driven by advances in technology, changes in regulations, and shifting patient demographics. In this dynamic environment, the ability to adapt quickly is crucial. Partners are better equipped to adapt because they have a deeper understanding of the healthcare organization's needs and can be more agile in responding to changes. A vendor may provide a product or service that becomes obsolete as healthcare needs evolve. In contrast, a partner actively seeks to stay ahead of industry trends and anticipates the changing needs of their customers. This proactive approach ensures that healthcare organizations have access to the latest innovations and solutions to address emerging challenges.

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AHVAP

Garrett and Niven

Enhancing Patient-Centric Care At the heart of healthcare is the patient. A partnership approach places the patient at the center of decision-making. Partners work collaboratively with healthcare organizations to understand patient needs and preferences, ensuring that products and services are tailored to enhance the patient experience. Moreover, industry partners actively contribute to improving patient care by providing education and training to healthcare staff. They become an integral part of the care team, helping to drive better patient outcomes through their expertise and commitment.

Conclusion “At the heart of healthcare is the patient. A partnership approach places the patient at the center of decision-making.”

The healthcare industry is undergoing a profound transformation, and the role of suppliers is evolving accordingly. The days of merely being a vendor are fading, giving way to a new era of partnership in healthcare. The importance of being an industry partner, not just a vendor, cannot be overstated. Partnerships in healthcare build trust, align goals, reduce costs, and enhance efficiency. They enable healthcare organizations to adapt to changing needs and, most importantly, promote patient-centric care. As healthcare continues to advance and face new challenges, the shift towards partnership models will become increasingly imperative for the success of both suppliers and healthcare providers. By embracing this approach, suppliers can become invaluable allies in the quest to improve patient outcomes and elevate the quality of healthcare delivery. Over the next few months, AHVAP will be releasing new guidance on how to evolve from a vendor/supplier to a strategic industry partner. For more information, visit www.ahvap.org.

Dr. Garrett is the Executive Director and Executive Vice President for the Association of Healthcare Value Analysis Professionals (AHVAP) and an Adjunct Assistant Professor of Medicine in the Division of Infectious Diseases at the University of Louisville School of Medicine. Karen Niven is the Senior Director of Clinical Value Analysis at Premier, Inc. and serves as the President-Elect for the Association of Healthcare Value Analysis Professionals (AHVAP).

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ValueKPI The Importance of Measuring Value Analysis Success with KPIs Robert T. Yokl, President/CEO, SVAH Solutions

The Importance of Value Analysis in Healthcare Value analysis is a crucial process for any healthcare organization looking to improve its performance and profitability. It involves functionally analyzing the value of the products, services, and technologies you purchase to identify areas for improvement and cost savings. Key performance indicators (KPIs) are essential metrics used to measure the success of your value analysis initiatives. In this article, we will discuss six important value analysis KPI metrics that you should track to effectively monitor your performance and make data-driven decisions.

The Role of KPI Metrics in Value Analysis KPI metrics can play a vital role in value analysis. They provide a quantifiable measure of

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ValueKPI

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performance, allowing value analysis practitioners to track the success of their value analysis initiatives. By tracking these metrics, you can identify areas where the initiatives are performing well and areas where improvements are needed. This enables you to make data-driven decisions that can lead to increased performance and profitability.

Value Analysis KPI Metrics are Road Maps

“Remember, KPIs are not all bad. You will want to compliment the Surgery Department Materials Manager when they are one of the best in the cohort for Suture Cost Per Surgery Case.”

The bottom line on value analysis KPIs is that they can give you great information that you would not get from any other source. Most importantly, KPIs can uncover cost and quality issues you may be having with the products, services, and technologies you are buying. They can show you patterns of positive and negative metrics that you will want to know about as well. Remember, KPIs are not all bad. You will want to compliment the Surgery Department Materials Manager when they are one of the best in the cohort for Suture Cost Per Surgery Case. Then again, you will also want to do a VA review if you are higher in your cohort with your suture costs. KPIs give you definite road maps to follow.

What is Measured Happens! By simply tracking your value analysis and supply metrics, your healthcare organization can gain valuable insights into its performance and identify areas that require improvement. Here are six essential value analysis KPI metrics that you should know: 1. Cost Avoidance: This metric measures the amount of money saved by not implementing a value analysis or contract initiative. Many do not find cost avoidance to be actual savings because you did not spend the money in the first place. We have found that cost avoidance is a very real savings and should be counted as savings. If you did not perform any type of value analysis review, you would have spent this money. 2. Value Improvement: Value improvement metrics measure the increase in value provided to customers through value analysis. It helps you assess the effectiveness of your value analysis efforts in delivering better products or services. This could be in the form of improved utilization/ consumption on products, recall mitigations, contract conversions, standardization initiatives, recycling, and reprocessing, to name a few. 3. Return on Investment (ROI): ROI measures the financial return on value analysis investments. It helps your healthcare organization evaluate the profitability of your value analysis initiatives and make informed decisions about resource allocation. Every contract and every

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initiative is more than likely going to come with the promise of savings attached to it, but you need to establish baseline metrics for each of these in order to truly know whether you have achieved your return on investment. Trust but verify! 4. Cycle Time Reduction: This metric measures the time taken to complete value analysis projects. It helps you identify bottlenecks in your processes and implement strategies to reduce cycle time, resulting in more efficient operations. I highly recommend that you measure this for your entire program, but you may also want to have metrics by team and perhaps by individual. We have found that some project leads or teams tend to roll through VA projects with a high level of quality results while others just plug along. You will want to tap into your own best practices within your organization or even benchmark with other similar organizations. 5. Supplier Performance: This metric evaluates the performance of suppliers involved in value analysis initiatives. It helps you to assess the quality, reliability, and efficiency of your suppliers, enabling you to make informed decisions about supplier relationships. 6. Customer Satisfaction: The customer satisfaction metric measures the level of satisfaction customers experience with the products, services, or technologies resulting from value analysis efforts. It helps you to understand customer preferences and expectations, enabling you to tailor your offers accordingly. By tracking these six value analysis KPI metrics, you can gain valuable insights into your value analysis efforts, make data-driven decisions, and continuously improve your processes, products, and services. Remember, it may be a challenge to get everyone on the bus with tracking your metrics, but once you have these in place they will help guide your current and future plans for your VA program!

