through the back door to clinicians , instead of coming through the front door and following protocol , for example . “ We need VA professionals and clinicians to understand the impact on patient safety that a front-door vs . a back-door approach can have . Sales reps must follow the proper process in place by the institution . Staff also need to be properly introduced to and educated around the use of the product or device , with initial and ongoing training to ensure competencies .”
The second step in the AHVAP methodology is gathering data on current and potential products and devices , as well as evidence from trials and data from manufacturers and suppliers to help inform the decision-making process and aid in problem-solving around product evaluation and purchasing . A common barrier to this step , Graham noted , is that products and devices can be “ emotional ” – meaning that clinicians frequently become attached to the products and devices they use and may be resistant to change . “ Clinical preferences can be very difficult to evolve ,” Graham observed .
The third step in the AHVAP methodology is conducting the analysis and securing approval . “ Be sure to build on the previous steps in the methodology ,” Graham advised , explaining that evaluation is about clinical acceptance at this point , and then choosing among vendors . “ Try to whittle down the choices you have among vendors and suppliers ,” Graham suggested . “ Look at everything out there , consider staff ’ s initial evaluation , then as products and devices fall out of consideration , get down to comparing just two or three options .”
The fourth step in the AHVAP methodology is acquiring and implementing the products and devices procured , where onboarding is conducted and orientation and training around the items can commence . “ It ’ s an orchestra of individual steps coming together at this point ,” Graham said , noting that a frequent challenge at this stage is the logistics around set-up as well as interdisciplinary training of clinical staff that is needed .
The fifth step in the AHVAP methodology is monitoring the procurement and sustaining best practices over time . Graham
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Healthcare Value Analysis and the COVID-19 Pandemic
The burden on resources that the COVID-19 pandemic has placed is of concern to all healthcare institutions . Barbara Strain and Gloria Graham provide their insight on how healthcare value analysis may provide some relief .
HHM You allude to the parallels with COVID-19 – how has the pandemic impacted the principles and practices of VA ?
Barbara Strain ( BS ): COVID-19 is caused by a novel virus , from symptoms , treatments , testing the world had not seen it before and had to start from scratch . As the need for personal protective equipment and other key products increased so did the vetting of available alternate products and suppliers . Value analysis was called upon to use their clinical based evidence and quality focused practices to work with clinicians , physicians , and leadership to advise supply chain what to purchase based on availability . All routine value analysis business came to a halt . No new products were reviewed unless related to COVID19 staff safety and patient care . All resources and practices were focused solely on supporting COVID19 healthcare . Through a network of communication channels within and outside hospital systems leading clinical and procurement practices were shared .
Gloria Graham ( GG ): As a result of the pandemic value analysis professionals had to pivot the principles and practices of value analysis in order to meet the new demand caused by COVID19 . The demand for PPE products was none like anyone had ever experienced which led to an “ all-hands-on-deck ” response in order to support the increase need of those products . This resulted in many hospitals putting a hold on all new requests unless it was an emergent patient situation or COVID related products . This shift in focus allowed value analysis and supply chain staff to concentrate solely on supporting the needs of the clinicians and patients related to COVID . The hiatus provided value analysis professionals the opportunity to re-evaluate their programs allowing them time to refresh their policies , guidelines and practices based on their most recent learnings . This impact has really highlighted how collaboration between clinicians and value analysis is the driving force behind a successful program providing healthcare organizations to achieve their clinical and financial goals .
HHM What could the discipline of VA look like as we enter the post-pandemic world and incorporate lessons learned ?
BS : Through a series of AHVAP podcasts and virtual learning opportunities lessons poured in quickly allowing value analysis professionals to focus on retooling policies , procedures , and practices to meet the novel demand . Early learnings like these also highlighted that value analysis was earning the trust and awareness of executive leadership which proved to set the stage for enhancing and supporting the future state of the profession in healthcare . Among some of the initial cultural changes was the realization of clinicians and physicians that the processes that value analysis had been supporting were now being understood . This set the stage for a transformation to focus on a “ what truly is needed vs a want ” mentality kicking off a new evolution .
GG : There have been so many valuable lessons as a result of the pandemic experience . First , I think it has allowed healthcare organizations to step back and review their value analysis programs for opportunities for updating or improving their existing programs . Additionally , some of the traditional contracting strategies of sole source suppliers was quickly brought to the forefront as a contributing factor to the disruptions seen within the healthcare supply chain . In my experience through this pandemic I have seen even more a shift of clinical integration within value analysis which will continue to have positive downstream effects as we head into the post-pandemic world . Recognition by the clinicians regarding the all of the intricacies that occur behind the scenes has led to increased collaboration between the two worlds within the hospital . It was pretty amazing to have staff say to me “ wow I had no idea about everything you do – how do you handle it ." The recognition of value analysis in healthcare organizations has led to better engagement and support of leadership which ultimately sets the tone for value analysis programs .