WO1999002407A1 - Method for the supply of medical supplies to a health care institution - Google Patents
Method for the supply of medical supplies to a health care institution Download PDFInfo
- Publication number
- WO1999002407A1 WO1999002407A1 PCT/US1998/013953 US9813953W WO9902407A1 WO 1999002407 A1 WO1999002407 A1 WO 1999002407A1 US 9813953 W US9813953 W US 9813953W WO 9902407 A1 WO9902407 A1 WO 9902407A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- supplies
- care
- medical
- supply
- materials
- Prior art date
Links
Classifications
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B65—CONVEYING; PACKING; STORING; HANDLING THIN OR FILAMENTARY MATERIAL
- B65G—TRANSPORT OR STORAGE DEVICES, e.g. CONVEYORS FOR LOADING OR TIPPING, SHOP CONVEYOR SYSTEMS OR PNEUMATIC TUBE CONVEYORS
- B65G1/00—Storing articles, individually or in orderly arrangement, in warehouses or magazines
- B65G1/02—Storage devices
- B65G1/04—Storage devices mechanical
- B65G1/137—Storage devices mechanical with arrangements or automatic control means for selecting which articles are to be removed
- B65G1/1373—Storage devices mechanical with arrangements or automatic control means for selecting which articles are to be removed for fulfilling orders in warehouses
- B65G1/1376—Storage devices mechanical with arrangements or automatic control means for selecting which articles are to be removed for fulfilling orders in warehouses the orders being assembled on a commissioning conveyor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G12/00—Accommodation for nursing, e.g. in hospitals, not covered by groups A61G1/00 - A61G11/00, e.g. trolleys for transport of medicaments or food; Prescription lists
Definitions
- This invention relates to the supply of medical supplies to patient care institutions, and particularly to methods for the assembly, transport and storage of disposable medical supplies.
- the clinical pathway concept has been applied internally of health care institutions, affecting only those services which originate within the institution and which are provided by the internal resources of the institution. No correlation of the protocol to the cost of supplies in known to have been made prior to the present invention. Yet, one of the major sources of costs associated with the treatment of a patient in an institution is the cost of the supplies which are consumed by the institution. Because of this shortcoming of the clinical pathway concept, health care institutions have failed to achieve significant cost savings with respect to the supplies used in the course of any given protocol. This is especially true with regard to disposable medical supplies which typically are supplied to the institution from outside sources.
- U.S. Patent No. 5,235,795 discloses a method for the delivery, storage, transport and disposal of medical supplies to a health care institution in which the ultimate cost to the institution of the medical supplies is reduced by supplying disposable medical supplies direct from a supplier in receptacles which may thereafter be used by the institution in safely disposing of waste medical supplies.
- This method is dependent upon the institution identifying the supplies needed and placing an order for the same from a supplier. The usefulness of the method therefore is limited by the institution's accuracy of ordering. If the institution has inadequate facilities to determine its supply needs, and as a consequence orders too little or too much of a given supply item, this prior art system has no means for detecting this shortcoming.
- Figure 1 is a diagrammatic representation of a generic clinical pathway as applied to the healthcare institution
- Figure 2 is a diagrammatic representation depicting various aspects of one embodiment of the method of the present invention
- Figure 3 is a diagrammatic representation depicting other aspects of one embodiment of the method of the present invention
- Figure 4 is a diagrammatic representation of the supply structure of one embodiment of the present invention.
- Figure 5 is a diagrammatic representation depicting various aspects of one embodiment of the present invention.
- Figures 6a through 6h is a printed listing of a bill of materials used in one embodiment of the present invention.
- Figures 7a through 7i are nine pages of sequencing instructions.
- the supply needs of a health-care institution are integrated into a system for the delivery of these supplies to the institution.
- the method comprises a nested multilevel system in which the smallest element of unitization in the system is termed a "unit". Units are combined into supply bundles which are subassemblies to consumption levels (i.e. care events), and consumption levels are subassemblies to a particular clinical pathway. In this manner, the institution may follow an object-oriented, unitized approach to supply consumption along with the clinical pathway.
- the method of the present invention includes the steps of expressing those items of medical supplies which a health care institution requires for a given care event (consumption level) in a clinical pathway for a given medical procedure, as a bill of materials, employing identification codes (identifiers) which include at least an identification of the care event with which the supply is to be used, and identification of the item itself.