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Featured Article Innovative Needle-Free Device Drives Evolution in Standard of Care for Inpatient Blood Draws Joy Selchow, MSN, RN, CRNI, Virginia Mason Medical Center, Seattle, WA, USA Kimberly Alsbrooks, BSN, RN, RT (R), VA-BC, Becton, Dickinson, and Company, Franklin Lakes, NJ, USA Shanna Salmon, MS-HCA, Becton, Dickinson, and Company, Franklin Lakes, NJ, USA

Significance of Blood Sample Collection and Recent Advancements Blood draws play a crucial role in evaluating a patient’s condition and optimizing care during hospitalization. Approximately two billion blood tests are conducted annually in the United States [1], and laboratory test results inform 60 to 70% of medical decision-making [2]. While venipuncture is the most prevalent method for blood draws [3], vascular access devices (VADs), such as central lines, are also used for collecting blood samples [4] and are especially useful for patients with difficult venous access [4]. Blood draws are frequently performed for patient care and can lead to potential complications with important economic and clinical implications. During a hospital stay, patients experience around 1.6 to 2.2 blood draws per day, primarily through venipunctures [5]. Repeated needle sticks can result in multiple adverse events, including infections, nerve damage, inadvertent arterial puncture, vessel depletion, and hematomas. Beyond these clinical outcomes, repeat venipuncture may lead to significant pain and disrupt patients’ sleep and healing processes [5-7]. Complications may also arise in alternative approaches to blood collection, such as sampling from a central line. For example, use of central venous access devices can lead to increased hub manipulation and potential for intraluminal contamination, alterations in VAD patency, and erroneous laboratory values associated with the adsorption of medications infused through VAD [8]. More than 22% of daily central line access is for blood collection; therefore, minimizing these risks is critical to help improve care [4]. Industry studies have shown that decreasing the use of central lines for routine blood draws may reduce associated bloodstream infections [9], which represents an annual cost of over $2 billion to the US healthcare system [10]. The risk of pre-analytical errors is another important consideration with all blood draw methods. Hemolysis of blood samples can make the specimen unsuitable for laboratory testing [11], and may increase the probability of significant delays in care. Furthermore, these delays may lead to multiple redraws, lost labor hours, and delays in providing the right care to patients. Therefore, improvements in blood draw practices may help reduce the clinical/economic burden while enhancing patient/ provider experience. Volume 12/Issue 2

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Featured Article

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Recent advancements have enabled “needle-free” collection of blood specimens [12]. The PIVO™ Needle-Free Blood Collection Device (BD, Franklin Lakes, NJ), an FDA-approved medical device, connects to an indwelling peripheral intravenous catheter to help reduce the need for collection of blood samples with repeated needle sticks [3, 12]. The novel device provides high-integrity samples and equivalent laboratory results compared to traditional methods [13]. The device may also lead to clinical benefits and improved patient satisfaction, highlighting it as an attractive advancement for blood collection [12]. Due to its needle-less and user-friendly design, the device also has the potential to improve provider safety and prevent accidental needle sticks [13]. This case study provides an overview of the adoption of the PIVO™ device for blood draws at Virginia Mason Medical Center (VMMC). It examines the key processes and partnerships that led to the successful implementation of a novel device from the perspective of an early adopter.

Virginia Mason Medical Center

“The device may lead to clinical benefits, improved patient satisfaction, and improved provider safety.”

VMMC is one of the premier healthcare facilities in the Pacific Northwest. It is part of VM Franciscan Health, one of the largest healthcare systems in the Seattle-Tacoma area. VM Franciscan Health has 10 hospital sites serving acute care, behavioral health, and rehabilitation needs, as well as primary care and urgent care sites across the region.

The Previous State At VMMC, there was a historic tendency to draw blood samples directly from a port-a-cath or central line, which originated from a desire not to inconvenience the patient with additional needle sticks. However, the repeated use of central lines was potentially contributing to high rates of central lineassociated blood stream infections (CLABSIs). In fact, a particular unit at VMMC was driving CLABSI rates across the state, making reduction in CLABSI rates a priority for the medical center. One of the objectives of the new quality leader appointed in 2016 was to address this during her tenure. The impetus from the hospital leadership coincided with a national push to reduce hospitalacquired infections, considering their significant economic impact due to treatment with medications, increased length of stay, and other associated treatment costs [14]. The stakeholders at VMMC initiated their efforts with a root cause analysis to determine what factors may be contributing to CLABSI rates. The analysis highlighted a need for emphasis and training in appropriate and consistent blood draw practices. Therefore, the quality leadership developed a series of initiatives, including re-teaching the blood draw basics, reinforcing appropriate insertion/care and maintenance practices, as well as reviewing the reasons behind central line placement and ensuring timely removal. Additionally, the Infectious Disease team sought to reduce the frequency of blood

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draws from central lines, as other hospitals had done so to mitigate the risk of CLABSIs. While the appropriate use of a central line may not result in complications, certain factors related including those related to patient type, length of use, anatomical site of catheter insertion, and healthcare practice such as insertion practice and handling may increase risk of infection [15]; therefore, this step was included in the broader measures to reduce infections. Although CLABSI rates decreased following the implementation of these initiatives, the facility had ambitious plans to achieve further success regarding infection and contamination rates. During their efforts to improve practice, the quality and nursing leadership identified the PIVO™ device at a conference and introduced the concept to other stakeholders at the hospital to receive their input. Initial impressions were positive, and the device was initially considered to replace venipuncture due to its potential for improving the patient experience and reducing repeated needle sticks. Eventually, the blood draws from central lines could also be transitioned to the PIVO™ device, representing a potential to reduce the incidence of associated infections and improve quality metrics. Based on these initial perceptions, the nursing leadership began the evaluation process for implementing peripheral line draws with the PIVO™ device.

