Split decisions forge smooth operations: Centra Health's CS team divided by locale, united in quality

Healthcare Purchasing News, Sept, 2007 by Julie E. Williamson

As most central service professionals can attest, effectively and efficiently managing instrumentation and meeting the supply needs of the operating room and other high-demand departments is no easy feat.

But when CS is responsible for more than one fast-paced hospital, the logistical challenges multiply--and the goals for a streamlined, top-performing function may seem frustratingly out of reach. Put simply, in such situations, any additional service requests (or demands) placed on CS may become the pro verbial straw that breaks the camel's back.

Amazingly, for two CS departments operating hand-in-hand at separate Centra Health hospitals in Lynchburg, VA, that couldn't be further from the truth. Much like the health system itself, which holds a four-time ranking as one the top 100 cardiovascular centers in the nation, as well as the prestigious nursing excellence Magnet Award from the American Nurses Credentialing Center, the CS teams at Lynchburg General and Virginia Baptist Hospital have earned bragging rights all their own--and the well-deserved honor of being named Healthcare Purchasing News' 2007 CS/SPD Department of the Year.

Teamwork and dedication exemplify these departments. Although a staff of 25 operate out of Lynchburg Hospital, a 270-bed emergency and critical care center with national recognition for its orthopedic and cardiac programs, and 13 are based three miles away at VBH, a 317-licensed bed regional facility offering hill-service family care for those in Central Virginia, they essentially function as one well-oiled machine. Both departments follow the same process, have identical systems in place and the same administrative reporting structure that flows up through the director of materials management and, subsequently, through Centra Health's chief financial officer. Aside from that, the staff works interchangeably between the two facilities, and share one highly efficient manager. Make no mistake, it's a process that works.

Building confidence

Because CS manager Erle Shepard splits his time between the two hospitals during the week--two days at each and then dividing his time between the hospitals on the fifth day to lend adequate support and encouragement--he relies heavily on two strong and capable coordinators (one at each hospital) to keep the departments running smoothly in his absence.

"I have a terrific team and I have all the confidence in the world in them," he raved.

Likewise, the hospitals have a high level of confidence in Shepard and his staff and have come to rely heavily on their services--a level of trust that eludes many CS departments. Not only do they efficiently manage the critical instrument processing function--in January alone, a combined 20,932 items were decontaminated and sterilized--CS also manages its own perpetual inventory, as well as the operating rooms', and to a lesser degree, also manages inventory for nursing units. About 90 percent of the perpetual inventory managed by the CS departments is for the OR.

Shepard, who assumed the Centra Health CS manager position nearly six years ago, acknowledged that the perpetual inventory project was a complex one, requiring cooperation and teamwork of CS and the OR, and the hiring and reallocation of staff into the surgery core to place inventory on a perpetual system and automate the case cart system. This relieved more than 12 nurses from the inventory process and allowed more time for them to care for patients.

"CS had to gain an understanding of the supply chain within the operating rooms and core, and blend it with the processes of the software system," Shepard noted, adding that some of CS' tasks included identifying each inventory item, creating bin locations, and rearranging shelving and storage units to house the inventory coming over from surgery.

When the project first got off the ground, there was some initial trepidation between both parties. "Understandably, there can be some turf issues that arise because of the fear of not delivering," reasoned Lewis Addison, senior vice president and chief financial officer for Centra Health. "But it didn't take long before CS earned their trust and proved that the [function] was in the right hands."

Some chalk that up to the CS teams' flexibility and Shepard's previous surgical inventory experience and understanding of key business functions. Shepard has been working in CS since 1981 and moved from a prominent Phoenix-based medical center to assume the CS manager position at Centra Health--a move that almost immediately began benefiting the Virginia health system.

"It's a terrific combination. Erle has an understanding of logistics and perpetual inventory that some CS managers don't," said Tom Lawton, the director of materials management to whom Shepard reports. "I'm also impressed by how the CS staff is so committed to quality and customer service. They do their very best and consistently exceed customer expectations."

Success in numbers

Confidence in CS, which was admittedly lacking when Shepard first arrived at Centra Health, soon became contagious and led to a number of new opportunities that allowed the team to shine. The department is now responsible for four perpetual inventory locations. It moves 23,495 items weekly, with a whopping average daily value of $4,368,868.