Electronic Requisitions for West Des Moines Hospital Marlene Turner Supply Chain Analyst Iowa Health Des Moines 2009

Electronic Requisitions for West Des Moines

HospitalMarlene Turner

Supply Chain AnalystIowa Health Des Moines

2009

Manager gets

missing signatur

es

Manager sends for approval for purchase

Depending on$$ amount

Under $ 25,000 Manager signs send

to purchasing

Greater than$25,000 but

less than or equal to 50,000


less than or equal to$500,000

y

Executive Director Signs

VP / Sr. VP signs

N

N

Greater than$500,000

N

N

y

y

COO signs



y

CEOSigns

Manager receives the signed documentation back and makes sure the quotes and other necessary paper work is attached, then mails or walks them overto purchasing

Documents complete

No

Missing quote Purchasing

contacts manager to have quotes

sent

Y

Missing signatur

e Purchasing

contacts manager and

sends back for signatures

To Sherry Stewart To Purchasing

Manager fills out

the requisitio

n

Purchasing processes order and sends to vendor

y

Manual process flow chart for a

requisition to purchase order

The prints 2 copies

and sends in mail to bio tech

and construct-

ion

Purchasing waits for quote; upon arrival begins to process request

After final signature document goes back to manager

this line symbolizes

rework

Flow chart of process before project started Red dotted line indicates rework Marlene Turner 2008

Manually takes 1,444 steps(1/2 mile) and 63 minutes to complete one time

Blue signifies a physical step to walk to each place

Yellow is informational

Goals/Outcomes To attain and maintain less than 1% error rate on missing information to

purchasing the first time. Current practice is averaging 30% returns to managers because of missing information quotes, signatures and budget numbers, and StrataCap numbers by 5-01-2009.

This will be achieved though the implementation of an electronic requisition template, application of electronic signatures and electronic delivery to the purchasing department within 48-72 hours.

Process to change from a hand written 3 part requisition form to an excell spreadsheet format, with macros to total purchase order and highlight needed signatures by total amounts.

To improve the process of purchase requisitions at IH-DM reductions in man power used to deliver the hand written requisitions to Senior management for signature approval

Managerfills out

Request on line

Approval routing is determined by purchase amount

Under $ 25,000

Manager Signs: auto

forwards to next route stop


less than or equal to 50,000



Executive Director

Signs auto forwards to next

route stop to manager

VP / Sr. VP Signs auto forwards to next route

stop

COO signs auto




CEOSigns auto


Manager determines routing of email following

route instructions

Purchasing

As the requisition is forwarded the next level the manager can get a notice of

status

Route to sherry Stewart

Construction Director for signature forwards

to next stop

Route to Bio Tech Manager (patient

Equipment for signature forwards to next stop

Set up routing for purchase approval

signatures

Receive information

from manager

Y

N

N

N

If greater

than $500,00

0

N

Y

Y

Y

Y

Y

Contact manager

for missing information

Process order type into AMS and send to vendor with

documentation

Routing instructions

If Capital equipment need project ID for projects and need

StrataCap number for normal capital

Route all projects to Sherry Stewart, then To Mike Bailey in Bio Tech for all patient equipment

All Leases are to be sent to Joe Corfitts for review.

Approvals on listed matrix

All Leases will need to be sent to Joe Corfitts, for CFO signature then

forwards to next stop

Automated Process flow chartFor West Des Moines Hospital Only

10-2008

Missing information

Reviews document

N

Scan copy of purchase order

to the WDM construction

group on scanner

prints requisition and

all documentation

Marlene Turner

Blue Manual process

Bright Yellow email routing

Light Green automated forward to next person

(outlook)

Darker Green Destination via email

Pale green information

Two shaded tan color either can read on line or print

PDSA – THE CHANGES

1. We started with manual requisitions sent by house mail or hand delivery to management levels for approvals and signatures

2. Created the electronic requisition in excell as a template with macros to identify signatures needed by dollar totals

3. Began routing in Outlook through email for signatures.4. All documentation (contracts/quotes) sent with the requisition in a PDF

format; complete the cycle at Central Procurement. 5. Highlighting the fields to identify whose signature is needed for

information only i.e. Biotech, Construction 6. The need to add a pop up box for capital orders to state that they need to

attach the quote to the 2nd worksheet.

Lessons Learned :

• Found it beneficial to set up a formula to automatically total the purchase requisition

• Found it beneficial to set up macros to highlight the people who need to sign for approval, avoids confusion as to who needs to approve the order next and use of Automatic routing through email.

• Found it beneficial to set up a macro to highlight different departments that needed to also see the purchase order i.e. Biotech, construction and use of automatic routing to send these to the managers.

• Be sure to follow up with the end users to review the macro security settings and show them how to change to a medium security level to allow all the macros in the document to work.

• Make sure to work with end users to show them the process in advance with a mock order so they are comfortable with moving around the document use of “live training” real document; helped to boost confidence in the management team that this could be as easy as it seems.

• We added a separate work sheet with step by step instructions to the process to allow users the freedom to maneuver around the document before the real thing came through. Additional training attached to each document to provide instant reference information.

• The need to move slowly to track success and complete the training needed, will allow for confidence and success for this project to be spread throughout the IH-DM system.

The cost to process 1 STAT capital purchase order : I chose a manager that is same statue and stride length as myself . From Powell 5 it takes 1,444 steps to walk from starting point (managers’ desk) to ending point (managers desk) at a distance of ½ mile and potential time wasted was 63 minutes waiting for signatures and walking. Add 30 minutes to complete requisition and print the quote Add 30 minutes to transport via courier to Central Procurement, then add 20minutes to process purchase order in software and send to vendor. Total time spent estimated at 143 minutes. I averaged the pay to be 21.88 per hour for a processing cost of 2.39 hours at 21.88 for a cost of $ 52.30

New cost to process an automated Purchase Requisition: is about 10 minutes to fill out the form , attach the quote and set up the routing schedule for signatures. All done at the desk top computer. Depending on the amount of signature, average time has been 15 minutes, then 15 minutes to process at Central Procurement .Same base average salary of 21.88/hr times 45 minutes equals $ 16.65 per purchase order

Potential savings $ 35.65 per 1 stat Purchase order

NEXT STEPS

• Schedule meetings with Central Procurement at Iowa Health System Corporate office to add training for their staff.

• Schedule training for new managers on how to fill out and send their requisitions.

• Begin using for Minor Equipment Orders for Methodist West Hospital July -2009

• Begin to use for all orders for Methodist West Hospital November 2009 . We have begun to roll out to al users Jan 2010

• Influence all key players to use the electronic signatures and accept as the new standard practices