- identification codes identifiers
- a bill of materials which is representative of those medical supplies identified for a given care event within a clinical pathway, is prepared preferably at a first location of medical supplies. At the first location, at least a first portion of the medical supplies on the bill of materials is unitized into a unit. One or more units may be prepared.
- the unit or units are deposited in a container having a void volume which is greater than the volume occupied by the unit.
- the container with the unitized medical supplies therein is releasably closed and thereafter transported to a remotely located second supplier.
- At the location of the second supplier at least a second portion of the medical supplies on the bill of materials is unitized.
- the container is opened and the unit or units of medical supplies provided by the second supplier are deposited inside the container, the container is re-closed and transported with the medical supplies, commonly to a department in a care provider (e.g. operating room of a hospital) . In certain instances it may be desired that the care provider also add medical supplies to the container.
- a care provider e.g. operating room of a hospital
- the container with the unitized medical supplies from the first and second supplier is releasably closed and shipped from the second supplier to the care provider.
- This care provider thereupon opens the container and adds to the container those medical supplies which it can most advantageously supply.
- the container may then be closed and either placed in inventory or transported to the end user.
- the present method accommodates these steps of the procedure in that the initial bill of materials lists thereon those medical supplies which are to be added to the container by the care provider prior to the container being forwarded to the end user.
- the advance notice provides to each tier of suppliers precisely where and what products are required and the means by which each supplier can ensure the availability of its designated medical supplies well in advance of the need therefor. Ordering of medical supplies from a manufacturer and inventorying of the supplies are both enhanced by the present method.
- the unique identifiers employed in the present method serve multiple purposes. These codes include identification of the supplier of each item of medical supply, through multiple levels of supply within the supply chain as necessary, thereby providing traceability of the item to its source as is required by federal and other regulations for the handling of medical supplies, particularly sterile medical supplies. Further, each code includes identification of that care event within the clinical pathway of the institution where the supply item is to be used, thereby assuring that the particular supply item is delivered to its intended point of use, so that the institution's clinical pathway is not disrupted by reason of the item of supply not being available at the time and place with the institution when needed.
- this aspect of the method permits the institution to order disposable medical supplies by procedure, as opposed to the traditional ordering of individual items of medical supplies for warehousing at the institution and withdrawing from the stock of these supplies as needed.
- this aspect of the method further permits the institution to stock medical supplies on the basis of historical information as to the number of given medical procedures (care events) that are to be expected within a given time frame. This capability permits the institution to stock standardized units of supplies for statistically calculable demands for the supplies and thereby reduce supply inventories.
- a generic clinical pathway for a given medical procedure within a health-care institution may include a series of care events such as admission 10, patient work-up 12, pre-op 14, anesthesia 16, operating room 18, post-op 20, floor 22 and discharge 24.
- the disposable medical supplies which the institution must obtain from a source outside the institution, as well as any medical supplies that are to be provided by the institution itself, and which are associated with a given care event are identified.
- Each identified item of supply is assigned a unique code which identifies at least the item itself, the source for the item and the care event with which the item is to be used within the institution.
- Each code also may include identifiers of the anticipated user of the supply, such as a surgeon's initials, and other identifier information.
- identifiers of the anticipated user of the supply such as a surgeon's initials, and other identifier information.
- the federally promulgated ICD-9 code International Classification of Disease - 9th Revision
- ICD-9 code International Classification of Disease - 9th Revision
- the preferred code further includes an identifier for the location within the clinical pathway, i.e. care event at which the bundle of the supplies is to be consumed, e.g. in the operating room.
- the code comprises a nested multi-level system - the supply item identification, bundle identification, supplier identification, and care event identification.
- Each identifier may include alpha, numeric or a combination of alpha and numeric characters .
- the maximum number of characters in any given identifier is limited only . by the data handling system (s) available to the manufacturer, the distributor, the institution, and the end-user. It will be recognized that the entity which initiates a bill of materials must have access to full information for each care event as will enable the entity to generate the bill of materials.
- the identifiers associated with the medical supplies intended for a given care event, within a clinical pathway are initially expressed as a bill of materials which is thereafter used as the basis for collecting and unitizing the medical supplies.
- a single bill of materials for a given supply bundle is used by all providers of medical supplies that go to make up the supply bundle.