Achieving Practice Change Through Stakeholder Engagement Following initial reception, stakeholders were eager to bring the PIVO™ device into VMMC and begin using the product first-hand. The implementation process began in 2018 and involved collaboration among multiple stakeholders across a variety of departments/functions, including the quality improvement and supply chain teams. Nursing leadership spent about 10 months preparing for the product evaluation to ensure a smooth adoption. Specific preparation efforts involved selecting the appropriate clinical sites, managing contracts/supply with the device manufacturer, and establishing protocols for implementation and associated data collection activities. Ultimately, three units were selected based on their high volume of blood draws: general med-surg, general surgery, and an additional surgical floor. After these preparations, the physical implementation of the device started with the coordination between nursing and laboratory teams. As both teams would be the primary users of the PIVO™ device at the patient bedside and in testing the samples, their buy-in and onboarding were crucial steps for the success of the initiative. The implementation was also supported by various stakeholders that were involved in product evaluation, clinical integration, and outcome tracking processes. The Kaizen Promotion Office, which educates staff across all areas of the organization to facilitate change in culture and produce high-quality outcomes, took part in understanding the relevant outcomes and data/metrics to assess the impact of peripheral line draws with the device post-implementation. This was crucial as the facility needed to collect its own data and confirm that the device was beneficial from both clinical and economic perspectives. The supply team contributed by stocking the device, making sure it could be implemented into current procedures, and planning the product evaluation. Lastly, the Scope of Practice Committee played a vital role to ensure smooth implementation by confirming that phlebotomists were allowed to perform peripheral line draws

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with the PIVO™ device. As their previous responsibility did not include drawing blood from a line, the scope of practice committee had to ensure that phlebotomists were authorized to perform peripheral line draws using the device prior to their onboarding.

Pre- and Post-Implementation Training Given the novelty of the product, implementation required a comprehensive training program to ensure users were well-educated on the use and benefits of the PIVO™ device. Both the device manufacturer and hospital staff supported this training program, which included classroom training, bedside in-servicing and coaching, as well as ongoing training support. From the beginning, the manufacturer offered on-site guidance and structured training to the internal VMMC education team. They provided educational modules for the VMMC personnel to complete before proceeding with classroom training, which consisted of a comprehensive explanation of blood draw procedures, why IVs have historically been unreliable for draws, and the benefits offered by the PIVO™ device. Following classroom training, the manufacturer performed bedside coaching and multiple two-week monitoring periods during which they observed live product use in the hospital. All new users were assigned educators who ensured proper blood draw technique was followed. The manufacturer then carried out post-implementation follow-ups and audits to focus their support on those facing challenges. They also offered a reference guide for clinical practice scenarios to assist VMMC educators in resolving any issues that arose during routine use. Furthermore, the manufacturer team remained available throughout the implementation process to provide any additional training as needed. The VMMC staff provided ongoing education, through incorporation of PIVO™ device training into the new hire curriculum, and development of a long-term multi-phase program to ensure the sustainability of the correct practice. Although these intensive training programs were well suited to providers in high-volume settings, it was challenging for providers in lower-volume settings to reinforce required skills in their day-to-day practice. In one of these low-volume settings (i.e., the birth center), a nursing leader developed an additional training program to help new nurses, or residents, gain experience quickly. This program allowed new hires within the birth center to rotate, and complete shifts in higher-volume units or even travel with the IV therapy team to increase their exposure to peripheral line draws using the device. This approach was proven to be effective, as nurses returning to the birth center demonstrated improved skills and proficiency to utilize the PIVO™ device when needed.

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Improving the Device Through Feedback from End-Users As early adopters of a novel device, VMMC stakeholders, as well as other facilities trialing the PIVO™ device, provided feedback to the manufacturer to improve the stability and access of the IV when utilizing for draws. Initial reports from the users were taken into consideration by the manufacturer, which led to the creation of a stabilizer component designed to help prevent the IV catheter pistoning/kinking, help reduce the compression of the underlying vessel, and help maintain the correct angle for attaching a flush syringe and connecting the PIVO™ device to avoid overmanipulating the catheter and creating vessel irritation or vessel spasms. The manufacturer incorporated all IV set-up components in a kit helping to streamline the process for users and supply personnel while optimizing the peripheral IV for compatibility, stability, and ease of use, improving the provider experience.

Implementation Hurdles and Solutions Despite thorough planning and preparation, several challenges arose during the “Each challenge provided an opportunity to better understand implementation process related to both clinical and economic evaluation. Challenges, such as the implementation of new those seen in this case, are common with the technologies such as PIVOTM.” implementation of novel devices, and are inherent to driving a change in clinical practice. Each of these challenges provided an opportunity to better understand the implementation of new technologies such as PIVO™ in the hospital setting, and provide learnings for later adopters as well as new adopters of other novel technologies. Nevertheless, the VMMC team and manufacturer worked together to alleviate these obstacles and achieve long-term success. Many of these challenges were resolved as users became more proficient with continued use of the device and support from the hospital and the manufacturer, who worked to ensure that all stakeholders were comfortable with all aspects of the practice change.

Workflow Integration and Turnaround Times: As expected with a change in practice, the new line draw procedure initially resulted in an increased procedure duration. This was in part due to providers becoming acclimated to a new device; however, several nurses also highlighted there was an added step of using the PIVO™ device versus directly drawing blood from an existing central line. These concerns were largely resolved as practitioners became more comfortable with the device and observed potential improvements. Furthermore, the process became more efficient as providers were able to complete the blood draws quicker with more experience/training. As device utilization improved, clinicians, including both nurses and phlebotomists, also appreciated that they could perform blood draws conveniently at the bedside without the need for a central line, ultimately decreasing the total time to obtain a sample.

