Becton, Dickinson and Company · NYSE:BDX
Becton, Dickinson and — MMS YNHH Maximizing Inventory Optimization webinar (September 2020)
39 slides from Becton, Dickinson and's conference presentation, Sep 29, 2020
Slide 1: Maximizing Inventory Optimization Utilizing Analytics Software
Maximizing Inventory Optimization Utilizing Analytics Software Nigjar Polat, PharmD, MBA, CPPS Kathleen W. Ferencz, RPh, MBA September 29, 2020
Slide 2: Speakers
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Speakers Nigjar Polat, PharmD, MBA, CPPS Associate Director, Medication Safety and Operations Director, Health-System Pharmacy Administration and Leadership Residency Program Yale-New Haven Hospital Kathleen Ferencz, RPh, MBA Coordina
Slide 3: Yale New Haven Health At-a-Glance
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Yale New Haven Health At-a-Glance Five Hospitals Primary teaching hospital of Yale School of • Yale New Haven Hospital Medicine • Bridgeport Hospital • > 5,000 medical staff members • Greenwich Hospital • 1,400 trainees • Lawrence
Slide 4: Yale New Haven Hospital (YNHH)
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Yale New Haven Hospital (YNHH) • 1541-bed hospital in New Haven, Connecticut • Two campuses, acquired Hospital of St. Raphael in 2012 • York Street Campus (YSC) • St. Raphael Campus (SRC) • 168-bed Smilow Cancer Hospital • 201-bed Chi
Slide 5: The Yale New Haven Hospital Pharmacy Team
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA The Yale New Haven Hospital Pharmacy Team • 500+ member team clinical/operations • Management • Clinical specialists, pharmacists • Residency Program • Support Staff • Technicians and technician training program • 5 quality assurance
Slide 6: Inventory Optimization and Waste Reduction: People, Process, Technology
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Inventory Optimization and Waste Reduction People Resource justification/reallocation Process Technology Evolving strategies with goal to Justification/Increased utilization increase medication availability
Slide 7: Yale New Haven Hospital Pharmacy Operations
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Yale New Haven Hospital Pharmacy Operations • Decentralized Model • 8 Carousels • 6 Central Pharmacy (2 campuses) • 1 Smilow Cancer Hospital • 1 Children’s Hospital • 433 Automated Dispensing Cabinets (ADCs) • 121 Anesthesia Stations
Slide 8: Analytics Solution: BD HealthSight Inventory Optimization (IO)
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Analytics Solution: BD HealthSight™ Inventory Optimization (IO) • Analytics software that assesses and suggests PAR levels of medications based on: • Utilization • Stock-Outs • Refill Frequency • Interfaces with BD medication manageme
Slide 9: Approach & Strategy to YNHH Inventory Optimization in ADCs
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Approach & Strategy to YNHH Inventory Optimization (IO) in Automated Dispensing Cabinets (ADCs) • Piloted IO tool at each campus • York Street Campus (YSC) • YNHH plan not well planned • Learning curve with IO tool • Staff had competi
Slide 10: St. Raphael Campus 90 Day Pilot - Process
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA St. Raphael Campus 90 Day Pilot - Process • MONTH 1 • Optimized 44 inpatient, profiled ADCs (2-3 machines per day) • Unloaded medications not used in >90days • Assessed medications frequently stocking out • Moved items to appropriate
Slide 11: St. Raphael Campus 90 Day Pilot - Results
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA St. Raphael Campus 90 Day Pilot - Results • ADC Results • Accepted 3,370 / 9,600 recommendations - 25% • Net decrease = $24K • Unloaded unused medication = $82K (returned to Carousel) • 55% decrease in stock-out of optimized medicatio
Slide 12: A fine balance
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Work Hours Analysis A fine balance FTE Volume of Work Time Tasks
Slide 13: Stock-Out Rates Pre- and Post- Implementation
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Stock-Out Rates Pre- and Post- Implementation • Experienced a 55% reduction for items where PAR quantities were adjusted in the BD Pyxis™ MedStation™ ES machines • Pre-optimization 1.68% • Post-optimization 0.67% • 3,015 avoided stock
Slide 14: Operational Efficiencies
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Operational Efficiencies • Improved Stock Out Rates • Increases medication availability to the Nurse at the right time and location • Increases EMPLOYEE satisfaction • PAR Level adjustments in ADCs/Carousels • Pulling less during bulk
Slide 15: FTE Analysis
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA FTE Analysis Campus BD Pyxis™ MedStations™ ES* St. Raphael (SRC) 78 York Street (YSC) 217 * Excluding Anesthesia Systems Task FTE Unplanned Stock-outs 0.4 FTE Operational efficiencies 0.5 FTE Total FTE Reallocation 0.9-1.0 FTE
Slide 16: Daily Process
Yale NewHaven Health Daily Process
Slide 17: Daily Optimization Tasks
