A Formula for Success
Standards and
Communication
Product formularies help drive savings and
create standards for multiple items in a large
integrated delivery network.
Cheri Berri-Lesh, CMRP
Value Analysis Manager
A picture is worth a thousand words
Knee Brace in MMIS (Lawson)
Knee Brace in Visual Formulary
KNEE PULL UP WITH 1
STRAP ON TOP AND
BOTTOM
PATELLOFEMORAL
BRACING
HAS HINGES
211395
211399
211398
211399
211400
211401
211402
211403
211404
211405
211406
211407
211408
211409
BRACE KNEE LITE RT XS TRU PULL • Bifurcated (twopronged) strap pulls the
BRACE KNEE LITE RT SM TRU PULL patella into proper
BRACE KNEE LITE RT MED TRU PULL alignment reducing pain
associated with
BRACE KNEE LITE RT LG TRU PULL patellofemoral
BRACE KNEE LITE RT XL TRU PULL dysfunction
BRACE KNEE LITE RT XXL TRU PULL • Dual Durometer
BRACE KNEE LITE RT XXXL TRU PULL Buttress System
interfaces directly with
BRACE KNEE LITE LT XS TRU PULL the patella applying a
BRACE KNEE LITE LT SM TRU PULL consistent corrective
force to reduce pain
BRACE KNEE LITE LT MED TRU PULL
BRACE KNEE LITE LT LG TRU PULL • Independent anchors at
the thigh and calf
BRACE KNEE LITE LT XL TRU PULL prevent rotation of the
BRACE KNEE LITE LT XXL TRU PULL brace
BRACE KNEE LITE LT XXXL TRU PULL
Insurer
and
Delivery System
Operating
Revenue $3B
Integrated Delivery
Network
Member Governed
600,000 Members
25 Medical Centers
9,750 Staff
1,055 Providers
Reasons to Consolidate & Standardize

To achieve best contract pricing

 Reduction in variation

No durable medical equipment license

Some Healthcare Common Procedure Coding System
(HCPCS) codes eliminated

Create standard process

Changing the culture of “if I want it, I get it” to one of
collaboration and standardization
How it Began!
Gemba Process Walk
Road to Reducing Variation
Representation of Initial Choices
Physician Attendance Varied
Partner Collaboration
Orthopedic Vendor Representatives

Key objectives included standardization & cost
savings

Partnered with Materials Management to captured all
product categories and annual usage

An opportunity to identify products improvement or
elimination

Identified products for item and cost savings
reduction
Orthopedics Soft Goods - Before
720 Items
300
265
250
200
181
150
BEFORE
112
100
42
50
43
31
30
16
Sh
ou
ld
er
ec
k
N
Le
g
an
d
H
Fo
ot
/A
nk
le
C
as
t
Sh
oe
s
Bo
dy
Ar
m
0
2008
$521,000
720 Items
Orthopedics Soft Goods - After
2008
$521,000
720 Items
250 Items
300
265
250
200
181
BEFORE
150
103
AFTER
112
100
50
2011
$419,000
250 Items
REDUCTION
42
14
49
43
30
44
19
31
16 17
4
0
Spend = 19.5%
SKU = 65%
de
r
Sh
ou
l
Ne
ck
Le
g
Ha
nd
Fo
ot
/A
nk
le
ho
es
Ca
st
S
Bo
dy
Ar
m
0
Manufacturers
From 84 to 29
Sample of Ortho Soft Goods
Visual Formulary
Expanding Use of Visual Formularies

More commodities added
◦ Wound Care: Advanced & Acute
◦ Cast, Padding & Splinting
◦ Medical Tapes
◦ Disposable vaginal speculum systems
◦ Infection Prevention
Product Standards & Formularies
Advance Wound Care - Before
Advance Wound Care - After
Cast, Padding and Splinting
Tapes
Disposable Vaginal Specula
Infection Prevention: Hand Products
Infection Prevention: Hand Products
Infection Prevention: Face Protection
Infection Prevention: Face Protection
Infection Prevention: Nonsterile Gloves
Partnering with Experts for
Visual Formularies

Orthopedic physicians, physician assistants &
technologists

Wound Care RN & University of WA Professor

Infection Prevention Team

Perioperative Services

Safety and Environmental Health Officer

Materials Management Specialists
The Benefits to a Visual Formulary
Standard
Work
Clear
Communication
Reduction in
Spend
Provides
Shopping list
Visual
Formulary
Benefits
Increases
Contract
Compliance
Patient & Staff
Safety
Rapid ID of
Errors or Defects
Summary
Challenges addressed

Consolidating needs of multiple physicians

Working with preferences versus needs

Seeking agreement

Large geographic area

Finding quality pictures

Formatting for ease of viewing
Summary
Steps/process created

Order history review

Collecting multiple product samples

Product demonstrations road shows

MMIS cleanup including description improvements

Formatting images

Entering into Excel

Engaging with staff & active listening
Summary
Key players involved

Materials Management

Participating departments

Vendors

Distributors

Physicians & nurses

Infection Prevention
Summary
Outcomes achieved

Established supply formularies

Visual communication tool used as shopping list

Defines best practices

Managed by Value Analysis Program

Reduced costs & SKU’s

Promoted Lean visual systems in other areas
Summary
Pre-requisites

Product familiarity

Engaged vendors and distributor

Engaged Materials Management staff

Support of Purchasing & Contracting Staff
Questions?
Contact information
Cheri Berri-Lesh
berrilesh.c@ghc.org