Materials management best practice

Leeds Teaching Hospitals NHS Trust

March 2003

Best Practice Guide

The following is extracted from a best practice guide documented by Simon Heywood . To download a copy in word format, please click here.

Contents

1.0 Background

2.0 Materials management team

2.1 The Team

2.2 Responsibilities and Development

3.0 Materials management process

3.1 Background

3.2 Materials management replenishment process

3.0 Review Process

3.1 Initial set up

3.2 Materials management review process

3.3 Location labelling

3.4 Theatre labelling

3.5 Sterility checks

3.6 6 monthly stockholding review

3.7 Product Selection Group (Monthly Review)

5.0 Storage solutions

5.1 Storage problems experienced before Mat-man

5.2 Module Shelving

5.3 Ward Shelving – Waist height

5.4 Difficult to store – IV Fluids

5.5 Bulk Storage

5.6 Mobile racking

5.7 Seasonal Requirements

6.0 Communication

5.1 Intranet

5.2 News Letter

7.0 Benefits

8.0 Savings

9.0 Acknowledgements

Appendices

1. Background

1.1 NHS Logistics Authority’s role

The Cabinet office review identified the need for a supply chain service provider for the NHS. NHS Logistics Authority now provides a range of supply chain services including:

• e-ordering (Logistics OnLine)
• e-catalogue
• e-management information
• e-billing
• e-direct
• Home delivery
• Support for trusts – Supply chain best practice, advice, training packages

NHS Logistics Authority aims to identify and spread best practice in areas such as the physical goods flow through trusts, transportation and materials management.

1.2 Materials Management

Over 250 of our customers currently use our materials management service and we receive almost 50% of all our customers’ orders via this method. Materials management uses bar code technology to maintain stock levels and re-order stock using hand held scanners.

We have relied upon the current materials management technology for over 10 years to provide the high standard of service upon which our customers depend.

2. Materials Management Team

The materials management team consists of 50 members of staff out of the total 79 employees in the Supplies department, providing a materials management service to the six sites within the trust (St James, LGI, Seacroft, Wharfedale, Chapel Allerton & Cookridge Hospital).

The coverage of Materials Management is now 203 sites over the four locations – The Leeds General Infirmary, St. James’s University Hospital, Wharfedale Hospital and Seacroft Hospital, (including Theatres).

Figure 1 St James<92>s Materials Management Team (Back Row: T. Kiane, W. Johnson, G. Varley, S. Barker, R.Wilson. Front Row: R. Brown , H. Woodhouse, S. Lodge)

Figure 1a Leeds General Infirmary Materials Management Team (Back Row: J. Park, C. Bull, D. Dews. Front Row: J. Woolhouse, J. Layton, R. Hornshaw, S. Pailing)

The Leeds Teaching Hospitals NHS Trust

Materials Management Department

Materials Management reduces time and costs

• the direct links between the data capture system and the supplier's ordering system reduces supply chain time and costs and reduces ordering errors

• by releasing a significant amount of Nursing time back into the ward

• by simplifying ordering - the data is inputted direct to the supplier via a hand-held barcode reader

Materials Management provides management information

• that can be used to forecast required stock

• it can provide statistical analysis of historical data and generate reports to review product use and to identify better efficiencies

Materials Management gives flexibility to manage products

• by helping with product standardisation programmes and effective stock control, leading to more efficient use of limited storage space on the wards

• by providing a modular storage system

• by streamlining receipting procedures, leading to improved payment systems

Materials Management saves money

• by saving on requisition costs, reducing obsolescence and waste and simplifying stock valuation for the trust

• by helping to give a clearer understanding of a Trust's spend and operating costs

• by providing realistic stock levels linked to actual usage - matching service delivery with Trust actual service needs

• Responsibilities and Development

At St James’ a member of the materials management team will carry out an average of 3 stocking points orders and 3 stocking point putaways per day. Each stocking point holds an average of 300 product lines. Other responsibilities of the materials management team are unloading, internal distribution, admin (barcodes, labels, etc), updates, stock outs, queries and training.

At the other 3 sites a member of the materials management team will carry out an average of 4 stocking points orders and 3 stocking point putaways per day. Each stocking point holds an average of 300 product lines. Other responsibilities of the materials management team are admin (barcodes, labels, etc), updates, stock outs, queries and training.

Each of the materials management team has a development plan, which includes:

• Supplier visits

• Product information training

• Professional Qualifications e.g. CIPS

• Other job related courses

These courses help the materials management team to gain a better understanding of products and enable them to answer queries from the end users.

The Leeds Teaching Hospitals NHS Trust achieved the Investment in People Award in June 2002.

3. Materials management process

3.1 Background

There are currently 203 materially managed areas within the Leeds Teaching Hospitals, which are set up to use the ADC functionality. The materials management team are aiming to add a further 80 stocking points to Materials Management, this will provide 100% coverage of possible stocking points.

