Making the Case for Providing Supply Chain Education Colleen Cusick - - PowerPoint PPT Presentation

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Making the Case for Providing Supply Chain Education

Colleen Cusick , DNP, MBA, RN, FAHRMM Interim Sr. Director, General Services & Director, Materials Management The Johns Hopkins Hospital July 19, 2019

Learning Outcomes

• Discuss importance of providing education to both

supply chain & clinical staff

• Determine what education you want to provide
• Describe how to develop an educational program
• Review data from a quality improvement nursing

education project

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Supply Chain’s Complex World

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Here’s a Thought!

• Majority of US jobs fall somewhere in a

supply chain

– Procurement – Logistics – Operations – Marketing – Sales – Service – Customer Service

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https://blog.foster.uw.edu/5-reasons-pursue-career-supply-chain-management/

Audience

• Incumbent Supply Chain Staff
• Nursing Colleagues
• Other Clinicians
• Future Workers

– Others Staff ~ Interns ~ School Career Days

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Supply Chain Education for Us

Formal – AA, Bachelors, Masters, Doctoral Degrees – Certifications (CMRP, FAHRMM, etc.) – Continuing Education (CEUs) – Conferences/Webinars – MASHMM – AHRMM Informal – On-the-job – Orientation/Onboarding – On-going Competencies – Train-the-Trainor – Internal Departmental Education – Scenarios – Best Practices Networking – Journal Club

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Education Enhances Engagement

• Training
• Professional Development
• Career Opportunities & Advancement
• Leadership Encouragement
• Engaged Behavior - Show a passion for learning
• Organizations make investments to make

employees more successful

• Incorporate meaning, variety, autonomy
• Understand contributes to the organization

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Develop a Culture of Learning

• Advocate for learning
• Investment
• Cultivate a learning environment
• Be an educational role model
• Provide resources
• Take Advantage of existing

programs

• Support the time commitment
• Share knowledge
• Move beyond lecture format

Type of Learner

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Supply Chain Topics

• Supply Chain Basics/Language/Processes
• Healthcare & Supply Chain Trends
• Customer Service/Telephone Etiquette
• Cultural Competency
• Recalls
• Substitutions
• Defective Products
• Product Safety
• Cost Savings Opportunities
• CMS Regulations/Maryland GBR/Waiver

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JHH Provides Training

• Nursing & Clinical Educational Offerings

– Supply Chain 101 – Advanced Pyxis Reporting – Nursing & Physician Pyxis Training

• Hospital Based

– Manager, Supervisor, Group Leader Cohorts – MyLearning

• Internal Supply Chain

– Materials Management Supervisor Training – Group Leader, Zone Coordinator, & CSR Training – Receiving Safety/Pallet Jack Training – Towline Safety – Field Trips

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Vendor Colleagues

• Medline: 4 Weeks/Annually/Off-site
• Baxter: MyCareer@Baxter portal & A.C.E.

(Align/Check-in/Execute) program

• Johnson & Johnson Procurement Leadership

Development Program

• Owens & Minor: Monthly training on various topics

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AHRMM 2018 Stats

AHRMM Comparison Report of the Compensation Survey 2015-2018

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• Educational Budget: 54%
• Paid Professional Development: 49.4%
• Paid Professional Association Dues: 47%
• Tuition Benefits: 63.2%

Statistics are based on AHRMM members who responded to the annual survey & includes providers & affiliate representatives.

What is Stopping You!

• Determine value to your institution & department
• Identify audience
• State educational goal(s)
• Create outline
• Harness content experts & vendor colleagues
• Plan timeframe
• Develop presentation
• Obtain feedback & evaluate program
• Just do it! (With apologies to Nike!)

