At Baptist DeSoto, the medical-surgical units faced a challenge with the supply carts. With the nursing staff feeling increased frustration about supply delays, Virginia (Ginger) Purvis, advanced nurse clinician, called the director and manager of materials to analyze the problem and discuss options.
“It seemed like we were having a lot of calls to materials, a lot of just overall frustration on the floor—[nurses] not being able to get what they needed in a timely manner so that patients could have what they needed,” she said.
What became immediately clear was the sheer volume of items on the cart made it difficult for materials team members to manage inventory using the existing inventory method.
Finding a solution began with evaluating inventory and usage. Virginia shadowed materials teams to observe how they did their jobs. “What we found is what we were asking them to do and the amount of items that were on the cart seemed to present a pretty unrealistic goal for them,” said Virginia.
First, too many materials prevented team members from capturing daily inventory. Instead of counting all the items on their carts (using a handheld palm device to scan the barcode on items), the materials staff was visually evaluating the cart and only scanning items that appeared to be running low or missing. This seemingly small omission greatly affected the stocking of carts because the materials warehouse staff relied on this data to replenish supplies. Virginia and the materials management team reduced inventory and created a new re-organized model for the carts.
Next they invited bedside nurses, patient care assistants, wound care and venous access nurses, respiratory therapists and laboratory staff to review the quantity, appropriateness and organization of items on the cart.
During the two-week trial run, Virginia, nurses on 7 Tower and the materials team continued to monitor and adjust cart inventory. She also created a diagram to show nurses where they could find supplies, and blank supply lists were posted in the clean supply room so nurses could note items that needed to be added or removed from the carts. All of this was part of the Plan, Do, Study, Adjust cycle. To help materials teams maintain inventory levels and reach their daily goals, Virginia’s team conducted a Training Within Industry (TWI) job instruction breakdown for scanning and restocking carts.
Since starting this project, 60 to 80 items (equivalent to about $950) have been removed from each medical-surgical cart, making it easier for nurses to find supplies on carts and helping everyone better manage and maintain cart inventory. In fact, materials now consistently inventory cart supplies 90 percent of the time, which means clinical staff members have the needed items. This project also improved relationships and conversations between materials and nursing staff, producing a more collaborative environment.