The roll out of the materials management programme is prioritised by using a report detailing stock value and weekly throughput by department. (see appendix 10.5)

The 203 stocking points have been set up on the manual ordering functionality in the ADC software, excluding the Seacroft site, which is currently set up using automatic ordering.

Each stocking point has one catalogue, which contains all the stock and non-stock items used within that area. (an example of a stocking point catalogue is shown in appendix 10.7)

The stocking points within The Leeds Teaching Hospitals, set up on ADC, which the materials management team do not visit, currently use “travelling requisitions”.

The target stock cover for all stocking points is 2 weeks . There is a variable frequency of replenishment depending on the type of department supplied by the stocking point.

The materials management team are responsible for the replenishment of Wards, Theatres and CSSD pre-sterile packs across the six sites.

Stock out and query management services are provided to all the end users.

Each stocking point has contact details (pager & telephone numbers) of the materials management member responsible for that area, this enables stock outs and queries are resolved quickly.

An example of the contact sheet is shown in appendix 10.2

The location of the modular storage is set up in the department to reduce nursing time in picking products.

Ordering Processes

Automatic Ordering

Manual Ordering (Top-up)

Direct Requisition (travelling requisition)

Automatic Ordering Process (Seacroft site)

Manual Ordering Process

Direct Requisition (Travelling Requisition)

Stocking points using ”travelling requisitions” are issued a pack by the materials management team, containing an authorisation sheet, a new product order sheet, barcodes and descriptions of any product used in that stocking point (see appendix 10.1).

This in effect becomes a bespoke catalogue for that particular Department.

Figure 3 PC based barcode reader for direct requisitions

Figure 4 Travelling Requisition Barcode Book

Travelling Requisition Process

3.3 Materials management replenishment process

• The replenishment cycle is as follows

Storeroom Type	Replenishment Frequency
Standard Ward	Once per week
A&E / ICU	Twice per week
Theatres	Daily

4. Review process

4.1 Initial set up

Stock levels

• The initial stock holding levels are set using the last 12 months demand, combined with the materials management team’s experience and any specific requirements from the end user.

• The stock level is calculated to equate to 2 weeks stock . The initial stock levels are agreed and formally signed off with the end user, giving them confidence in the new system.

• Any additional stock in the stocking point at the initial set up stage are removed into the supplies area and drip fed back into the stocking point as required to maintain a two weeks stock cover.

• As part of the initial set up of a stocking point onto Materials Management, a sterility check is carried out on all products. Any products identified as obsolete are removed from the stocking point for disposal.

4.2 Materials management review process

4.3 Location Labelling

• Location labels use end user friendly descriptions (figure 5).

• Each location has a module code label at the top of each set of drawers (figure 6), this module code label relates to the print key in the barcode books used for ordering

• Each location below waist height has a label on the lip of the tray, making identification of products in these locations easier (figure 7)

• Each stocking point contains a listing of all the locations and products in that area. This is the responsibility of the materials management team to keep updated.

This allows the end user to quickly locate new products and is of particular help to staff unfamiliar with the stocking point (e.g. new staff)

Figure 5 End User Friendly Description
Figure 6 Module Code Labelling
Figure 7 Location Labelling on lip of trays

4.4 Sterility checks

Every time a replenishment is performed the materials management assistant responsible for the stocking point will conduct a sterility check on all products.

4.5 6 monthly stockholding review

Every six months the materials management team conduct a review of the stock requirement for each storeroom. By looking at the last 12 months demand for the storage area maximum stock figures, reorder levels and reorder quantity are amended (where applicable) and locations are adjusted accordingly.

There is a meeting between the materials management team and the end users to agree the changes in the stock holding requirements.

4.6 Product Selection Group (Monthly Review)

The group includes all stakeholders including the materials management supervisors, purchasing manager, nurse managers, infection control and consultants.

This group meets on a monthly basis to review the product ranges available in the trust and to approve new products. If a decision is made at these meetings the products will be changed when the existing stocks have been exhausted.

5. Storage solutions

5.1 Storage problems experienced before Mat-man:

• Health and Safety problems

• Product Damages

• Poor location labelling - difficult to locate product & picking errors

• Poor stock rotation

• Poor space utilisation

• No management information

Figure 8 Jubilee A&E LGI before Matman

Figure 9 Jubilee X-ray LGI before Matman

Modular Storage

Modular storage is flexible allowing for the storage of many different products.

• Storage units maximise use of space.

• Shelves can be subdivided for different products.

• Stock recognition easier with transparent shelving.

• Stock damages reduced as stock cannot fall from location.

• Stock integrity improved as stock cannot overspill from location.

• Fast moving products are located at arm level in the storage modules for easy access.