- a typical supply chain for products made, delivered and eventually used in a medical care facility such as a hospital, which employs the clinical path concept in its patient care functions, includes one or more manufacturers 30 and 32 of one or more of the supply items used in one or more of the care events 34, 36, 38 and 40 of a clinical path, indicated generally by the numeral 42, and, optionally, is a distributor 44 of one or more of the supply items used in one or more of the care events of the clinical pathway.
- the supply chain is completed by the inclusion of the medical care facility 46 itself.
- medical supplies for a given care event may be supplied by the manufacturer and by the hospital, or by the distributor and the hospital or by all three, or even including multiple distributors or multiple manufacturers .
- supply bundles 50, 52, 54 and 56 which are intended for use within respective care events 34, 36, 38 and 40, originate with one or more manufacturers 30 and 32.
- one or more supply items, manufacturer are unitized into a unit 58.
- This unit of medical supply items is placed in a container 60 which is releasably closed, as by a removable lid 62.
- this container and its contents are thereafter transferred to the location of a distributor 44 where one or more additional supply items are unitized into a further unit 64 and placed in the container 60.
- the container with its contents of medical supplies is referred to as a "supply bundle".
- the supply items provided by the distributor commonly are products provided by a second manufacturer 32 other that the first manufacturer, thereby, requiring that either the distributor or the second manufacturer cooperate in assigning to the supply items provided to a supply bundle appropriate identifiers that are consistent with the identifier protocol established between the medical care provider and the first manufacturer, for example this most commonly is accomplished by the first manufacturer initially establishing an identifier for each medical supply item to be included in a given bundle, plus other appropriate identification elements, which the distributor also uses. For example, the distributor may affix the appropriate identifier which is provided by the manufacturer, to each supply item which the distributor adds to the bundle.
- each supply bundle comprising the container, its lid, and one or more units of medical supply items, is delivered to the location of that care event for which the supply bundle was designed, for example, to OR
- the hospital through its historical usage records for its medical supplies for a given care event, can readily order from a manufacturer, and the manufacturer ( and distributor) can readily deliver, in a timely fashion, those medical supplies which are required for the given care event. Timing of the ordering and delivery of a given supply bundle is further enhanced through the use of the hospital's historical records relating to the frequency of occurrence of a given care event within the hospital.
- the inventors have found that many care events, as defined in the clinical pathway concept of providing patient care, even though taking place at different levels of a given clinical pathway and/or even in the clinical pathway for disparate illnesses (i.e. for different ICD-9 codes) call for the use of common items of medical supplies. Therefore, based upon a given hospital's historical occurrence rate of all (or many) of its ICD-9s in combination with the hospital's usage rate for each of its care events, irrespective of the ICD-9 with which the care event may be associated, the inventors can project the total usage by the hospital over time of each item of its medical supplies.
- a manufacturer of a variety of medical supplies can anticipate the usage of those medical supplies which it contemplates that it will provide to the supply bundle.
- the manufacturer therefore, can more efficiently control its ordering and inventorying of raw materials, can better schedule its manufacturing operations, and can reduce its inventories of finished goods.
- the medical supplies can be provided to the hospital at a cost that permits the hospital to minimize its costs of providing health care to its patients.
- One feature of the present method provides for the generation of the bill of materials at the outset, i.e. upon receipt by the manufacturer of an order for a particular procedure. Since the bill of materials as initially generated includes identification of the supply items which are to be provided by each of the manufacturer, the distributor and/or the hospital, a copy of the bill of materials provided to each entity substantially immediately upon its completion provides useful advance notice to the entities so notified that the order has been received and is being processed. Importantly, this advance notice also identifies to each entity the products which they are expected to provide so that they can "preprocess" the order by collecting and unitizing the supply items in anticipation of receipt of a container from the entity ahead of them in the supply chain.
- the present method permits the hospital to include patient- specific items in a given bundle.
- patient-sized items such as endotracheal tubes and foley catheters commonly can not be specified until the patient surgery (or other specific treatment) is scheduled.
- the hospital and/or distributor had to keep on hand inventories of such patient specific supplies. Because of the control over inventory and short lead time afforded by the present method, these items can be included in a specific bundle which is labeled for a specific patient. Again, this permits the hospital to reduce its level of inventory of the medical supplies and realize monetary savings.
- the unitizing of the medical supplies by a manufacturer may take any appropriate form, but preferably includes collecting the medical supply items and enclosing them in a protective cover, such as a bag (which may be sealed) or a wrap of the type known in the art as a sterile wrap.
