expired suture without investigating whether the ASC's 18 surgeons
were still using that particular suture, or if there were more boxes
already in stock.
The ASC was routinely stocking 145 different types of suture. Ms.
Heckmaster set out to untangle the suture mess by decreasing
suture inventory to a more reasonable and realistic level, storing all
suture on one suture cart in one location, establishing a PAR
(Periodic Automatic Replenishment) level inventory system based
on usage levels and educating staff on first-in, first-out (FIFO).
Thinning the herd
The first step was evaluating the suture inventory. Ms. Heckmaster
created a master suture list that itemized all the types of suture in
stock, the names of the surgeons who used each type of suture and
what the PAR levels should be. She referenced surgeon preference
cards to determine what suture the surgeons used on each case.
"Suture not found on any preference cards was automatically
removed from our stock," says Ms. Heckmaster, adding that they con-
solidated multiple types of the same suture into one and then updated
the preference cards to reflect the change.
They removed 27 types of suture from the 145 that they stocked, an
18% reduction, but that was just the tip of the iceberg because there
were multiple boxes of each of the 145 different suture types in the
inventory, ranging from 2-6 boxes each, says Ms. Heckmaster. To recov-
er some of the financial loss, AdventHealth Surgery Center Lenexa
returned for credit any recently purchased unopened boxes. They sold
or exchanged within its hospital system any unopened suture boxes
they couldn't return. With multiple boxes of the same suture already
opened, they labeled the boxes in order, based on expiration date, to
notify staff from which boxes to pull.
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