Figure 10 Modular Storage

Figure 11 Modular Storage

5.3 Ward Shelving – waist height

Waist height storage in nurse work area allows maximisation of storage capacity and negates the need for a separate storeroom. This storage solution allows for easier access to frequently used products. The feedback from the stocking point user was very positive on this storage solution.

Figure 12 Waist height Storage

Figure 13 Waist height Storage (Front)

5.4 Difficult to store items - IV Fluids & Catheters

IV Fluids

IV Fluid storage is a common problem as they have bulky and heavy. The tray runners are designed to safely hold heavy products.

Figure 14 IV Fluid Storage

Catheters

Catheters create a problem for storage as they cannot be folded or squashed. These trays provide protection for the product and allow easier stock access and rotation.

Figure 15 Catheter Storage

5.5 Bulk Storage

An example of bulk storage within the Trust can be found within the Renal Unit. The store is Materially Managed and provides product to 4 service users who are unable to store the items in clinical areas. Due to the quantity and nature of the products, modular storage was inappropriate and an alternative robust metal racking system was used.

Figure 16 Renal Unit Bulk Storage

5.6 Mobile racking

The mobile storage units in one of the Theatre Stores are the preferred method of storage for items that are not available from NHS Logistics or the Trust’s 3 rd Party Wholesale Distributor. This ensures optimal use of the available storage space.

Figure 17 Mobile racking

5.6 Seasonal Requirements

Seasonal wards are set up to over the increase in demand, ward moves and ward refurbishments.

In wards, which are not open all year round, Mat-man can accommodate temporary store locations within their usual day-to-day workload. Prior to the ward opening, the stocking point is set up and stock transferred.

On closure all remaining stock can be redistributed internally. Mat-man information can help burn off excess stock quickly by redistributing the stock to high usage storerooms.

6. Communication

• Intranet

The materials management team have set up a dedicated section on the trust intranet to inform internal departments about material management issues. This has been achieved by having an IT expert employed within the supplies team.

This section contains a substantial amount of information on the materials management team, catalogue, how to order from supplies, how to order on line, etc. There are also links to NHS Logistics Online and Pasa.

This section helps the different departments within the trust to find out more information about materials management and the team. It also helps to promote the team internally and therefore helps with the buy in from end users into materials management.

• Trust Newsletter

This is a monthly newsletter, which the materials management team use to inform the trust of achievements and issues. This is another way to promote materials management and the team throughout the trust.

7. Benefits

Stock

• Increased product lines available in storerooms with space optimisation.

• Rationalisation of product range and supplier base.

• Reduced stock value with stockholding policy and regular review.

• Increased space with optimal product storage.

• Reduced damages with location trays.

• Reduction in write-offs for out of date stock with regular stock rotation.

• Reduced obsolete stock as usage regularly reviewed.

• Products deemed required on a ward by specialist (i.e. Control of Infection) are made available.

End user

• Easier to locate stock for end user (Layout by product type and end user information friendly labelling).

• Reduced stock outs as stockholding regularly reviewed. (Stock outs caused by increased demand are reported to the materials management team who source stock internally, raise order and review stockholding figures)

• Service delivery based on stakeholder needs.

General benefits

• Improved quality of management information.

• Streamlining the flow of goods.

• Reduction in the number of “visitors” to wards and theatres.

• In line with the NHS Plan.

• ADC can interface with Medical and Surgical Distributors, this reduces the amount of paper requisitions raised as non-stock items are requisitioned through ADC.

• Reduction in nursing time spent on stock/non stock requisitioning and queries.

8. Savings

• 6 Nursing staff WTE’s have been saved through the introduction of Materials Management. This resource has been transferred into the supplies team, which ensures the continuing improvement of the materials management team and process.

• Approximately £0.3 million stock savings were achieved in theatres with the implementation of Materials Management. The Theatre central store room was decommissioned and replaced with an additional operating theatre. Supplies staff now delivery items directly to the point of use in the operating theatres.

• Stock value reduction of 52% in the Neo-Natal Ward, Children’s Services and Obstetrics

• Charts showing the savings per ward/department as result of the implementation of Mat-man are shown in Appendix 10.3 and 10.4

• 1 full day per week savings of nursing time per typical ward

• A minimum of 35% stockholding reduction in a typical ward

• 20% reduction on stock obsolescence at initial set up of stocking point

9. Acknowledgements

• The Leeds Teaching Hospitals NHS Trust

• Steve Barker Materials Manager

• Helen Woodhouse Materials Management Supervisor

• Materials Management Team

• If you require additional information about materials management at the Leeds Teaching Hospitals NHS trust please contact:

Steve Barker, Materials Manager

Telephone 0113 2064617

Email steve.barker@leedsth.nhs.uk

Leeds Teaching Hospitals NHS Trust Website:

www.leedsteachinghospitals.com/supplies/index.html

10. Appendices

Appendix 10.1

Appendix 10.2 Supplies Department