When it comes to busy ASCs, maintaining the proper inventory to support your case volume can be time-consuming and cumbersome. Solid inventory strategies are essential when it comes to streamlining efficiencies and preventing headaches related to ordering, tracking, and billing for IOLs. As a result, some have turned to, or at least considered, software systems that automate these processes. Still, many remain successful in utilizing manual tracking solutions that have been refined to suit their needs.
A well-managed inventory is a key component of an efficiently run ASC, explains Carrie Jacobs, COE, CPSS, OCS, administrator at Chu Surgery Center in Minnesota. But Jacobs has yet to find an inventory management software system that would boost efficiency for her practice’s operation.
“In our experience, many systems still have a large manual component and, frankly, slowed down the pace for us in our higher-volume ASC, which primarily performs cataract surgery,” Jacobs says. “We have found that QuickBooks has been the most efficient. Purchase orders can be created and sent to the vendor very efficiently. When product comes in, it is received into QuickBooks, which streamlines accounts payable.”
Mark A. Kontos, MD, senior partner with Empire Eye in Spokane, WA and Coeur d’Alene, ID, adds that there seems to be a direct correlation with volume and need. Kontos says that being a one-room center makes it easy for his surgical coordinator to manually track what lenses go out.
Vickie VanHoose, lead surgical technician at the Cataract & Laser Center, LLC in Crossville, TN, agrees.
“We utilize a large consignment inventory to decrease our need for ordering,” says VanHoose. “But due to the fact that we are a one-room surgery center, and because we do not have a large number of specialty lenses, we don’t have the need for a software system to manage our IOLs at this time.”
Things may soon change for Dr. Kontos, however. Currently, he is in the process of building a new two-room surgery center and believes the increased complexity will likely warrant exploring new options.
“A multi-room ASC is inherently a more complex arrangement,” says Dr. Kontos. “The increased volume alone makes an automated system more prudent when it comes to managing the inventory.”
“Large, high-volume ophthalmic centers and multi-specialty ASCs would benefit from an inventory management software rather than a manual system,” she says. “However, we haven’t typically found such a system necessary in a single-specialty ASC such as ours, primarily because most of the inventory dollars are contained in relatively few items — IOLs, custom packs, and so on — and can be managed manually in a cost-effective manner.”
Chu Surgery Center uses its IOL inventory on consignment, as many surgery centers do, in order to limit the amount paid for inventory that isn’t used.
“Consignment payment does require a change in approach to inventory,” notes Jacobs. “Instead of doing all the purchasing up front, practices must interact with the manufacturer virtually every day of surgery to pay for IOLs. We try to consign different products versus sitting on inventory. In the case of consigned products, if any item expires, the manufacturer simply switches out the expired product for non-expired replacement. We track all lenses and MIGs devices we implant manually, and we cross check billing against our inventory supply monthly. Weekly inventory checks are done for implants and drugs.”
Jacobs says that the OR team meets weekly to plan ahead for upcoming cases and determine any non-routine procedures on the schedule in order to make sure they are prepared.
“That way, for procedures that we are not doing often, we do not have to purchase and sit on inventory that may expire before being used,” Jacobs adds. “After surgery is finished, we do a physical recount to make sure items compare with what we see on our checklist. By Thursday, at the latest, we place orders. On Monday, we perform a final check, accounting for items that may have just arrived. Doing this in advance saves time and costs. Everything is available for surgery. All we have to do is pull lenses and whatever medications and packs we need for the next week.”
Of course, those who have made the switch to an automated system have found that it has had a dramatic effect on efficiency. Michele Schenk, surgical coordinator for The Eye Associates in Bradenton, FL, says that implementing ORBITS, a barcode-based solution for multi-vendor inventory by McKresson, has been a huge time-saver when it comes to bill and replace efforts and tracking IOLs. In fact, the system has reduced the workload to only one staff member (Schenk) handling IOL inventory management instead of two full-time employees, as was previously needed.
“Now that bill and replace is automatic, it’s even freed up a lot of my time to be doing other tasks,” Schenk says. “When the IOL is implanted, we receive the replacement in 2 days. The system creates reports for the implants being used. All I have to do is perform a quick double-check that what has been billed is matching up with what has been used. Everything is incredibly streamlined and much more efficient.”
Dianne Burdick, ASC director, adds that no longer having to call each manufacturer for re-ordering is a definite time-saver for The Eye Associates.
“Plus, inventory is not just sitting on shelves not being used,” she adds. “We don’t have to worry about overstocking. The inventory reports created by the system include expiration dates, which is also incredibly helpful.”
Having gotten so used to this system makes it difficult if the computers are ever down and the manual process needs to be performed temporarily, say both Schenk and Burdick.
“It’s hard to ever imagine going back to a manual process,” says Schenk. “I really believe that any high-volume ASC that tries a system like this will never want to do it any other way.”
Finding the Right System for Your ASC
Finding the right system to suit your ASC’s needs is critical. Schenk says that it’s important that the system is user-friendly to the ASC staff. It should also have the ability to run reports relating to usage, inventory, and returns as well as bill and replace IOLs and perform barcode scanning. All of these factors optimize the usefulness of a system, says Schenk.
Of course, Schenk adds, it’s also incredibly valuable to have good support from whichever manufacturer you choose.
“The support is instrumental to your success,” she adds. “When you need to troubleshoot, you want to know you can count on help or else you start to diminish the efficiency factor.”
When the time comes to explore options, Dr. Kontos says that it will be imperative the inventory management system his practice chooses is compatible with its current EMR system.
“The ability to have that extra data and to generate reports with a software system that handles inventory could be a definite advantage as the practice grows,” Dr. Kontos adds. “Being able to see utilization trends, such as whether one surgeon utilizes one lens type more often than another, could be very beneficial information when trying to determine economic decisions and forecasting.”
Jacobs says that she also foresees a potential future in which an electronic inventory system is implemented into practice — though for now, she says their manual system works.
Whether an automated approach or a manual one, having checks and balances in place is important.
“I strongly recommend having one surgeon at the ASC that pays attention to supplies and expenses,” adds Jacobs. “Staff should take care of the details with one person responsible for ordering, but the engagement of a shareholder’s oversight is critical for good checks and balances. At the end of the day, it is a team effort.” ■