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Training and Staffing Challenges: At the beginning of implementation, the understaffed state of relevant departments (i.e., core lab) resulted in delays in onboarding/training. This led to limited experience with the PIVO™ device and insufficient capacity to solve problems when needed. Training challenges were exacerbated by interruptions due to the COVID-19 pandemic, which introduced restrictions on the number of manufacturer representatives allowed in the hospital. Therefore, the burden of training fell to an already overextended hospital team during the pandemic. As restrictions were lifted, the manufacturer provided updated training sessions, along with a new fully integrated stabilized extension set, both of which played a major role in bolstering usage. Achieving High Utilization: By the end of the product evaluation, peripheral line draws with the PIVO™ device were recommended as the preferred approach for drawing blood at VMMC, while using central lines or traditional venipuncture served as secondary options. However, particularly in clinically urgent situations, nurses or phlebotomists reverted to previous practice. As expected, there were also lower success rates on the first attempt blood draws during the training phase, leading to increased material costs due to additional attempts. As nurses and providers gained more experience, many began to prefer the new practice over traditional approaches as the benefits were recognized from both the provider and patient perspectives. Providers realized that patients were more comfortable with needle-free draws, and appreciated gaining new skills and responsibilities that the novel device offered. With experience, phlebotomists were grateful to learn a new method for drawing blood and to provide care with greater patient experience. Demonstrating Cost Effectiveness: The primary economic obstacle was determining whether the device was cost-effective. This was a crucial hurdle since implementation incurred incremental costs for the hospital. In the initial phases, there were compounding material costs due to training, failed first attempts, and outdated/incompatible lines that could go unused. Department leaders and decision-makers wanted to know if the pricing was sustainable as the practice was expanding across the hospital. However, the utilization increased, and cost-related barriers were overcome by positive direct/downstream economic outcomes that were observed during the product evaluation period.

Observed Impacts of Peripheral Line Draw Practice Change Several positive clinical, economic, and quality outcomes were observed by the providers and hospital leadership following the implementation of the PIVO™ device and other efforts to shift blood draw practices. Within the first year post-implementation, there were notable improvements in various metrics, including infection rates, hemolysis rates, and patient satisfaction.

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Clinical Metrics and Workflow Efficiency: Overall, the stakeholders at VMMC reported reductions in hospital-onset bloodstream infections, TPA utilization for de-clotting lines, and overall central line days. As the majority of blood draw practice shifted to less invasive lines, central lines were not kept only for potential blood draws that may be needed. Furthermore, the practice change allowed nurses to draw blood conveniently at the bedside and share this responsibility with phlebotomists, which was especially important during the pandemic; fewer individuals were needed in patient rooms, resulting in decreased exposure/risk of COVID-19. Improvements in specimen quality and hemolysis rates were also noted as drivers of improved clinical efficiency and timely patient care.

Patient and Provider Satisfaction: Both providers and patients favored needle-free blood draws with the PIVO™ device. The patients requiring frequent tests were particularly happy to experience fewer needle sticks and a decrease in associated discomfort/pain. Moreover, the device and practice change allowed for better integration of care into the patient’s day since a sample could also be drawn in the morning by nurses who were performing other duties. Most providers were happy with causing less discomfort to patients, and some phlebotomists appreciated taking a more prominent role in patient care. Initial concerns with the learning curve associated with device use eventually disappeared, and the clinicians were pleased with the expansion in their scope of work, and their ability to improve patient experience. Economic Considerations: While the full economic impacts of the implementation of the practice change were not captured, the savings from the practice change were clear through the reduction in adverse events and their associated costs. There were avoided costs associated with infection treatment, lab/materials costs of contaminated samples, lack of reimbursement or reimbursement penalties for hospital-acquired infections, and shorter hospitalizations. Worth noting, there were costs associated with implementation (i.e., obsolete extension sets), though these investments were necessary for improved blood draw practices.

Keys to Success in Achieving Sustained Utilization The sustained use of the PIVO™ device, coupled with the observed clinical, economic, and patient satisfaction outcomes, indicate that the adoption of this novel device at VMMC was largely successful. Even in the face of challenges during the product evaluation process, VMMC and manufacturer stakeholders were able to deploy support and device iterations to promote the long-term success of the initiative. Understanding the crucial tactics and tools that led to success at VMMC can be illustrative to other organizations working to integrate a novel medical device into their workflow. Key contributors to success included the manufacturer’s dedicated involvement and obtaining stakeholder buy-in from the start. Manufacturer’s Dedication to Improve Practice: The manufacturer's commitment to enhancing patient care and patient/provider experience played a major role in facilitating successful practice change and ensuring the sustainability of its impacts. The clearest examples of this

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dedication can be seen in the significant contribution to training programs, and the iterations of the compatible IV set-up based on provider feedback. The manufacturer was involved in training from the beginning, facilitating the initial orientation to the hospital education team to develop in-house expertise. The tools provided along with this orientation (e.g., reference guides) helped establish an ongoing collaboration in educational efforts. Beyond the physical tools, the 2-week evaluation periods conducted by the manufacturer showed not just their dedication to educating providers on the use of the product, but ensuring the appropriate technique and protocols as well as optimizing peripheral intravenous catheter (PIVC) practices. Ultimately, these educational efforts contributed to the comprehensive training programs developed by the internal teams at VMMC and achieving and sustaining positive outcomes. A second example of the collaborative efforts between VMMC and the manufacturer was the open channel for feedback throughout the evaluation/implementation process. Through this collaborative approach, the VMMC stakeholders were given a unique opportunity to provide direct and thorough feedback and see concrete improvements in the experience of using the device and driving practice change. At the same time, the manufacturer received valuable insights into the real-world usage of the PIVO™ device, which led to the introduction of clinically informed components to improve patient care and provider satisfaction. The benefits of this process are not limited to VMMC and could impact patients and providers in various regions, as the adoption of this novel technology and related practice change increase across the nation.