- a protective cover such as a bag (which may be sealed) or a wrap of the type known in the art as a sterile wrap.
- the function of the protective cover is two-fold primarily. First, the cover protects the products from possible contamination and from possible damage due to shifting or movement during transit or handling. Second, the cover unitizes, that is segregates, the collection of medical supplies so that the unit can be readily identified. This identification includes identification of the unit as a billable item for purposes of reimbursement accounting. That is, the unit, through its unique identifier, provides both the hospital and a third party payment provider, such as Medicare, Medicaid or insurance company, with sufficient information to qualify the unit of medical supplies as a valid reimbursable entity.
- the container employed in the present method can be one of the type which is disclosed in U.S. Patent No. 5,235,795, for example, which patent is incorporated herein in its entirety, by referenced. This patent further describes a type of packaging of medical supplies which is acceptable for use in the present method. Other containers, including bags or conventional boxes may be employed.
- FIG 4 shows an alternative supply arrangement to that previously described.
- the previously described supply method could be described as “series” or “Sequential” since the container is shipped from source of supply to source of supply and is packed with additional supplies at each source.
- Figure 4 shows a method for constructing the unitization of medical supplies at a central "sequencing center.” This method still relies upon the nested bill of materials, previously described, to provide for the proper ordering, assembly and packing of the supplies, but does not require the physical shipment of the container to multiple locations and allows for bundling of supplies from multiple sources within the unitized container for ease of use by the end-user.
- the nested bill of materials associated with the procedure is automatically associated with the order and ha the attributes previously described. This nested bill of materials is printed at or sent to a Unitized Container Sequencing Center 100.
- this Sequencing Center 100 is located at a geographically central location so as to be easily reached by supply shipments and to allow for the quick shipment of unitized containers to various distributors.
- orders are provided to Regional Operating Centers 102 which are operated by the various suppliers who supply components for the procedure. The components are shipped form the Regional Operating Centers 102 to the Sequencing
- the unitized container is then packed (as will be described later) and closed for shipment to a specified distributor 104. This distributor, without opening the container, will then further ship the container to the appropriate customer.
- the efficiency in packing the container is enhanced.
- Figures 6a through 7i the nested bill of materials of Figures 6a through 6h corresponds to the set of sequencing instructions provided in Figures 7a through 7i.
- Figure 7a is a pick list showing the parts that are needed to build the pack.
- Figure 7b shows the unitization instructions which show how to group the supplies into unitized bundles (such as the bundles of Figure 5) ;
- Figure 7c shows a label which would be applied to one of the unitized bundles assembled in accordance with the unitization instructions.
- Figure 7d shows the sequencing instructions that determine the order in which the unitized bundles will be placed in the container.
- Figure 7e is a checklist which is used to insure that the bundles have been placed within the container in the proper order. With these instructions, the supplies may be grouped according to functional relationship and then placed within the container in the most convenient fashion for retrieval .
- the supplies in the unitized container were bundled according to functionality, but were also bundled according to source.
- all of the supplies from a particular source relating to a specific care event were bundled together, but there would frequently be multiple bundles for a given care event.
- the example nested bill of materials set out above has two operative care event bundles, one from DeRoyal and the other from Owens and Minor. While more efficient than old supply methods, this method still requires two bundles to be opened for the particular care event, adding to the workload of the operating room assistants.
- efficiency my be enhanced by grouping supplies solely by usage functionality without regard to source.
- the methodology described with respect to Figures 1 through 3 will be sufficient to meet the needs of the customer; however, the methodology described with respect to Figures 4 through 7 may be required by some customers. However, if desired, similar sets of sequencing and unitization instructions could be provided to the various suppliers along the path of the container as described with respect to Figures 1 through 3. Also, the centralized processing provided by the method of Figures 4 through 7 allows for a reduction in the number of times the unitized container 108 must be shipped, limits the number of people who will be opening and packing the container and facilitates greater quality assurance over the process for providing unitized containers in accordance with a nested bill of materials.
- the supply chain may not include a distributor, but rather the first provider may be the manufacturer and the second provider to add supply items to the bundle may be the hospital, itself.
