BestPractice
April 8, 2016

By partnering with their supply chain colleagues, clinicians are helping deliver significant savings for the Johns Hopkins Health System. They analyze products considered for purchase or contract renewal and select those that present the greatest value for their hospital or health system.

“We’re seeing more of these partnerships and seeing great results,” says Lisa Ishii, senior medical director for clinical integration for the Office of Johns Hopkins Physicians and chief quality officer for clinical best practices for the Johns Hopkins Health System.

When teams agree to stock fewer products for, say, the operating room, surgical team members are more familiar with every item, improving both clinician satisfaction and patient outcomes by reducing the risk of harm, Ishii says.

Experience has shown that “what leads to meaningful and sustainable change is having the clinicians at the table,” says Ishii.

One of the most effective clinician-supply chain collaborations to occur at Johns Hopkins to date involved spinal surgeons from across the health system. They worked with the Johns Hopkins supply chain’s contracting department to secure $3.3 million in contracted savings on hundreds of spinal implant products from 14 vendors.

First, the contracting department informed spinal implant product vendors that, going forward, the health system would pay only a certain price for each product. Some vendors did not agree, and negotiations began. To back up the contracting department, the Armstrong Institute for Patient Safety and Quality’s Spine Clinical Community evaluated each implant’s importance to patient care. After the group’s assessments supported the arguments for lower prices, the contracting department managed to exceed its original projected savings by about $800,000, says health system perioperative contracting manager Tom Frasca.

The Blood Management Clinical Community is another physician-led group that works to identify and achieve value-related treatment goals at Johns Hopkins. Clinicians from across the health system recently collaborated with the supply chain to reduce the number of red blood cell units transfused unnecessarily at Johns Hopkins member hospitals. Although the long-standing infusion protocol called for infusing patients with two units of red blood cells at a time, one is more appropriate in most cases, says Steven Frank, medical director of the health system’s Blood Management Program.

Last year, the clinical community implemented a Why Give Two When One Will Do? campaign using evidence-based criteria for transfusions. As of February 2016, the campaign had resulted in a 48 percent reduction in orders for two or more units of red blood cells across the health system — for an annual savings of $1.25 million, Frank says.

Two years ago, the Joint Clinical Community helped achieve $1.5 million in savings by participating in hip and knee implant pricing negotiation efforts.

Given the financial pressures of health care delivery, Ishii expects collaborations like these will blossom at health systems and hospitals across the country.

“I think this is the future,” she says. “This is the way that we will achieve sustainable results — through an open dialogue and partnership between clinicians and the supply chain department.”