By Sam Weech, Vizient Consultant, Spend Management Operations
My first foray into healthcare Clinical Value Analysis (CVA) was tainted by inexperience and bias, originating from ineffective monthly meetings with clinicians. In that instance, the value analysis format was lacking in substantive topics or product consideration. Often, decisions were based on the novelty of new trends in a technologically starved standalone system or by clinicians who could promote the strongest appeal to emotion or most forcefully voice their opinion. Far too infrequent were substantive discussions supported by relevant analysis.
Key to moving forward were overcoming barriers of distrust, avoiding misunderstanding, and focusing on getting the right items to patients at the right price and at the right time. Product decisions in the healthcare supply chain do not happen at the snap of a finger. Considerable time and effort are required behind the scenes to successfully introduce new items. To say the effort involved is unappreciated is an understatement. But who has time to worry about hurt feelings?
Fast forward a few years in my healthcare career journey, and I now combine increased wisdom with more experience. I understand the value of investing in relationships and combining strengths. While operating under a different set of circumstances, the stage is set for an enhanced perspective. Here are some key strategies that enable a successful working relationship between CVA and purchasing operations.
Purchasing and value analysis must accept one another’s strengths — and align accordingly.
It's crucial to understand the importance of, and embrace, the clinical role. That includes a focus on patient safety, minimization of risk and ensuring the best possible outcomes. Additionally, you must overcome bias from a supply chain perspective by considering CVA as an essential ally instead of a necessary evil and build upon common objectives including awareness of incurred costs, item availability and achieving desired outcomes.
Also, it is important to demonstrate proper respect for the sourcing process. This means acknowledging that there is tremendous pressure to produce results while navigating confined workstreams that come with numerous restrictions. Layered within this lengthy process is the work of category and contract management as it relates to overall purchasing operations, contractual obligations and compliance. To collaborate effectively, it's important to understand the obstacles within the supply chain environment and their resulting limitations.
Strive for balance and collaboration given different levels of experience, backgrounds and objectives.
To do this, you must always maintain a patient-centered focus and employ cross-collaboration to overcome disruptions and limitations such as manufacturer backorders, product discontinuations, and natural disasters and their impact on the entire supply chain.
For example, when there is a deficit of pediatric warming blankets or a commonly used syringe due to a manufacturer's shortage, there will inevitably follow a multitude of questions from the CVA team. They are focused on downstream impact and may not know all the methods a buyer will use to avoid disruption. Focus on leveraging relationships with other staff members and suppliers to arrive at a solution instead.
Establish a productive cadence and protocol.
Having a weekly meeting with the value analysis team to discuss ongoing issues and proactively identify potential problems is a great use of time. Use information available from internal tracking, supplier reports or trends highlighted in industry publications to help ensure that the lines of communication remain open.
In most cases, it is best to follow established processes. In some circumstances, a high-priority workflow might be useful to speed the turnaround time for urgent approvals. One tip from a purchasing perspective would be to establish when it is necessary to engage CVA. For specific instances when non-clinical products are an issue, purchasing might proceed without CVA input by working directly with end users.
The following are instances to consider. Clinical preference items will certainly require three-way communication. For non-stock items that do not involve direct patient use, such as chemo spill kits, CVA input is not required. Be aware that many seemingly inconsequential inventory items, like adhesive remover wipes, for example, have far-reaching implications. When determining suitable substitute items, confer with the CVA team to consider overall price, contract aspect, item availability, accessibility and sustainability.
Once an acceptable balance and working relationship between purchasing operations and value analysis is achieved, it is important to sustain the momentum. Working together to establish clear objectives and allowing for effective process flow within the different roles require constant maintenance. Open lines of communication are imperative to ensure order and efficiency. Regular meetings should be scheduled to review the status of items under consideration and those of emerging importance.
Disruption in the relationship between purchasing or contracting operations and clinical value analysis has far-reaching implications to the overall supply chain and clinical functions of a healthcare system. Stress and tension can build naturally and contribute to a potential breakdown. Take time to reflect, discuss and refocus on maintaining a healthy professional relationship.
Too much is at stake to allow misunderstandings or petty differences to interfere with the important roles we perform.
About the author
As a consultant within Vizient’s spend management operations, Sam Weech handles purchasing and contracting roles that involve assisting with acquisition-related projects, mentoring staff and providing guidance to provider organizations. Weech has more than 18 years of supply chain experience, nine of which are in healthcare. He earned a Bachelor of Arts in Russian and a Master of Business Administration. He has maintained his CMRP certification since 2016.