COHPA Central Ontario Healthcare Procurement Alliance

Transcription

1 Supply Chain Shared Services leading practices and lessons learned April 22, 2010

2 Discussion Outline Organizational Background April 2010 Status Accomplishments Some Key Metrics Leading Practices Lessons Learned 2

3 Presenting today Brad Sinclair COHPA General Manager Jim Talbot Director Materials Management, Southlake Regional Health Centre Denise MacLean Logistics Lead for Shared Services Conversion, Markham Stouffville Hospital 3

4 Organizational Background

5 Corporate Vision COHPA will be a results-oriented, integrated supply chain organization. It will leverage the combined resources and support of all partners, applying industry best and leading practices, technology and economies of scale in order to reduce costs and increase service levels in support of patient care. 5

6 Owners of the Shared Services Corporation (Member hospitals) Markham Stouffville Hospital Peterborough Regional Health Centre Ross Memorial Hospital, Lindsay Royal Victoria Hospital, Barrie Southlake Regional Health Centre, Newmarket York Central Hospital, Richmond Hill 6

7 Customer Hospitals Customer hospitals pay a fee for COHPA to manage their strategic sourcing and supply chain services. 7

8 Current Customer Hospitals Haliburton Highlands (Nov 2009) Stevenson Memorial, Alliston (Nov 2009) Penetang Mental Health Centre (Jan 2010) Georgian Bay General, Midland (March 2010) Northumberland Hills, Cobourg (March 2010) And more to come 8

9 Manufacture Distribute Hospital Caregiver Patient Supply Chain Deliverables Reduced Costs Sustainable Customer Service Reduced Cycle Times Improved Asset Utilization 9

10 Key Deliverables Combine purchasing power to deliver reduced prices and increased value for medical/surgical supplies and contracted services Leverage Information Technology to centralize and improve the efficiency of: Contract management Procurement Logistics / Inventory Management Accounts Payable 10

11 Key Deliverables Create a shared services organization with a scalable operating model for public sector supply chain functions. Pay out member investments in 2 years or less through contract savings and process efficiencies. 11

12 Chronology & Milestones Date April 2005 December 2007 March 2008 Event Informal meetings of Central Ontario Hospital Purchasing Association (COHPA predecessor) Steering Committee for iscm project formed Business case submitted to OntarioBuys Inaugural meeting Board of Directors Startup funding received Weeks from funding March 31, 2008 IT contract signed with McKesson 1 August 28, 2008 First payroll run Leadership team and Contract Specialist 22 September 10, 2008 Servers installed and powered up at Data Centre 24 December 2008 Startup team relocates to Service Centre 36 April 2009 Go Live at YCH and SRHC 52 August - December 2009 April 2010 Fall 2010 Fall 2010 Onboard RMH, PRHC and MSH COHPA assumes back office support functions for Haliburton Health Services Planned onboarding of RVH 3 year strategic planning 12

13 April 2010 Status

14 Regional Hospital Supply Chains Implementation: funded pre-07 funded Underway/ partial funding Regional hospital supply chains have been or are being established for 70% of the sector, up from 25% in 2004.

15 Negotiating contracts and running RFP s on behalf of 6 member hospitals since June COHPA is leading a team of hospital representatives to seek product standardization opportunities. The transformation to standardized processes, paperless transactions and an independent service provider has generated considerable frustration among hospital users. 15

16 Savings for COHPA Members FY 2008/2009 $1.0M, approx 5% of contract value FY 2009/2010 $2.9M

17 Purchasing Metrics 1200 users (e-requisitioners) in 5 cities 350 purchase orders placed per day (7 Buyers) 85% of requisitions placed as PO s same or next day FY 2009/2010 volumes 20% over budget 46,000 catalogue items 17

18 Materials Management Hospital Supplies supply carts per hospital items per cart or bin Hospital technician scans via handheld device to generate replenishment order Overnight delivery, next day restocking 98.5% line fill rate Master services agreement with uniform pricing and service expectations, Third Party Logistics (3PL) provider 18

19 Finance Metrics 700 invoice payments per day (8 Accts payable staff) Approximately $1.5M per day in disbursements 80% of vendor payments by Electronic Funds Transfer All employee expense payments for 5 hospitals All physician payments for 5 hospitals 19

20 Leading practices

21 Interested sectors within the Central LHIN Long Term Care Sector (Retirement homes, Nursing homes, Long Term care homes) = 46 organizations in Central LHIN Community Support Services Sector = 35 organizations in Central LHIN Mental Health & Addictions sector = 24 organizations in CLHIN Community Health Centres = 2 organizations in CLHIN Community Care Access Centre = 1 organization in CLHIN Hospital sector = 7 public organizations in CLHIN discuss the supply chain applications and opportunities

