Value- and Science-Based Healthcare Evaluation and Purchasing
By John Scherberger FAHE , T-CSCT , VPEI
“ The time has come ,” the Walrus said , “ To talk of many things : Of shoes — and ships — and sealing-wax — Of cabbages — and kings — And why the sea is boiling hot — And whether pigs have wings .”
Source : “ The Walrus and the Carpenter ” by Lewis Carroll
Editor ’ s note
This article is part of a yearlong series describing an Industry journey led by environmental services and infection prevention toward better patient outcomes , quality and cost savings .
What a strange way to start an article about value and science-based healthcare evaluation product purchasing . What does the poem have to do with product evaluation and purchasing ?
Recognize this : When considering all the essential elements needed to purchase critical healthcare essentials , many people bypass the science , safety , efficacy , value , and cost ( not just the price ) of crucial products . It ’ s as if some people become the Walrus and concentrate on too many nonsensical and dissonate issues such as shoes , ships , sealing-wax , cabbages , and kings . Their minds take flight in search of the unrealizable , and yes , the impossible , such as if pigs have wings .
But when it comes to needs , product assessments , and desired outcomes , it often appears those decision-makers take flights of fancy like the Walrus or ignore the fundamental goals of all healthcare products -- safety for staff , patients , and visitors , the efficacy of the products to accomplish the intended outcomes , and the lifetime costs involved in using the products . Cost is not the same as price , and expenses must include life-cycle issues . The training involved in using the products , the time needed to use the products , the physiological stress tools and equipment have on staff , and the potential for workers ’ compensation claims , the ecological effects products have on the environment , and so many other costs involved during the lifetime of the products . Be mindful that if the price is the determining factor in a purchase , that is when everyone should expect to see pigs fly . Because pigs will never fly , and in value-based and science-based purchasing , the price will never be the fundamental reason for buying anything . The old axiom of getting what one pays for is so true .
For example , when a hospital purchases disposable items that have reusable counterparts based upon the word of a company representative , an offered price , or a rebate not based on scientific evidence , one must ask questions , and others must provide scientific answers . If reusable items are purchased , yet disposable products offer safer , science-based desired outcomes , the purchasing department should choose the disposable products .
The patient cannot be the “ oh , yeah ” part of the equation when considering infection prevention and environmental services tools . In this context , tools are liquid cleaners and disinfectants whether they are concentrate or ready-to-use ( RTU ), wipers , mops , dusters , toilet mops , mop handles , EVS carts , and other tools of the trade . Not following value and science-backed purchasing decisions can have a detrimental impact on patient health and outcomes .
There are no preternatural measures needed for infection prevention to be effective . Infection prevention may be strictly clinical by nurses , physicians , phlebotomists , or quasi clinical EVS professionals tasked with rendering healthcare environments hygienic . Whether tackling the effects of a Clostridioides difficile outbreak or the COVID-19 pandemic , infections cost $ 40 billion in the United States each year . Healthcare-associated infections ( HAIs ) cost the average 500-bed hospital $ 5.5 million in lost revenue .
Conditional reasoning and logical equivalence (“ If-Then ”) should dictate that healthcare professionals ’ reason if the $ 40 billion in lost revenue has one source , HAIs , then many tributaries that contribute to the source . If clinicians do their utmost to prevent central line-associated bloodstream infections ( CLABSIs ), catheter-associated urinary tract infections ( CAUTIs ), ventilator-associated events ( VAEs ), surgical site infections ( SSIs ), and methicillin-resistant Staphylococcus aureus ( MRSA ) bloodstream events , then contaminated healthcare environmental surfaces remain as a significant contributor to other HAIs . And who is tasked with disinfecting healthcare environmental surfaces and rendering them hygienic ? Environmental services ( EVS ) is . Yes , hands are the biggest spreaders of germs , but the germs are transferred to and contracted from surfaces , other people , uniforms and scrubs .
Questions must be asked : “ Why are scientific and value-based