to assure original goals are being met,” says Strain, who is
also principal of Barbara Strain Consulting LLC, and formerly
director of value management at the University of Virginia
Health System.
Hilary M. Babcock, MD, MPH, professor of medicine in
the Division of Infectious Diseases at Washington University
School of Medicine in St. Louis, acknowledges the challenges
around the hospital supply chain consulting frontline staff
before products and technologies are introduced within the
healthcare facility.
“Supply chain professionals may be tempted to think
it’s an easy switch when they go to a different product or
a cheaper product that may look similar on paper without
engaging infection prevention and frontline users,”
Babcock says. “Infection prevention’s input on
those decisions and frontline user acceptance
of those changes is important. I recognize that
it is a challenge and there are definitely provider
Hilary M. Babcock preferences in every direction about everything,
and so it is not that you are necessarily going to
get absolute consensus on a specific product or a specific
technology change but supply chain personnel must realize
that the product will be more expensive in the long run
when you discover it is harder to clean or more difficult to
use or prone to breakage, so you end up using two every
time instead of one. Those points get missed with just an
on-paper assessment. Supply chain personnel may not have
the clinical expertise, through no fault of their own, and
thus don’t have that insider perspective, and therefore they
can’t necessarily assess risk.”
The VA professional can be instrumental in guiding
a healthcare institution’s capital equipment and other
purchases before such items are installed and used at the
care level – the point of no return.
“While there are many similarities, each healthcare
organization is not quite the same on how they practice
and the patient population they serve and having an
understanding of the practice implications prior to purchasing
is essential,” Graham emphasizes. “To understand the
practice implications, clinicians and key stakeholders need
to be engaged from the very beginning. First, the clinicians
or key stakeholders will help identify the problem or issue
with the current products/technology/equipment whether it
is of a clinical or possibly a financial nature. They also help
to outline the key requirements for use within patient care
which subsequently dictates the model or type of products
or equipment necessary for patient care. It is important to
understand which staff will be using the product to ensure
appropriate education is completed along with ongoing
competency training. Additionally, as the product/technology/
equipment has been implemented they help to provide
feedback on the clinical effectiveness, any unintentional
outcomes and or utilization.”
Strain adds that there are three reasons for inclusion of
key end users of products/technology/equipment before
purchase, including producing the same or better outcome,
ensuring that training, knowledge and usability occurs to
avoid harm to patients or staff, and bringing overall value to
the organization, as the cost associated with the purchase
is not higher than the cost of the outcome being improved.
“VAPs use the equation Value= Outcomes/Cost in their
analysis phase to visually express this work,” Strain says.
To ensure that the perspective of the clinician, IP and VA
professional be taken into consideration going forward, the
experts point to the value of risk mitigation and management.
“Healthcare organizations who adopt an institutional
policy regarding the introduction of products/technology/
equipment/pharmaceuticals/purchased services provide the
safest clinical environment in which patients, visitors and
staff reach desired outcomes,” Strain says. “Such a policy
would ascribe oversight responsibility which aligns to the
value analysis process. Using a consistent value analysis
assessment approach, the institution would be assured of
an appropriate functional, safety, outcomes-based process
creating the best overall value.”
Graham concurs: “VA professionals provide an incredible
service for the healthcare organizations they serve. The top
performing healthcare organizations recognize the need not
only to reduce the cost of care for the patient but understand
the connection to reducing variation in practice and products
and proper utilization to improve patient outcomes. For
healthcare organizations who do not currently have a value
analysis program, adopting such a program would improve
their ability to achieve optimal outcomes through the lens
of clinical efficacy, safety and quality as well as financial.”
Gaining a better understanding of product/technology
evaluation and purchasing can be challenging due to
the immense amount of information coming from the
marketplace daily.
“There are many technologies that sound exciting and
promising and there’s definitely always an appetite for a
single ‘silver bullet’ that will address all of our HAI prevention
PRODUCT EVALUATION AND PURCHASING TOOL
James Davis, MSN, RN, CCRN-K, HEM, CIC, FAPIC, senior infection prevention and patient safety analyst/
consultant with ECRI Institute, suggests healthcare institutions “let ECRI help cut through the ‘white noise’
in the marketplace.” He adds, “We do this work daily and have the expertise to help clinicians prevent
infections and save costs, using science and comparative effectiveness research. We test the claims of
the manufacturers, especially if the device is not FDA-regulated as many infection control technologies
are not, such as many UV-C disinfection technologies.
Davis has developed a tool that assesses many of the factors one should consider when purchasing
new equipment. The tool and associated article are available at: http://patientsafety.pa.gov/pst/Pages/
Infection%20Prevention,%20Ergonomics/assessment.aspx
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february 2020 • www.healthcarehygienemagazine.com