“VMMC leaders obtained buy-in from stakeholders from the beginning of the product evaluation and ensured that many perspectives were heard throughout the implementation process.”

Stakeholder Buy-In and Sustainability of Practice Despite dips following initial implementation due to COVID-related challenges (e.g., personnel/stock shortages), line draws with the PIVO™ device were maintained at a consistent level. The current official hospital recommendations state peripheral line draws with the PIVO™ device as the primary method for blood draws. This was largely thanks to the efforts of VMMC leaders, who obtained buy-in from a variety of stakeholders from the beginning of the product evaluation and ensured that many perspectives were heard throughout the implementation process. Attention to the needs of the end-users, particularly with respect to training and device utilization, proved crucial to successful implementation. Obtaining buy-in from key stakeholders was crucial to ensuring the successful adoption and sustainability of the practice. The goal for both VMMC leadership and the manufacturer was a long-term shift in blood draw standard of care. This is seen in part through the comprehensive training, which was integrated into the general hospital onboarding for new hires. Moreover, the

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ongoing training initiatives, including one-on-one preceptor sessions, hands-on training with dummy arms, and long-term support through the IV-therapy educator and manufacturer materials, illustrate a commitment to the proper technique and long-lasting positive outcomes. Support for adopting the new technology and practice change is also achieved through the manufacturer’s openness to receive feedback and introduce additional components with an emphasis on the user experience. The introduction of the stabilizer and extension sets was largely focused on ensuring ease of use for providers. Rather than expecting providers to adjust to the product, the manufacturer developed and incorporated additional components to meet the needs of the clinicians. Worth noting, the importance of stakeholder buy-in for lasting impact was highlighted by the variable levels of success across units. Units with more consistent and innovative training approaches generally observed greater success in implementation and associated improvements in outcomes, as evidenced by increased patient and provider satisfaction, higher device utilization, and greater reduction in infection/contamination rates. Moving forward, the observed positive impacts will likely lead to increased buy-in and interdepartmental learning to improve the blood draw experience for all patients. The VMMC leadership will continue to identify optimal clinical scenarios and determine the most appropriate utilization to enhance sustained use over the long term.

Final Thoughts Novel and purpose-built devices can address longstanding and overlooked patient care challenges. VMMC’s experience with the PIVO™ Needle-Free Blood Collection Device demonstrates that novel solutions can be implemented successfully with a commitment to patient care and provider experience. The successful implementation of a new technology, and the sustainability of associated improvements, would not have been possible without the collaboration between VMMC stakeholders and the device manufacturer. With a solution-oriented approach, the VMMC team obtained buy-in from key stakeholders across the facility and implemented a new technology as part of a long-term quality improvement program based on the historic challenges identified by the hospital leadership. The device manufacturer kept an open channel to receive real-time feedback from the VMMC providers, improving the experience of using the device. Ultimately, this collaboration enabled successful implementation for an early adopter of the device, despite challenges in changing a longstanding practice, ensuring proper training, and integrating a novel solution into the clinical workflow. VMMC stakeholders highly recommend that other institutions consider adopting new technologies, such as the PIVO™ device, and advise them to ensure that they have the right personnel, both internally and through partners, and obtain substantial buy-in from all parties involved early on. Lessons from VMMC’s experience as an early adopter of a new technology serve as guidance to other facilities and show that innovative solutions can address pervasive/overlooked issues and evolve the standard of care.

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Balter, M.L., et al., Automated end-to-end blood testing at the point-of-care: Integration of robotic phlebotomy with downstream sample processing. Technology (Singap World Sci), 2018. 6(2): p. 5966.

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O’Malley, C.H., The frequency and reasons for central line accesses in critical care units. Canadian Journal of Infection Control 2018. 33(3): p. 165-167.

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Matthews, E.E., Sleep disturbances and fatigue in critically ill patients. AACN Adv Crit Care, 2011. 22 (3): p. 204-24.

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DuBose, J.R. and K. Hadi, Improving inpatient environments to support patient sleep. Int J Qual Health Care, 2016. 28(5): p. 540-553.

Gorski LA, Hadaway L, Hagle ME, Broadhurst D, Clare S, Kleidon T, Meyer BM, Nickel B, Rowley S, Sharpe E, Alexander M. Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021 Jan-Feb 01;44(1S Suppl 1):S1-S224. 9.

Kuriakose, L., Decreasing Central Line Associated Bloodstream Infection Through Limiting the Use of Central Venous Catheters for Routine Blood Draws. J Dr Nurs Pract, 2020. 13(2): p. 173-183.

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Son, C.H., et al., Central line-associated bloodstream infection surveillance outside the intensive care unit: a multicenter survey. Infect Control Hosp Epidemiol, 2012. 33(9): p. 869-74.

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Lippi, G., et al., Hemolyzed specimens: a major challenge for emergency departments and clinical laboratories. Crit Rev Clin Lab Sci, 2011. 48(3): p. 143-53.

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Mulloy, D.F., et al., Effect of peripheral IV based blood collection on catheter dwell time, blood collection, and patient response. Appl Nurs Res, 2018. 40: p. 76-79.

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Cadacio, C. and I. Nachamkin, A Novel Needle-Free Blood Draw Device for Sample Collection From Short Peripheral Catheters. J Infus Nurs, 2017. 40(3): p. 156-162.

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Haddadin, Y., P. Annamaraju, and H. Regunath, Central Line Associated Blood Stream Infections, in StatPearls. 2023, StatPearls Publishing Copyright © 2023, StatPearls Publishing LLC.: Treasure Island (FL).

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Pitiriga V, Kanellopoulos P, Bakalis I, Kampos E, Sagris I, Saroglou G, Tsakris A. Central venous catheter-related bloodstream infection and colonization: the impact of insertion site and distribution of multidrug-resistant pathogens. Antimicrob Resist Infect Control. 2020 Dec 1;9(1):189. doi: 10.1186/ s13756-020-00851-1. PMID: 33261661; PMCID: PMC7708904.

