ASCs Remain Challenged, New Tech is Here to Help

Brendan Dooley, senior vice president, ambulatory surgery centers, Medline, says that from an inventory management perspective, ASCs share many of the same supply chain challenges and priorities as other healthcare settings. “One difference between supplying ASCs vs. other facilities,” he said, “is the ability of an ASC to focus on equipment, surgical packs, and supplies best suited to their specialty services vs. sharing supplies used in other lines.”

Jason Grzyb, vice president, non-acute sales for Cardinal Health’s U.S. Medical Products and Distribution business, added, “The ASC model offers patients a cost-effective option that may be more convenient than a full-service hospital for certain surgical needs. As more procedures are receiving approval and being performed in outpatient settings, we are seeing the volume and scope of care within ASCs grow significantly.”

“Additionally, new builds and existing ASCs are regularly experiencing complex issues like keeping up with evolving regulations, supply chain management, storage optimization, and logistics within a fast-paced market,” he said. “This means that ASCs have unique needs that other facilities may not. One need that stands out is optimizing storage, as ASCs typically don’t have the storage capabilities of a large hospital facility.”

Challenges and solutions

As for the biggest challenge when it comes to supplying ASCs? Dooley commented, “ASC supply chain challenges can include the following:

• Size of facility – Smaller ASC footprints mean less storage space, and centers that may not be equipped with loading docks facilitating regular supply deliveries
• Hours of operation – ASCs’ receiving hours are more restrictive than a hospital’s
• Staffing and vendor partnerships –  Because ASCs are rightfully focused on providing quality care, some ASCs may not have a dedicated team member or vendor partner responsible for supply chain solutions, managing inventory, pricing integrity, and ordering to drive efficiencies and cost savings
• Limited back-up resources – ASCs cannot borrow supplies from other in-hospital units when supplies run out”

Interestingly, Grzyb noted, “The ASC market is highly competitive and growing quickly. Our customers face a variety of complex issues that range from optimizing storage space, monitoring product usage, limiting waste, and managing inventory and logistics. ASCs also face staffing challenges – for example, a materials manager at a surgery center may wear many hats throughout their typical day.”

And for solutions? Grzyb said, “For new ASCs, collaborating with a distributor at the very start, especially when they’re planning a new build, can help them get ahead of these challenges. For example, an experienced distributor can help create and manage project plans and building timelines, as well as share clinical and operational insights to help maximize the investment in a new facility. A successful facility opening depends on a distributor who understands the unique needs within an ASC and can provide recommendations for equipment, supplies, optimal layout, and storage solutions.”

“Speaking of storage, as demand for ASCs grows, optimizing storage is becoming increasingly important. Both new and existing ASCs benefit from working with a distributor that has expertise in creating actionable plans to increase usable space and improve efficiencies by maximizing storage,” he added.

Further, Grzyb said, “ASCs can also benefit from clinician-led assessments, in which a team of consultants with clinical backgrounds provides onsite support and product expertise. Assessments may include identifying process improvements, evaluating efficiency of current procedure supply, and reviewing existing procedural pack components for waste. Consolidating procedure-specific items can reduce costs as well as pick and setup time.”

Dooley commented on costs. He said, “One of the ways to overcome supply chain challenges is to look at the total cost of supply chain – the dollars and time spent from ordering and acquisition to point of use and disposal. ASC leaders that make decisions and investments around ‘processes’ vs. ‘pricing’ will build a more efficient and resilient operation overall.”

“It is also a major advantage when an ASC works with a supplier or distributor who understands and can reference real-time information about what’s working for other ASCs, hospitals, and physician offices in the area,” he added.

Post-COVID landscape

Medline’s Dooley noted that the migration of surgical procedures from hospital settings to ASCs continues to accelerate as healthy patients are increasingly choosing to have surgery in healthy ASC environments. ASC leaders need to stay ahead of the procedures, reimbursements, and cost capture that support ASC revenue generation and growth. “Look for vendor partners who can support and enable expansion of services and specialties, increased caseloads, and center expansions,” he said.

“ASCs also need to consider that staffing is an even larger issue now than it was during COVID,” he asserted. “Clinicians continue to exit healthcare en masse, and ASCs may find it challenging to find and keep experienced clinicians. For staff retention, consider keeping clinicians working at their credentialed levels, allowing them to stay focused on quality outcomes and patient care. Also, consider how automation of certain processes benefits staff members – saving time and streamlining repetitive tasks.”

Automation nation

Medline’s Dooley also noted that automation is now making an impact on supplying ASCs. He said, “Over the years, Excel spreadsheets have been the go-to for data management and automation for ASCs and other providers. But for many, this manual process is becoming increasingly inefficient for managing inventory and pricing. Working with data-heavy spreadsheets lacks real-time collaboration; has higher potential for errors, discrepancies, and multiple versions; and is limited in terms of integration with external systems -- among other challenges that hinder supply chain efficiency and transparency.”

He added, “With ASC becoming the preferred setting for patients and payors alike on a growing number of outpatient procedures, proactive ASC leaders are turning to automated supply chain technology scaled to support the ASC setting. Supply chain automation benefits include effectively predicting product demand and preparing for possible shortages, improved fill-rate performance translating into less disruption to the clinical end user, time savings for staff, and pricing integrity.”

As for other innovations assisting with supplying ASCs, Cardinal Heath’s Grzyb noted, “Delivery via Sprinter van is well suited to meet the unique needs and footprint of ASCs. These vans offer the flexibility of more regular deliveries and final mile support. Also, the ability to leverage technology on-the-go can offer ASCs a new level of convenience and flexibility.”

And Medline’s Dooley noted, “Auto-substitution programs are designed to ensure that clinically approved substitutes for high-need medical supplies automatically get to a hospital’s dock, supply rooms, and most importantly, into the hands of clinicians who need them. One of the primary benefits of auto-substitution is time savings, which is as important to ASCs as flow of product because staff are typically stretched in many different directions.”

Dooley also noted other technologies that are positively impacting ASC supply chain on the inventory management side, including:

• Platforms that give ASCs complete control over surgical and other custom packs
• Periodic automatic replenishment systems that can identify optimal minimum and maximum inventory levels for specific supplies
• Weighted bins that track high-volume items
• Electronic shelf labels that can provide real-time inventory updates and alerts