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Nursing & Clinical Colleagues

15 https://www.beckershospitalreview.com/supply-chain/why-the-supply-chain-is-a-health-system-s-most-untapped- resource-and-how-to-unlock-its-value.html

Education for Clinicians

• Nurses are the largest hospital staffing component
• Health care environment needs to be conducive for

nurses to care for patients

• Support services provide vital services to support

patient care activities

• Staff needs a variety of supplies & equipment in a

timely manner

*Reference: AACN, n.d

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Background

• A knowledge gap about what supply chain support services and

processes do and cannot do leads to misunderstandings, frustrations, and distrust for the non-clinical operational side of the business of healthcare.

• SWOT Analysis
• Availability of supplies & other supply issues is a problem for nursing staff.
• Knowledge gap points to a need to provide learning opportunities about

supply chain operations.

• A literature review points to nursing dissatisfaction related to support

services (AONE & Aramark Healthcare, 2009).

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Significance

• Lack of formal supply chain training

– Increase patient care time – Reduce unsafe supply work-a-rounds – Reduce work dissatisfaction – Increase collaboration with supply chain staff

• Accountability for supply costs

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* Reference: O’Connor (2012)

Literature Synthesis Analysis

Strengths

• Common Themes

– Work-a-rounds – Time away from patient care – Industry groups vs. single hospital

• Same results

– Nursing dissatisfaction

Weaknesses & Limitations

• Limited articles related to

project topic

• Limited interest in the topic
• Lack of scholarly rigor
• Publications by

manufacturers’ representatives – Conflict of interest – Possible bias

• Evidence-based:

– VII: Expert opinion*

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* Reference: Polit & Beck (2008)

Evidence Based Practice

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Concepts

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Interactions

Basic Supply Chain Education: A Program for Nurses

Education Supply Chain Processes Safety Financial Impact Patient Outcomes

Basic Supply Chain Education: A Program for Nurses

Theoretical Framework

• Kotter’s 8-Step Change Model

– Increase effectiveness & efficiency – 3 Major Areas

• Creating a climate for change
• Enable & engage the organization
• Implement & sustain change

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Kotter’s 8-Step Change Model

Steps Kotter’s 8-Step Change Model DNP Project 1 Create Sense of Urgency At Health System level, many supply chain changes are happening that affect clinicians 2 Build Guiding Coalition Support needs to come from both supply chain & nursing leadership 3 Form Strategic Vision & Initiatives Include nursing & other clinicians in future educational offerings 4 Enlist Volunteer Army Nursing leadership will encourage front-line staff to attend educational programs 5 Enable Action by Removing Barriers Allow time for RN participants to attend the class during work time for the project phase 6 Generate Short-Term Wins DNP project’s success would be measured by knowledge gain & increased satisfaction 7 Sustain Acceleration Plan additional new supply chain course for RNs and other clinicians 8 Institute Change If successful, discuss ways to have more RN involvement in classes 23

Reference: https://www.kotterinternational.com/8-steps-process-for-leading-change/

Methodological Framework

August 1, 2019

• Analyze pre- & post-

program survey results

• Complete the analysis of

the data

• Compare data to

predictions

• Summarize what was

learned

• Disseminate results via

paper, presentation, & poster

• Plan additional classes
• Adopt the change /
• Abandon the change /
• Run through cycle

again, under different conditions, materials, people, or rules

• Develop supply chain

educational programs

• Develop assessment

tools

• Implement the 4

educational sessions

• Carry out test
• Document problems

and unexpected

• bservations
• Begin analysis of

the data

• Increase front-line RN

supply chain knowledge from baseline to 10% by implementing a supply chain educational program for RNs

• State objectives of

the test

• Make predictions
• Develop a plan to

carry out test

PLAN DO STUDY ACT

Programs & Surveys

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Data Collection Assessment Tools

• RN Participants:

– Educational program paper pre- & post-surveys – Qualitative demographics – Collect & document questions asked & comments from educational sessions

• Cohen’s Kappa Statistic Validity Test:

– Tests interrater reliability – Undergird the survey tool development

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Data Analysis – Survey Validity Testing