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Duvera

Solutions Group

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Clinical Value Analysis Enhancing Your Contracting Strategy Anne Marie Orlando, RN, MBA, RCIS, CVAHP, Senior Director, Clinical Programs at Blue.Point Supply Chain Solutions; Treasurer, Association of Healthcare Value Analysis Professionals

The contract cycle is a familiar space for most healthcare organizations. It may look like the following scenario. A GPO vets manufacturers’ pricing and products. The healthcare organization selects the manufacturer that works for their specific needs, selects tiers, and conversions occur. Three years later, this process begins again. Every month, different contracts cycle and new product requests filter through to the contracting team. It is a constant state of evaluation and, at times, change. While this describes a standard approach to contracting, how can organizations enhance this strategy for maximum savings? The answer is not with custom contracting or bundling contracts (think endomechanical). The answer lies with clinical product utilization. At its core, clinical product utilization includes elements such as standardization, evidence-based decision-making, education and training, and continuous improvement. The overarching goal is to ensure supplies are used efficiently and effectively to provide high-quality patient care while minimizing waste and unnecessary costs. To uncover these opportunities, teams can employ a few tactics.

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Clinical Value Analysis

Anne Marie Orlando

One tactic is to empower cross-functional teams (contracting, value analysis, supply chain) to ask questions. These inquiries mustn't be punitive to the questioner nor received negatively. They are intended to serve as a foundation for greater understanding. It can support cross-collaboration and teamwork. Consider asking some of the following questions: How are clinicians using the products purchased? How should they use these products? Are there factors creating opportunities for misuse or overuse? Is there clinical evidence supporting the use of these products on the patient population served? Are there clinical features of the product that increase the cost but do not add value to the patient's care? Asking the right questions can lead to significant savings. I worked with a facility that stocked a higher cost but contracted central-line dressing tray that was used systemwide. One department stood out in its utilization rates. Initial discussions with the Director revealed that this department cared for most patients with central lines and thus the increased usage. However, the numbers did not add up when compared to actual patient volume. Further discussions with an end-user revealed that staff often needed tweezers for various tasks, and this particular tray included tweezers, which were unavailable a la carte. This simple fix of adding a separate, low-cost tweezer showed that greater understanding on both sides can uncover greater opportunities. A second tactic is to collaborate with your contracted supplier. This is where the rubber meets the road. Is the supplier in it for the short game and views the relationship as merely transactional? They want the volume, and volume equals dollars. Or is the supplier committed to the long game and wants to work collaboratively to optimize the organization’s clinical supply needs? This may result in decreased sales in the short term but foster a stronger partnership for the future. These are supplier partners.

“A good supplier partner will align with the organization's goals and support the team's contracting strategy.”

Supplier partners can benefit the organization by assisting in identifying clinical product utilization savings.

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Clinical Value Analysis Their product expertise is unparalleled, encompassing education, clinical criteria application, best practice identification, knowledge and protocol sharing between institutions, and identifying instances where the product should not be used. A good supplier partner will align with the organization's goals and support the team's contracting strategy.

In the evolving healthcare landscape, incorporating clinical product utilization into the contracting strategy can uncover significant savings. Empowering cross-functional teams and identifying supplier partners are just a few tactics to use with current contracting strategies. Together, this approach will support the delivery of high-quality, cost-efficient patient care.

Anne Marie Orlando, RN, MBA, RCIS, CVAHP, Senior Director, Clinical Programs at Blue.Point Supply Chain Solutions; Treasurer, Association of Healthcare Value Analysis Professionals Anne Marie has been a critical care nurse for over 19 years with a leadership foundation in the Interventional Cardiology and Interventional Radiology space. During her supply chain tenure, Anne Marie held a dual role of Supply Chain and Clinical Resource Director where she operationalized many clinical initiatives while maintaining fiscal accountability. At the GPO level, Anne Marie served as the Director of Clinical Services for Yankee Alliance supporting member value analysis teams and their work with clinical utilization. Anne Marie is currently the Senior Director, Clinical Programs for Blue.Point Supply Chain Solutions supporting value analysis teams in the use of the Blue.Point platform focusing on aligning product utilization and standardization with evidence-based practice.

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Value Analysis Advisor (For Sales Reps) How to Develop an Effective Sales Mindset Robert T. Yokl, President/CEO, SVAH Solutions

Having a strong sales mindset is crucial for success in the competitive world of healthcare sales. It's not just about having the right skills and techniques, but also having the right mindset to approach potential customers and close deals. In this article, we will discuss how to develop an effective sales mindset that will help you achieve sales success.

Believe in Your Product The first step in developing a strong sales mindset is to truly believe in the product or service you are selling. If you are not convinced of its value, it will be difficult to convince others. Take the time to understand the benefits and unique selling points of your product and be passionate about it. This will come across in your sales pitch and make it more convincing to potential customers.

Embrace Rejection Rejection is a common part of the sales process, and it's important not to let it discourage you. Instead, embrace rejection as a learning opportunity. Analyze what went wrong and how you can improve for the next pitch. Remember, every "no" brings you one step closer to a "yes." A strong sales mindset is one that is resilient and can bounce back from rejection.

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Robert T. Yokl

Focus on Building Relationships Sales is not just about making a one-time transaction, but about building long-term relationships with customers. This requires a shift in mindset from a focus on making a sale to a focus on building trust and rapport with potential customers. Take the time to get to know your customers and their needs, and tailor your sales approach accordingly. This will not only lead to more sales, but also to loyal customers who will continue to support your business.

Continuously Learn and Improve A strong sales mindset is one that is always seeking to improve and learn. Keep up with industry trends and techniques and be open to feedback from colleagues and customers. Attend sales training workshops and conferences to expand your knowledge and skills. By continuously learning and improving, you will become a more effective salesperson and achieve greater success.