22 Purchasing and Strategic Sourcing Jim Talbot Group tendering and contracts Before After Result Non Contract-Spot Purchasing Decentralized Process Non Compliance for GPO Harmonization of Contracts Centralized Process Compliancy improving Streamline & Standardized process Ensures compliancy with Supply Chain Guidelines Coordination of contract Reduction of lost opportunities Electronic requisitions Mix of Manual & Electronic No real-time online information Year 1-95% Electronic ( not Capital) Year 2- planning to include Capital Real-Time Information P/O #, Del Date Etc Downloading of work to the hospital Still Evaluating/ Considering Improved Approval level accountability/process Centralized buying Hospital Buyers were on site, informal interaction with clinical staff Buyers are off site, focus on $ value and process efficiency Frustration from clinicians Importance of performance metrics and services agreement 3 way match, process rigor Manual for Non P/O i.e. Utilities, Lawyers Electronic for P/O s Electronic Cheque process for Non P/O Same Process Accurate Coding Reduced Data Entry/errors. Reimbursements. Non P/O s 22

23 Materials management Denise MacLean Before After Result Supplies On site storerooms Just in time replenishment 3 way match Paper invoices and receiving reports Best Practices Technology Supplier Relationship Management Hospital Employees working with hospital team Each hospital using their own technology Each hospital working with each supplier Electronic Purchases, receipts and invoices Collaboration between member hospital with working teams Shared Technology Platform Suppliers managed against combined scorecards Frees up Healthcare $ for patient care Frees up physical space, working capital and people All transactions are automatically captured in the system Standardized work processes: cycle counting, receiving Better flow of information, less manual work, better data for decisions Improved supplier performance

24 Back Office Consolidation Before After Result Collaboration Individual organizations with independent, local processes for purchasing and accounts payable Centralized, standardized process for all stakeholders After settling period, streamlined and efficient work processes Building Relationships Occasional meetings of key players at conferences and special events Regular monthly meetings of four working teams Ongoing benchmarking and dialogue in pursuit of mutual benefits Thinking Outside the Box Paper requisitions Cheques Just do it Paperless processes EFT payments 3 way match Streamlined processes, increased accountability Patient Safety- Device Alerts Individual organizations with independent, local processes Single point of contact, standardized process subject to audit Timely and reliable deployment of information to clinical users 24

25 Supporting the LHIN s IHSP: Integrated Approach 6 hospitals working together to standardize, centralize and optimize back office processes Common technology platform and service provider Patient Centered Automate processes to free up time from clinical resources Save $ via group contracts to enable hospitals to invest savings for local patient care priorities Accessible 1200 users in 5 cites using desktop PC s 46,000 catalogue items 25

26 Supporting the LHIN s IHSP: Effective/Efficient Hospital staff able to focus on clinical priorities, supported by purchasing and payables professionals Not yet as effective as expected Safety Improving call response and issue resolution Standardized tendering of business to common specifications Contract awards consider supplier performance and quality Medical device recalls and alerts 26

27 Lessons learned

28 Southlake Regional Health Centre What went well: Member hospital involvement in IT solution Regular meetings for each stream of work On site support for end users post go live Focus group meetings to build awareness and understanding Hospital advocate allocated Dedicated staff committed to the project 28

29 Southlake Regional Health Centre What could have been improved: Aggressive time lines impacted quality data, internal communications and planning Spend the time to develop Detailed process maps (as is, to be) Lack of available resources for the hospitals (back fill not considered or identified early enough in the project) Key people at both COHPA and member hospital required to work unreasonable hours for an extended period of time to meet deadlines End users did not have the ability to practice after training Training for Super Users not sufficient Product shortages due to vendors not having COHPA set up as a customer Critical issues with systems and processes at go live: o Handhelds not functional in Distribution o Handheld and scanning issues in Receiving o Workload increase due to additional receiving steps 29

30 Markham Stouffville Hospital Spend time mapping out work processes (as is to be) Ensure that all current work processes have a way to be done in the new environment Align Staffing before cutting over Investigate whether current staffing exists to properly support required work effort in the new environment Clean up Spend time cleaning up current state so that old data is not transferred into new technology platform Validate and test Ensure that the data build in the new technology platform is correct and that it works Training Over train people on the new system and work processes

31 Future opportunities... Back office shared services

32 Leverage group spend for joint RFP s and contracts, driving increased value for scarce health care dollars. Participate in working teams to benchmark leading practices, apply technology and share learnings with other members of the group. Leverage group size and supplier relationships to achieve things like JIT inventory management, freeing up storage space and working capital. Utilize internet-based technology for requisitions, catalogue, purchasing, materials management and accounts payable free up administrative staff for core services 32

33 Our mission: providing cost-effective supply chain services for healthcare 33

34 Questions and discussion 34