DNP Project: Survey Validity Testing Results

Survey Raters Total % Agreement Agreement By Chance Cohens kappa Statistic Agreement Not by Chance kappa Result Rater 1 0.90000 5.53333 0.87738 Near Perfect Agreement Rater 2 1.00000 0.18778 1.00000 Perfect Agreement Rater 3 0.93333 0.18667 0.93291 Near Perfect Agreement Rater 4 0.93333 2.20222 0.93291 Near Perfect Agreement 27

Reference: www.statisticshowto.com/cohens-kappa-statistic/

Data Analysis

Data Statistical Technique & Interpretation Display

Qualitative Demographic Information from RN Participants Actual Data Descriptive Statistics

• Table Excel Document

Pre- & Post-Survey Results from RN Participants Cohen’s Kappa Statistic Survey Validity Testing Mean Sample Paired t- test (dependent sample t- test)

• Survey Validity Testing:
• Data: Excel Spreadsheet
• Table Format
• Report:
• Data: Excel Spreadsheet
• % Change Knowledge Gap
• Report Statistical

Significance Information from Q&A Period & Survey Short Answers Project Leader Review

• Documentation of Questions

& Comments

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Data Analysis – Demographics

• RN Participants (n = 17*):

– Female 87% to Males 13% – >31 years of Experience: 31% – Basic Nursing Education: BSN 87% – Masters Degree of >: 50% – Formal Supply Chain Training: 19% – Discussions with staff or Nurse Managers: 75 % – 17 participants – Only 16 completed the process

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Data Analysis – Pre- & Post-Survey Results

• Individual Survey Questions (30)

– Likert-like Scale – Total mean score for each question for 16 participants for both pre- & post-survey – 18 of 30 questions:

• Change from pre- & post-survey answers was

significant at a p<.10 level

– 12 of 30 questions:

• Change was not significant since p-value of >than .10

level

Data Analysis – Pre- & Post-Survey Results

• Overall t-test for paired samples

– Summary Mean: 90.75 (Pre) & 124.31 (Post) – Mean difference: 33.5625 – SD: 11.7074 – Confidence Level (CL) at 95%: 2.1314 – Lower CL: 29.0196 – Upper CL: 39.8008 – Mean difference falls between Lower & Upper CL – Null is rejected – Statistical significance showing reduction in knowledge gap between baseline & post-surveys – RNs gained knowledge about supply chain

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Data Analysis - Discussion Topics

• Describe role in supply chain processes?

– Recommending products – Checking supply inventor & expiry – Controlling costs – Using products safely

• What would you change about supply chain?

– Teach nurses how to control costs – Provide time for nurses to learn about supply chain

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Project Strengths & Limitations

• Strengths

– Evidenced by the results – Nurses expressing interest

• Limitations

– Lack of participation – Lack of interest in topic or lack of understanding how topic is important – Marketing barriers & timing – JHH IRB challenges

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Future Implications for Practice

• Increasing Supply Chain Knowledge

– Area of opportunity – Understanding the supply chain process – Increased safety for patients & staff – Recommending new product – Reduction in supply costs – Improved patient outcome – Enhanced nursing productivity & satisfaction – Leadership consideration

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Summing It Up!

• What is your educational plan?

– What? ~When? ~ Who?

• How will you add to the mix?