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE69834656T DE69834656T2 (en) | 1997-07-10 | 1998-07-09 | METHOD OF DELIVERING MEDICAL PRODUCTS TO A HEALTH INSTITUTION |
EP98936816A EP1023223B1 (en) | 1997-07-10 | 1998-07-09 | Method for the supply of medical supplies to a health care institution |
JP2000501950A JP2001509464A (en) | 1997-07-10 | 1998-07-09 | How to supply medical equipment to medical facilities |
CA002296058A CA2296058C (en) | 1997-07-10 | 1998-07-09 | Method for the supply of medical supplies to a health care institution |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/889,948 | 1997-07-10 | ||
US08/889,948 US6085493A (en) | 1995-06-12 | 1997-07-10 | Method for the supply of medical supplies to a health-care institution based on a nested bill of materials on a procedure level |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1999002407A1 true WO1999002407A1 (en) | 1999-01-21 |
Family
ID=25396031
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1998/013953 WO1999002407A1 (en) | 1997-07-10 | 1998-07-09 | Method for the supply of medical supplies to a health care institution |
Country Status (7)
Country | Link |
---|---|
US (1) | US6085493A (en) |
EP (1) | EP1023223B1 (en) |
JP (1) | JP2001509464A (en) |
AT (1) | ATE327158T1 (en) |
CA (1) | CA2296058C (en) |
DE (1) | DE69834656T2 (en) |
WO (1) | WO1999002407A1 (en) |
Cited By (2)
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WO2002019193A1 (en) * | 2000-08-30 | 2002-03-07 | Arkray, Inc. | Consumables supply system |
WO2002048827A2 (en) * | 2000-12-12 | 2002-06-20 | Deroyal Business Systems, Llc | Modular tracking and profiling system |
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US6567822B1 (en) * | 2000-03-21 | 2003-05-20 | Accenture Llp | Generating a data request graphical user interface for use in an electronic supply chain value assessment |
US20020116372A1 (en) * | 2000-06-27 | 2002-08-22 | Dave Ladouceur | Integrated management of product information |
US20020082866A1 (en) * | 2000-06-27 | 2002-06-27 | Dave Ladouceur | Integrated management of medical information |
US7251611B2 (en) | 2001-03-14 | 2007-07-31 | International Business Machines Corporation | Method and system for determining an economically optimal dismantling of machines |
US7774211B1 (en) * | 2001-04-13 | 2010-08-10 | General Electric Company | Method and system for graphically displaying consolidated condition data for equipment in a host facility |
US7216086B1 (en) | 2001-04-30 | 2007-05-08 | Cisco Technology, Inc. | Method and apparatus providing a supply chain management system useful in outsourced manufacturing |
US7366772B2 (en) * | 2001-06-29 | 2008-04-29 | International Business Machines Corporation | Method and apparatus for creating and exposing order status within a supply chain having disparate systems |
US20030037034A1 (en) * | 2001-08-16 | 2003-02-20 | Tim Daniels | System and method for lubricants supply chain management |
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US8779924B2 (en) | 2010-02-19 | 2014-07-15 | Hill-Rom Services, Inc. | Nurse call system with additional status board |
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1997
- 1997-07-10 US US08/889,948 patent/US6085493A/en not_active Expired - Lifetime
-
1998
- 1998-07-09 DE DE69834656T patent/DE69834656T2/en not_active Expired - Fee Related
- 1998-07-09 EP EP98936816A patent/EP1023223B1/en not_active Expired - Lifetime
- 1998-07-09 JP JP2000501950A patent/JP2001509464A/en not_active Withdrawn
- 1998-07-09 WO PCT/US1998/013953 patent/WO1999002407A1/en active IP Right Grant
- 1998-07-09 AT AT98936816T patent/ATE327158T1/en not_active IP Right Cessation
- 1998-07-09 CA CA002296058A patent/CA2296058C/en not_active Expired - Lifetime
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Also Published As
Publication number | Publication date |
---|---|
EP1023223A4 (en) | 2004-05-19 |
JP2001509464A (en) | 2001-07-24 |
EP1023223B1 (en) | 2006-05-24 |
CA2296058C (en) | 2007-05-01 |
CA2296058A1 (en) | 1999-01-21 |
US6085493A (en) | 2000-07-11 |
DE69834656D1 (en) | 2006-06-29 |
DE69834656T2 (en) | 2007-02-15 |
EP1023223A1 (en) | 2000-08-02 |
ATE327158T1 (en) | 2006-06-15 |
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