OR Manager - February 2019 - 30

Success stories
projector. Attendance, minutes, and unresolved
agenda items from prior meetings
are reviewed. Each product request
is reviewed with links to peer-reviewed
publications, videos, and direct links to
images of the product being discussed.
The product requester attends the
meeting in order to clarify any issues
and to enhance engagement. Trials are
planned in real time, complete with product-specific
parameters and measurement
modes (eg, continuous scales or
pass/fail). The criteria for a successful
trial are established in collaboration with
the requester and committee members.
Stakeholders are defined and included in
the trial as appropriate. Between-meeting
activities include tabulating trial results
and reminders for trial participation.
After we transitioned to the new software,
the committee was energized,
and workflows improved. Having developed
the software in-house, we were
able to incorporate changes quickly
and efficiently. Over a 3-year period, we
modified the software so that new improvements
were rarely needed.
During the initial phase of implementing
our in-house software conversion,
the committee chair and OR finance
director spent 2 to 3 hours per week to
fully incorporate the software into the
workings of the committee through an
iterative process of improvement. Before
we converted from our in-house software
to the vendor's software, we shared
our existing software-based workflows
with the vendor. Once the conversion occurred,
we spent no more than 2 hours
per week over a 4-month period to align
the software to the required workflows.
The vendor handled the programming
changes, using customizable software.
Our surgical VAC serves as a model
for other value analysis teams in Lahey
Health, and we believe this would not
have been possible without the incorporation
of database software management
into our committee's operations.
Our vision to expand this local knowledge
and success of the system led to
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a request for proposals from national
software vendors.
By transitioning to a national vendor's
software platform, we took our
experience in our local committee and
generalized it to the system. We identified
several vendors and engaged a
vendor with software that was quite
similar to what we had developed. Having
a mature local software product
with established workflows eased the
transition to the vendor's software and
facilitated communication so that the
vendor was able to quickly incorporate
our needs into the product. The vendor
was able to go live within 4 months.
Lessons learned
It's important to plan and implement
workflow changes as much as possible
within the existing structure and using
existing resources before the new software
is introduced. That way, the software
can be used to support existing
workflows and enforce accountability
with those workflows while also offering
the flexibility to incorporate process
improvements.
The software will need continuous
improvement, especially within the first
few months or years, depending on the
complexity of the underlying work processes.
Database
tools bring a myriad of advantages
over paper-based systems,
including data transparency, searchable
data, enhanced communications,
aligned and organized workflows, and
detailed documentation. Including key
stakeholders in the software development
process ensures that the values
of the committee are upheld. We had
the participation of a surgeon as well as
finance and supply chain staff throughout
our transition.
Sharing ideas, technological advancements,
standardization of protocols and
supplies, supply utilization, cost-saving
initiatives, and contracting leverage are
just some of the successes achieved by
value analysis teams.
Often, one hospital becomes
aware of a new product or
technology
and requests approval for use at
its facility through its surgical VAC.
The requests are reviewed at the system
level, and an analysis is done to
gauge the benefits to the patient and
the surgeon, potential cost reduction/
savings, additional revenue potential,
strategic advantages, and potential
volume growth and standardization. If
the request is approved, the decision
is then shared with the rest of the
Lahey system so that the other surgical
areas within our system become
aware of the opportunity. These processes
are seamless and efficient,
thanks to a common systemwide software
platform.
Working with a software vendor to
share ideas and help develop and customize
the software is important to success.
Creating and developing software
in-house, using commonly available database
software, is very successful in
laying the foundation for a rapid and
successful deployment of a professionally
created and supported software
product from a national vendor.
Our workflows were well established
and supported by our software.
Expanding this technology to our system
required a more sophisticated
and professionally supported software
product that incorporated our established
workflows and experiencedbased
software needs. ✥
The authors (L-R) are with Lahey Hospital
and Medical Center in Burlington, Massachusetts:
Robert Dolan, MD, is vice
chair, department of surgery; Kristen
Murphy, MBA, is director, surgical services;
and Edward Aiello is director of
value analysis, supply chain.
OR Manager | February 2019 29
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OR Manager - February 2019

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