– Presentations ~ Articles ~ Posters ~ Research

• Questions?
• ccusick@jhmi.edu

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References

References

http://www.statistics howto.com/cohens-kappa-statistic/ Johns Hopkins Medicine. (November, 2013). Johns Hopkins Medicine News and Publications. http://www.hopkinsmedicine.org/news/media/releases/the_johns_hopkins_hospital_once_again_achieves_magnet_designation_for_nursing_excellence_ Kotter International (n.d.). Kotter 8-Step Change Model Process. Retrieved from https://www.kotterinternational.com/8-steps-process-for-leading-change/ Landis, J. and Koch, G. (March, 1977). The measurement of observer agreement for categorical data. Biometrics. 33(1): 159-174. McHugh, M. (October, 2012). Interrator reliability: the kappa statistic. Biochemia Medica. 22(3): 276-282 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900052/ Merriam, S. (Spring 2001). Andragogy and self-directed learning: Pillars of Adult Learning Theory. New Directions for Adult and Continuing Education. Chapter 1, No. 89. John Wiley & Sons, Inc. O’Connor, C. (May 2012). Recognizing the critical role of nurses in a successful supply chain. Hospital Newspaper – NJ. www.gnyhaservices.com/841/File.aspx Polit, D. & Beck, C. (2012). Nursing research: Generating and assessing evidence for nursing practice. Wolters Kluwer/Lippincott Williams &

• Wilkins. (9th Ed.).

Richardson, D., Rupp, V., Long, K. Urquhart, M. Ricart, E., Newcomb, L, Myers, P. & Kane, B. (2014, November). Using lean methodology to decrease wasted RN time in seeking supplies in emergency departments. Journal of Nursing Administration. Volume 44(11), p. 606-611. Schwarting, D., Bitar, J., Arya, Y., & Pfeiffer, T. (2011). The transformative hospital supply chain balancing costs with quality. Booz & Company. http://www.strategyand.pwc.com/media/uploads/Strategyand-Transformative-Hospital-Supply-Chain.pdf Thompson, P. & Stanowski, A. (January 2009). Maximizing nursing productivity: The benefits of improved collaboration between nursing and support services. Healthcare Financial Management.

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References

Toba, S., Tomasini, M., & Yang, Y. (2008). Supply chain management in hospital: A case study. California Journal of Operations Management. Volume 6, Number 1, pp. 49-55 Tucker, A. L., Heisler, W. S., & Janisse, L. D. (2014). Designed for workarounds: A qualitative study of the causes of operational failures in hospitals. The Permanente Journal, 18(3), 33–41. http://doi.org/10.7812/TPP/13-141 Tucker, A. & Spear, S. (2006) Operational failures and interruptions in hospital nursing. Health Research and Educational Trust. Volume 41, Issue 3p1, pages 643-662. DOI: 10.1111/j.1475-6773.2006.00502.x United States Department of Labor Bureau of Labor Statistics. (n.d.). Occupation Outlook Handbook: Medical and Health Services Managers. https://www.bls.gov/ooh/management/medical-and-health-services-managers.htm United States Department of Labor Bureau of Labor Statistics. (n.d.). Occupation Outlook Handbook: Registered Nurses. https://www.bls.gov/ooh/healthcare/registered-nurses.htm University of Utah Website. (n.d). Link nurses and physicians to supply chains. http://healthcare.utah.edu/nursinginnovation/10ideas/ten.php Van de Castle, B. & Szymanski, G. (2007). Supply Chain Management in Clinical Units. In Karagiannis, D, Ursula Hübner, N. LeMaster, & Marc A. Elmhorst (Eds.). eBusiness in healthcare: eProcurement to supply chain management. (197-217). London: Springer. Doi. 10.1007/978-1-84628-879-1_9.

• Vanek. C. (April 24, 2013). Likert Scale-What is it? When to use it? How to analyze it? https://www.surveygizmo.com/survey-blog/likert-scale-what-is-it-

how-to-analyze-it-and-when-to-use-it/ Vesely, R. (2015). Linking patient safety and the supply chain. Health Facilities Management. Dec2015; 28(12): 37-39. (3p). CFA Staff. (August 2, 2017). How a culture of learning Produces a more engaged workforce. Workforce Insight. https://www.beckershospitalreview.com/supply-chain/why-the-supply-chain-is-a-health-system-s-most-untapped-resource-and-how-to-unlock-its-value.html https://collegeforamerica.org/learning-culture-engaged-workfroce/ https://www.shrm.org/resourcesandtools/tools-and-samples/toolkits/pages/sustainingemployeeengagement.aspx

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