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Daily Optimization Tasks York Street Campus – 114 profile machines St. Raphael Campus – 50 profile machines • 2 - 4 BD Pyxis™ MedStation™ ES machines optimized on each campus per day (Monday – Friday) • Process includes: • Adjusting P
Slide 18: Additional Daily Tasks
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Additional Daily Tasks • Managing medications with min 0 • Utilizing the IO tool’s dashboard to identify any new frequently stocking out medication • Other Quality Assurance responsibilities • ADC meds escort • Barcode scan maintenanc
Slide 19: QA Tech Personal Dashboard
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA QA Tech Personal Dashboard
Slide 20: Medication Pullbacks
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Medication Pullbacks • Medications that have not been used in greater than 60 days are unloaded and returned to carousel or vault in Central Pharmacy • Items that are standard stock are not removed • Unloading BD Pyxis™ CIISafe medica
Slide 21: Medications Not Used Export Recommendations
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Medications Not Used Export Recommendations
Slide 22: Medications Not Used Export Recommendations
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Medications Not Used Export Recommendations
Slide 23: PAR Level Adjustments
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA PAR Level Adjustments ALL PAR levels are reviewed, not just medications for which the tool provides recommendations Primary Goals: • Decrease stock-outs • Fewer medication pulls, less unplanned deliveries to units, quicker medication
Slide 24: File Export of Stock-Out Recommendations
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA File Export of Stock-Out Recommendations
Slide 25: Medication Detail
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Medication Detail
Slide 26: Medication Detail
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Medication Detail
Slide 27: SRC - BD Pyxis MedStation ES Stock-Outs
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA SRC - BD Pyxis™ MedStation™ ES Stock-Outs Pilot Start of dedicated COVID-19 technician role
Slide 28: YSC - BD Pyxis MedStation ES Stock-Outs
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA YSC – BD Pyxis™ MedStation™ ES Stock-Outs Start of dedicated COVID-19 technician role
Slide 29: SRC - PAR Changes
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA SRC – PAR Changes 20000 18000 16000 14000 12000 10000 8000 Care Areas 6000 Central Pharmacy 4000 2000 0 Jan Feb Mar Apr May Jun Jul Aug 2019 2020
Slide 30: YSC - PAR Changes
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA YSC - PAR Changes 7000 6000 5000 4000 Care Areas 3000 Central Pharmacy 2000 1000 0 Jan Feb Mar Apr May Jun Jul Aug 2019 2020
Slide 31: Expiring Medications
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Expiring Medications
Slide 32: Expiring Medication Recommendations Exported from BD Knowledge Portal
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Expiring Medication Recommendations Exported from BD Knowledge Portal Standard NumberOfDoses MedID MedDescription Stock StationWithExpirationRisk PocketWithExpirationRisk DaysToExpire AtRisk UnitCost ExpirationCostRisk TargetStation D
Slide 33: Valuation Reduction: ADC Inventory
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA ADC Inventory $180,000 $160,000 $155,915 $140,000 Valuation Reduction $120,000 ADC PAR level optimization attributed to > $750,000 of $100,000 $99,380$95,025 $88,293 inventory valuation reduction $80,000 $77,845 $78,630 $60,000 $59,78
Slide 34: Valuation Reduction: Carousel Inventory
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Carousel Inventory $120,000 $100,000 $98,090 Valuation Reduction $80,000 $60,000 Carousel PAR level $40,000 $35,162 optimization attributed $27,775 $28,477 $25,695 $26,439 $20,000 $18,581 to > $250,000 of $15,732 $16,090 valuation red
Slide 35: COVID-19 Impact
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA COVID-19 Impact • QA team was utilized in different ways • 20 ADCs converted to ICU • Multiple installations/relocations across the campuses • Unloading and reloading of medications • Tool aided in identifying medications frequently u
Slide 36: Lessons Learned
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Lessons Learned • Cost information • Which cost to use (GPO, WAC, 340B) • Data skewed when working with multi-dose vials (units, mls vs. bottles) • Consistency • Time dedicated to the work each month • Method of responding to recommen
Slide 37: Early Experience Pilot Sites
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Early Experience Pilot Sites • Offered 3 month pilot to other Delivery Networks (DN) • June-August 2020 • Developed processes similar to YSC/SRC • Measured progress • Lessons learned • First weeks were getting use to tool • Resources
Slide 38: Additional Opportunities
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Additional Opportunities • Additional focus on BD Pyxis™ CIISafe optimization • BD Pyxis™ Anesthesia Stations • Drug shortage management • Data mining
Slide 39: Questions?
− Nigjar Polat, PharmD, MBA, CPPS − Kathleen W. Ferencz, RPh, MBA Questions?