Stay Positive Maintaining a positive attitude is crucial in sales. It can be easy to get discouraged by rejection or setbacks, but a strong sales mindset is one that stays positive and motivated. Surround yourself with positive influences, whether it's motivational quotes, podcasts, or colleagues who have a similar mindset. This will help you stay focused and motivated, even during challenging times.

Celebrate Successes Finally, it's important to celebrate your successes, no matter how small they may seem. This will help you stay motivated and reinforce your positive mindset. Whether it's closing a big deal or receiving positive feedback from a customer, take the time to acknowledge and celebrate your achievements. This will help you stay motivated and continue to strive for success. By following these tips, you can develop an effective sales mindset that will help you achieve sales success. Remember to believe in your product, embrace rejection, focus on building relationships, continuously learn and improve, stay positive, and celebrate your successes. With the right mindset, you can become a top-performing salesperson and achieve your goals.

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Value Analysis 101 Why You Should Adopt a Value Analysis Policy and How to Develop One Robert T. Yokl, President/CEO, SVAH Solutions

VAP is Necessary to Clearly Define VA’s Role in Your Healthcare Organization Too often, value analysis practitioners assume that they have the support and commitment from their healthcare organization’s management team, when in fact their management’s support and commitment is weak or non-existent. Therefore, it is important to have your senior management adopt a Value Analysis Policy (VAP) to ensure that you and your value analysis team(s) have the acceptance needed to have a successful Value Analysis Program.

Goals and Objectives for a Value Analysis Policy The following VAP goals and objectives are outlined below to assist you in developing your own VAP: •

To formally create the staff function of value analysis reporting to supply chain management (or other department).

To establish an annual value analysis budget and performance goals (e.g., percentage savings achieved, average approval time, percentage approved, etc.).

To demonstrate strong organizational leadership and commitment to a Value Analysis Program.

To define accountability for new and existing product, service, and technology cost reduction, quality, and safety improvements.

Naturally, additional goals and objectives can be added that make sense for your healthcare organization.

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Value Analysis 101

Robert T. Yokl

What Else Does a Value Analysis Policy Contain? In addition to your goals and objectives, you will need to elaborate on specific topics as follows to define the authority and scope of your Value Analysis Program: •

A statement authorizing a Value Analysis Steering Committee (VASC) to be formed and comprised of your healthcare organization’s COO, CFO, and stakeholders to monitor and guide your Value Analysis Program. The VASC will meet monthly for this purpose.

A statement permitting your Value Analysis Team(s) to review and approve ALL new product, service, and technology requests, GPO contracts, and renewals, in addition to ongoing assessment of all existing products, services, and technologies with the goal of reducing their cost or improving their quality and safety.

Guidelines for establishing, reinventing, or maintaining a Value Analysis Program such as:

VA will perform value analysis studies on products, services, and technologies with an annual expenditure of more than $25,000.

All VA studies will be completed within a 90-day period, or they will need to be reassessed by the Value Analysis Steering Committee.

Value analysis studies will be performed on products, services, and technologies which represent 80% of the healthcare organization’s supply budget (including purchased services) annually.

Additional essential elements of a Value Analysis Program such as:

Job descriptions of value analysis staff, VA team leaders, and team members.

Selection and appointment process for value analysis team leaders and team members.

Training and education requirements for your value analysis staff, VA team leaders, and team members.

Value Analysis Is a Mission Critical Management Function Value analysis is a mission critical management function of your healthcare organization, whether you realize it or not. VA is responsible for evaluating and approving millions of dollars of products, services, and technologies annually, as well as performing value analysis studies on existing products, services, and technologies. Therefore, it is critically important that you have your senior management’s support and commitment for your Value Analysis Program. We have found one of the best ways to do so is to have a Value Analysis Policy approved by your healthcare organization’s management team. Don’t start or renew your Value Analysis Program without one!

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Value Analysis 101

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Utilization Management 3 Steps to Fast Tracking Clinical Supply Utilization Savings By Robert W. Yokl, Sr. VP, Supply Chain & Value Analysis — SVAH Solutions

Every chief financial officer at every health system wants more savings from their supply chain organization and even more so today with the challenge of inflation hitting our marketplace. Don’t be surprised when you are tasked with bringing about some quick savings for your CFO to add to their bottom line savings report as well as removing these dollars from the respective departmental budgets. One of the best ways to be prepared for this next level of savings demands from your CFO is to start to venture into the realm of clinical supply utilization management (CSUM) that can yield your organization an additional 7% to 15% in overall budget expense. This is all beyond the contract pricing and standardization that you have in place.

Up to 15% of Additional Savings is Available! Clinical supply utilization management is geared towards patient volume centric metrics compared to historical, cohort, or system-wide key performance indicators on an ongoing basis. This will show you at any given point of time where 7% to 15% of savings beyond price is hiding. Knowing where the dollars are hiding and of course where the dollars are not going to bear fruit is important

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Utilization Management

Robert W. Yokl

as your time is limited and you will want to focus on a proven savings opportunity instead of blind luck.

