GS1 UK Healthcare Conference - Masterclass Presentation - Jackie Pomroy

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Inventory Management – A Journey

Jackie Pomroy – Head of Supply Chain

Portsmouth Hospitals NHS Trust

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Queen Alexandra Hospital

• PFI hospital opened July 2009

• Single site acute 1,200 beds

• 27 Operating Theatres

• Approximately 6,500 Staff

• Largest MOD Hospital Unit in UK

• Regional Renal, Transplant and Cancer Unit

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What is Inventory Management ?

• It is an activity of determining the range & quantities of materials to be stocked in an organisation & regulation of receipts & issues of these stocks

• It might include managing products at different locations within a single site or within many locations of a supply chain or network.

• It is also about having those items required available for use when you need them and in a healthcare environment without risk to delivering patient care

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Considerations of Inventory Management

• Replenishment and lead times • Inventory holding costs• Inventory forecasting• Inventory valuation• Inventory visibility• Physical inventory• Available physical space for inventory• Quality management• Returns and defective goods• Demand forecasting • External Supply chain reliability • Product criticality (Must haves)

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What was the problem?

• No Inventory Management system in place• No formal processes• Cost Improvement Programme • Cultural issues – end user acceptance of change• Lack of base data to start from • No Bar codes on many items, no unique or standard bar codes • Poor contract coverage• Merging of 3 Hospitals into 1 PFI and lack of storage space• Receipt & Distribution run by PFI • Overstocking, inherited stocks and bad practices• Needed accurate, reliable and accessible information• Risk of stock outs, out of date products, waste

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How it was

• Clinical staff ‘informally’ managing inventory and placing/approving orders (waste)

• “Supermarket sweeps” of stores by clinical staff due to lack of advanced planning

• Poor Consignment stock management • Waste – not measured • Incorrect declaration of Inventory value• ‘Stock turns’ as low as 2 in some areas – 6 months stock• Much too much – or just too late!• Poor data• Supply chain knowledge embedded in Individuals

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How we solved the problem

• Implemented Inventory management system as part of Supply Chain improvement

• Put processes around a system• Identify savings and efficiencies, reduce stock holding, increase stock

turns• Improve information, true usage data by speciality, visibility • Reduce and record wastage• Monitor Supplier performance • Reduce clinical staff time spent on stock issues• Required a trust wide system, one way of working with no ties to

consumable suppliers

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How we used GS1 standards to help deliver the solution

• Came across a situation where we found two different types of clinical products in the theatre store room, from two different manufacturers, that shared the same barcode and identifier -No standards in Healthcare

• We knew we had a big problem• All we wanted was to scan products out at point of use – to capture

essential data - Patient, product, place• Found the 13 different types of barcode which meant we had to

undertake a large exercise to cross reference all products into the Inventory Management System

• Engaged with GS1 UK for help• Carried out Supplier assessment exercise

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2012 20162012 2013 2014 2015 2016

VisitbyGS1Consultant30/06/2012

6GS1Consultantsvisited12/12/2012

GS1wrote toour top30suppliers30/04/2013

ReviewedGTINsinplace31/01/2014

SouthernGroupMeeting12/06/2014

GS1video18/01/2015

GS1HealthcareUserGroup03/03/2015

HUG12/05/2015

ReviewedGTINsinplace29/05/2015

HUG07/07/2015


ImplementGLNsandGSRNs04/01/2016

Found2productswith thesamebarcode04/01/2012

PresentedatIMSOpenDay28/09/2012

GS1Southern Groupformed12/04/2013

HealthcareTraining18/07/2013




HUG14/04/2015


SubmittedGS1Strategicplan totheDH

30/06/2015

HUG08/09/2015

SubmitBusinessCasetoDH13/11/2015

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Supplier Readiness 2013

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ABBOTT VASCULARAMBU LTDAPPLIED MEDICAL UK LTDARTHREX LTDARTHROCARE UK LTDASTRA TECH LTDBAXTER HEALTHCARE LTDBIOMET UK LTDBOSTON SCIENTIFIC LTDBUNZYL HEALTHCARECOOK UK LTDCOVIDIEN (UK) COMMERCIAL LTDGE HEALTHCARE CLINICAL SYSTEMS (UK) LTDHUNTLEIGH HEALTHCARE LTDINTERSURGICAL LTDJOHNSON & JOHNSON MEDICAL LTDKIMAL PLCLINA MEDICAL UK LTD

3M HEALTH CARE LTDMEDARTIS LTDMEDTRONIC LTDMOVIANTO UK LTDOLYMPUS KEYMEDSMITH & NEPHEW HEALTHCARE ST JUDE MEDICAL UK LTDSTRYKER UK LTDSYNTHES LTDTELEFLEX MEDICALTIMESCO OF LONDON LTD

69% say they are ready

17% not ready

7% 7%

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Positive direction not quick enough

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Scanning products

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Barcode Checker

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Different Barcode Formats & Types

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2D Data Matrix

Singular GS1-128 Linear

Multiple GS1-128 Linear

HIBCC Barcodes

Ensure your solution is capable of reading the multiple barcode formats and types

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Items with no barcodes at all

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Some items don’t have barcodes at all

Some items only have the barcode on the outer box and not at the each level

In order to work around this issue we create our own barcodes

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Suppliers on the GS1 journey

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Supplier Product Range Changes -GTIN

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Supplier Product Range Changes -GTIN

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• Need to have a process in place to ensure that GTINs are requested for the new product range, when changing and ensuring GTINs are maintained in the catalogue.

• Ensure there are protocols in place to rectify any that have been missed.

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Multiple barcodes/close together –Which do I Scan?

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Understanding which barcode relates to what. Users need to be trained and systems need to validate the barcode application identifier that is scanned is the correct one. Ensuring correct data is input.

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Extra Identifiers

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Often suppliers will include additional data to the GTIN, Expiry Date and Serial or Lot No. In this example (11) stands for Manufacturer Date. But there can be many others that suppliers may add for their own benefit.

The systems used needs to be able to cope with Additional Application Identifiers and know when to acknowledge or reject them.

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Other anomalies

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• Problems caused by suppliers creating barcodes with incorrect Application Identifiers

• A GTIN that is not correctly formatted e.g. Serial Number AI (21) present when it should have been Lot No. AI (10)

• The work around was to manually enter the Lot No. increasing the possibility of human error

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Same items different GTINs

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Incorrect Barcode Format

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The ProblemThe GS1 barcode shouldn’t contain the (01) in the bracket within thebarcode. The Solution We created an internal barcode

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Suppliers on the journey

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GLNs

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Physical Location – Within the Hospital

Supplier within the supply chain

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Identifying Items within a GLN

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Patient ID (GSRN)

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The Patient ID bands use the GS1 Key –GSRN (Global Service Relation Number)

The structure is an 18 digit number, comprising the company prefix, 10 digit NHS Number and a check digit

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What were the benefits

• Patient safety

• Efficiency

• Financial

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Waste Reduction

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Additional Benefits

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Stock Reduction

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Contract coverage

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35%

65%5%

95%

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Supplier Engagement Program 2015/16

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Key learnings for you to takeaway

• Don’t underestimate the scale of the task• Don’t run before you can walk• Data – Quality and quantity• Change management - culture• Systems capability – today, tomorrow and the future

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Summary

• Prepare data• Communicate the message so it’s not a shock• Involve people – cross department – Clinical and non –clinical• Identify Champions• Quick wins to get buy in• Shout about the successes• Talk to other Trusts and learn

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Thank you

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