In order to strengthen the control of high-value consumables procurement, storage, issuance, use, effect evaluation, adverse event reporting and other links, to encourage the rational use of clinical high-value consumables, the formation of high-value medical consumables from the access until the safe use of clinical traceability of the whole process of integrated management, to ensure the quality of medical care and medical safety, the development of the management of the
1, medical high-value consumables management scope
(1) medical high-value consumables definition: refers to the direct effect on the human body, the safety of strict requirements, the production and use of strict control must be relatively high value of consumable medical devices.
(2) medical high-value consumables category: cardiac intervention, peripheral vascular intervention, neurological intervention, electrophysiology, cardiac surgery, orthopedic materials and instruments, artificial organs, digestive materials, ophthalmic materials (IOLs, etc.), neurosurgery (dura mater, titanium mesh, etc.), gastrointestinal surgery (anastomosis, etc.).
2, high-value consumables requisition
High-value consumables procurement follow the principle: to meet clinical requirements, quality assurance as a prerequisite for the selection of technologically advanced, preferential pricing, focus on service, credibility of the products and suppliers, and to maximize the maintenance of hospitals and patients' interests.
(1) Application for purchase of high-value consumables
A) Application for general high-value consumables: implementation of the operating room, interventional catheterization room, the management of the second level of storage, the second level of storage pre-storage of a certain amount of the base, clinical use to the operating room, interventional catheterization room to request the operating room, interventional catheterization room according to the base of consumption of batch applications.
B) Application for elective and follow-up high-value consumables: a single application from the using department, and an application to the equipment and equipment management office 3-7 days before the surgery is finalized.
C) Emergency high-value consumables application: emergency cases can be implemented by the Equipment and Equipment Management Division in accordance with the procedures for emergency procurement.
(2) Procurement process
A) The surgeon submits an application for purchase to the Department of Devices and Equipment Management 3-7 days before the operation, and at the same time fills in the Application Form for Disposable Medical High-value Consumables, setting out the reasons for the demand for the product, its clinical use and its comparative advantages with similar products, and then submits it to the Department of Medical Services after the signature and consent of the head of the department.
B) The Medical Department will demonstrate the feasibility of the project from the medical point of view for approval.
C) Equipment and Equipment Management Division to collect product information, review the product, supplier qualifications, and submit to the dean in charge for approval.
D) Health Bureau unified tender procurement of high-value consumables varieties, the implementation of the tender results; Health Bureau did not have a unified tender procurement of high-value consumables varieties, according to the clinical departments of the purchase application, the organization of the surgeon, the use of the department in charge and auditing, financial, disciplinary supervision according to the procurement of high-value consumables follow the principle of bargaining negotiations, the implementation of the negotiation results.
E) emergency surgery (single case) the use of high-value consumables to be used again to the Equipment Management Division requisition, accompanied by a copy of the "patient (or family) informed consent for surgery.
3, the procurement method
The hospital decided to purchase high-value consumables, to be applied by the Department, Equipment and Equipment Management Division (including engineers and technicians), Audit, Supervision Office **** with the participation of the decision to purchase, argumentation. If possible, there should be more than three similar products (brands, suppliers). To meet clinical needs, cost-effective for determining the procurement principles, all the original information is archived in a book.
4, the workflow of the secondary warehouse
(1) Arrange for the management of high-value consumables.
(2) the establishment of a specialized warehouse for the storage of high-value supplies.
(3) The surgeon submits an application for the preparation of high-value consumables to the secondary warehouse 2-3 days before the operation.
(4) Weekly statistical analysis of the trend of changes in the types and quantities of general high-value consumables, set a safety stock level; reasonably estimate the number of the next week's purchase, and submit a request for stocking to the Equipment and Equipment Management Department. (Incoming quantity=predicted quantity+safety stock)
(5) Consumables are delivered to the warehouse of the supply and maintenance center (the first-level warehouse), and the warehouse supervisor is responsible for acceptance, signing, storage, and issuance.
(6) The secondary warehouse picks up the goods from the supply and maintenance center warehouse (primary warehouse) and checks the name, type and quantity.
(7) Daily inventory of the remaining quantity of consumables, if there is a shortage or in case of special conditions (such as emergency surgery) to contact the Equipment Management Division in order to order, or notify the surgeon to replace the appropriate consumables.
(8) To keep a record of the varieties and quantities of high-value consumables (number of arrivals, number of uses, and number of residuals) in the department.
(9) Record charging information to ensure that there are no missed or duplicate charges.
(10) Record in detail the "Register of Information on the Use of High-Value Consumables" and provide weekly feedback to the Equipment and Facilities Management Division.
5, in and out of the warehouse process
(1) The equipment and equipment management department notifies the supplier to issue invoices based on the feedback from the department of the use of "high-value consumables use information registration form", and signs to confirm.
(2) The treasurer of the warehouse of the Supply and Guarantee Center (the first-level warehouse) checks the invoice and the "Registration Form for the Use of High-Value Consumables", requiring that the face of the invoice and the "Registration Form for the Use of High-Value Consumables" correspond to each other and sign to confirm the relevant contents.
(3) After checking and signing, the invoice and the "Registration Form for High-Value Consumables" are submitted to the accounting personnel for the procedures of entering and leaving the warehouse.
(4) "High-value Consumables Use Information Registration Form" is archived by the warehouse and submitted to the Equipment Management Office quarterly for record.
Two, how to improve the quality of management of medical supplies
In view of the problems in the procurement, supply and use of medical supplies, in order to improve the quality of management of medical supplies, it is necessary to purchase and sale of medical supplies in hospitals in the field of the introduction of lean recruiting, precise control and precise analysis of the "three fine" management methods:
1, lean recruitment
"Lean" is the use of modern management methods and tools to give full play to the role of people as the fundamental, based on the actual demand, the effective configuration and rational use of resources, and seek to maximize the benefits. Lean recruitment is a scientific tool for selecting more suitable medical consumables through bidding. Lean recruitment with the help of economics evaluation means, will realize the cost-effective evaluation of consumables from subjective, qualitative to objective, quantitative, and to achieve the lowest medical cost, to obtain the best medical effect, the best medical utility and optimal medical benefits.
2. Precise control
Precise control is a management and operation system based on quantitative management and continuous improvement by project teams. The "precision" here mainly refers to simplification, easy to operate, the time cost between the goal and the results, capital costs, risk costs, etc. are constantly reduced, so as to improve the management efficiency and marketing efficiency and the quality of the results. Accuracy" refers to the clear definition of results and the ability to quantify and refine the operation. Precision management is an effective method from experience-based management to standardized management, specifically to the precise control of medical consumables, is to solve the problem of the use of medical consumables in the clinical departments of the second level of the library of the problem of the direction of the use of medical consumables, to build the application of consumables - planning - receiving - consumption - billing of the associated system. Ultimately, through the flow supervision and flow control technology, the establishment of efficient circulation, accurate billing, to eliminate the loss and avoid waste of medical supplies transportation and management system.
3, accurate analysis
Accurate analysis is to analyze and evaluate all kinds of information and data, through the use of consumables composition analysis, consumption statistics, standard mastery and evaluation assessment, the formation of a complete effect of feedback and quality improvement loop.
With the development of information technology, network information and artificial intelligence has become an important means to address social operation and governance. With the help of modern information technology, "three fine" management can realize the scientific access to hospital medical supplies, rational storage and standardized use of the purpose, and the establishment of the PDCA cycle, and ultimately to reduce the "consumption ratio" control goals.