What Are We Looking for with CSUM? CSUM savings are more than likely from waste, inefficient use, feature-rich products, or even just from not getting the full value of life cycle use out of a product that you require. CSUM is the system to identify, track, and follow-up before, during, and after the value analysis study is performed. This all sounds easy on paper but there are some best practices that I would recommend you follow before you jump into CSUM with both feet. 1. Get the Data Right. An ongoing goal for supply chain organizations is to get their data together into a “Your time is limited and working format. How do solutions providers like my you will want to focus on a firm, SVAH Solutions, find a way to enhance our clients’ proven savings opportunity data? Well, we create separate databases that we instead of blind luck.” enhance with improved categorization, normalization, and cleansing that puts a sharper eye on the reporting you use. If you are only working from your own Masterfile, then I can easily tell you that there will be data challenges because the “too many hands in the pot” syndrome occurs. Many are constantly updating your product master files and vendor profiles. We have found that up to 17% to 29% for each monthly download we receive has changed. We then have to run it through our categorization, normalization, and cleansing process in order to keep up with the previous data you have provided us. Why all this work when you have it right in your own active systems? When performing clinical supply utilization reviews with key performance indicators and cohort benchmarks, we have found that even if just one or two line items are off, the end customers and stakeholders you are presenting to will automatically discount what you are showing them. To avoid this, you need to get your data right in a systematic way that works every time. 2. Be Consistent in Your Approach. When you start establishing your methods, benchmarks, and key performance metrics, you don’t want to bounce around all over the place with this best practice here and another there. Keep in mind, benchmarking is really activity-based costing which is an accounting-based principle we are using and is thus a standard with decades of use behind it. Your budget is activity-based costing whereby they are projecting the volumes of each department against the spend and labor costs to the organization. You will be doing the same but only looking at supplies and services. By using the activity-based costing model, or as I refer to it, patient volume centric metrics and key performance indicators, you will have a rock solid foundation in order to build from no matter what product, service, or technology you are analyzing/tracking.

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Utilization Management

Robert W. Yokl

3. Once You Have a Savings Opportunity, Start with the Easy Low-Hanging Fruit First. Now that you have some sort of targets that your benchmarks and key performance indicators are pointing towards, you are going to want to select one of the easy ones to perform your value analysis study on. This may sound like a no-brainer, but sometimes getting your feet wet and learning the ropes of the clinical supply utilization game for you and your customers and stakeholders is best. I know you are tempted to go after a nice big juicy savings opportunity that could be a few hundred thousand dollars, but you need to learn the dynamics of clinical supply utilization. Here are my recommendations you should stick by: Stay Away from HouseWide Use Products – Even though these may seem like a no-brainer, such as pulse oxisensors or exam gloves, these are used universally throughout the organization with varied functional use patterns. Pick a product more specific. For example, if MRSA lab test kits are running 33% over in cost per admission, you can focus on just that one set of products (maybe five SKUs) and uncover the utilization pattern that is causing •

the cost increase. Avoid Going Into Junior Buyer Mode – Many times when we get into clinical supply utilization targets with customer value analysis teams, some of the project leads immediately want to start bidding, renegotiating, or changing the products without truly understanding the why and where of the utilization misalignment. I have been working with CSUM for 20 years and rarely have I ever recommended a change in contract. It just isn’t necessary. Find Out the Root Cause(s) – The simplest thing to do with CSUM is to find out why and where the savings opportunity is occurring. Don’t be naïve, it may happen more than once in a department and/or clinical unit.

Once you get your CSUM System in place, whether you buy one or create one yourself, you will find that you not only use this system on value analysis savings studies but quality and new product request auditing as well. Plus, it will now all be ready for your CFO at any given point in time if they are looking for major savings opportunities. You will be prepared, and you never know, those savings areas that you wanted to get into but perhaps had your hands tied could open up and you will be ready for them because you have your own CSUM reporting system in place and can make a case for positive clinical change!

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Perspective Are Manual Systems Holding Back Value Analysis Decision Making? Robert T. Yokl, President/CEO, SVAH Solutions

“Close to one in four (22%) of respondents still rely heavily on manual methods to process data, which can lead to inefficiencies and errors,” states a recent GHX Survey. In today's fast-paced healthcare world, value analysis practitioners are constantly looking for ways to streamline their processes and increase efficiency. However, many hospitals, systems, and IDNs are still relying on manual systems and spreadsheets for important decision making, which can lead to delays and errors.

The Problem with Manual Systems Manual systems, such as spreadsheets and paper-based processes, have been used for decades by value analysis staff to track and analyze data. While these systems may have been effective in the past, they are no longer sufficient for today's complex healthcare environment. Manual systems are prone to human error, which can lead to incorrect data and decisions. They are also time-consuming, as employees must manually input and analyze data, (or deal with hundreds of emailed requisitions annually) which can result in delays and missed opportunities.

Volume 12/Issue 2

www.ValueAnalysisMagazine.com

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Perspective

Robert T. Yokl

The Solution: Automated Systems The solution to overcoming the challenges of manual systems is to implement automated systems. Automated systems use technology to streamline processes and eliminate human error. For example, value analysis practitioners can use automated systems to receive, triage, and track new product, service, and technology requisitions, analyze data, and make decisions. This automation not only saves time and reduces errors, but it also allows for real-time data analysis, and provides you with up-to-date information for decision making.

The Benefits of Automated Systems Automated systems offer numerous benefits for value analysis professionals, including: Increased efficiency: Automated systems can perform tasks faster and more accurately than manual systems, saving time and resources. Real-time data analysis: With automated systems, value analysis staff can access real-time data, allowing for faster and more informed decision making. Reduced errors: Automated systems eliminate human error, resulting in more accurate data and decisions. Cost savings: By streamlining processes and reducing errors, hospitals, systems, and IDNs can save money and increase profitability.

Implementing Automated Systems Implementing automated systems may seem like a daunting task, but it is a necessary step for value analysis practitioners looking to stay current in today's market. The first step is to identify areas where manual systems are causing delays or errors. This could include project management, requisition processing, data analysis, or decision-making. Once these areas have been identified, you can research and invest in automated systems that best fit your needs.

Improve Your Value Analysis Decision-Making Process Manual systems, like spreadsheets, may have been effective in the past, but they are no longer sufficient for today's fast-paced healthcare environment. By implementing automated systems, you can overcome the challenges of manual systems and improve your value analysis decision making. This not only saves time and resources, but it also allows businesses to make more informed decisions and increase profitability. Don't let manual systems hold your business back. Make the switch to automated systems today.

Volume 12/Issue 2

Healthcare Value Analysis & Utilization Management Magazine

44


Volume 12/Issue 2

www.ValueAnalysisMagazine.com

45


www.UtilizerDashboard.com Volume 12/Issue 2

Healthcare Value Analysis & Utilization Management Magazine

46


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