By the Numbers Statistical Linen Management Using Usage and Utilization Data to Effect Change Janice Larson, CLLM Heidi Ayala, RN, CLLM Objectives Determine your facility s baseline Compare your baseline to industry data Use the data to make actionable decisions Present data to EVS and nursing staff in order to generate action. In other words What reports should I start with? What do they really tell me? What do I do next? How do I use the data to change behavior? 1
Usage Management Setting Your Baseline Pounds per Adjusted Patient Day Annual Clean Pounds Processed Annual Adjusted Patient Days = Pounds per APD Pounds Per Adjusted Patient Day 20 15 19.0 15.5 10 10.0 5 0 Sample Hospital Industry Average BDP 2
What is an Adjusted Patient Day? The American Hospital Association Formula Total Hospital Revenue = A ratio Inpatient Revenue (usually around 1.35) $1.00 of Inpatient Revenue = $0.35 of Outpatient Revenue Inpatient Days x ratio = Adjusted Patient Day It is hospital census adjusted for outpatient activity! How do you get this data? From your linen management software program Clean pounds delivered by your processor Adjusted patient days are available from your hospital accounting department Analysis Process If you have APD s Compare to industry averages Identify items If you also have department census Identify departments Focus in on items in those departments 3
Industry Averages Encompass National Average Database The Phillips Report New Encompass NADB Reports Other Textile Provider Reports Step One Facility Pounds per Adjusted Patient Day 4
Step Two Facility Use per Item per Adjusted Patient Day 5
Step Three Department Pounds per Activity Step Four Department Use per Item per Activity 6
Utilization Management Need for Par Level Management Carts and closets are stocked based on how many fit Linen policies and usage has changed but par levels haven t Non-circulating inventory = $ 7
Overstocking This cart serves a Med/Surg unit with 8 beds Avg. daily use of gowns = 13 Par level gowns = 16 Approx. 80 gowns Avg. daily use of sheets = 17 Par level sheets = 21 Approx. 120 sheets Avg. daily use of towels = 25 Par level towels = 31 Approx. 110 towels Utilization by Facility 8
Utilization by Department Par Level Management Establishing Par Levels when Usage is Known User Area Par Level = (Avg. Daily Usage) (Safety Stock Factor) (# of Days Usage on Cart) EXAMPLE: Average Daily Usage = 30 Safety Stock = 1.25 # of Days Usage on Cart = 1 Formula: 30 1.25 1 = 37.50 rounded to 40 Par Level Safety Stock Factor Range 1.25-1.30 9
Par Level Management Establishing Par Levels when Usage is Unknown User Area Par Level = (Normal Usage per Inpatient Day) (Avg. Daily Census) (Safety Stock Factor) (# of Days Usage on Cart) EXAMPLE: Sheets - Normal Usage per Inpatient Day = 1 36-Bed Unit, Average Daily Census = 28 Safety Stock = 1.25 # of Days Usage on Cart = 1 Formula: 1 28 1.25 1 = 35 Par Level For maximum census: 1 36 1.25 1 = 45 Par Level Auditing Linen Accuracy Pounds of Linen Distributed Throughout the Facility Versus Total # of Pound Delivered from the Laundry Sharing Data with Nursing Present at Nurse Managers Meeting Provide departmental reports Conduct report analysis training Eventual goal is to charge back 10
Rational Consumption is the right product at the right time for the right reason and in the right amount Linen items are consumable medical supplies designed to be used for specific purposes. Creative use = Cost abuse!! Understanding Your Customers Needs The most successful linen management initiatives are a comprehensive combination of two integral pieces: Understanding your current linen practice by observation and linen utilization data analysis Change nursing practice and educate staff emphasizing rational consumption of linen Who do you educate? Nurses Nursing Assistants Student Nurses Registry/Traveling Nurses Environmental Services Linen Distribution Patient Transport 11
Why do they need to be educated? Because Linen choices affect patient care Linen choices affect cost More is not always better Benign abuse is preventable Hospital s financial health is everyone s business What do you teach them? Concept of Rational Consumption Baseline Data Current facility lbs/apd Annual expenditures for processing and replacement Product Use Guidelines Cost to Use/Cost to Lose Analysis Bed Make-up/Linen Change Policies Discard/Rag-out Policy Garment Control Policy Some people change when they see the light, others when they feel the heat. Caroline Schoeder 12