In order to strengthen the control of the procurement, storage, distribution, use, effect evaluation and adverse event report of high-value consumables, encourage the rational use of high-value consumables in clinic, form the traceability management of high-value medical consumables from access to clinical safe use, and ensure medical quality and medical safety, this management method is formulated:
1, management scope of medical high-value consumables
(1) definition of medical high-value consumables: refers to consumable medical devices with relatively high value, which directly act on human body and have strict requirements on safety, and must be strictly controlled in production and use.
(2) Medical high-value consumables: cardiac intervention, peripheral vascular intervention, nerve intervention, electrophysiology, cardiac surgery, orthopedic materials and instruments, artificial organs, digestive materials, ophthalmic materials (intraocular lens, etc.). ), neurosurgery (dura mater, titanium mesh, etc. ), gastrointestinal surgery (stapler, etc. ).
2. Buy high-value consumables
The purchasing principle of high-value consumables is to select products and suppliers with advanced technology, preferential price, service first and reputation first on the premise of meeting clinical needs and ensuring quality, so as to safeguard the interests of hospitals and patients to the maximum extent.
(1) Purchase requisition for high-value consumables
A) Application for universal high-value consumables: the management of secondary warehouses of operating room and interventional catheter room shall be implemented, and a certain number of bases shall be pre-stored in the secondary warehouse, which shall be collected in the operating room and interventional catheter room for clinical use, and the operating room and interventional catheter room shall apply in batches according to the consumption bases.
B) Application for high-value consumables at the same time: the department shall apply once, and submit the application to the equipment management office 3-7 days before the operation is confirmed.
C) Application for emergency high-value consumables: Emergency procurement can be implemented by the equipment management office according to procedures.
(2) Procurement process
A) Surgeons should apply to the Equipment Management Office for purchasing 3-7 days before operation, fill in the Application Form for Disposable Medical High-value Consumables, explain the demand reason, clinical use and the comparative advantages of this product with similar products, and submit it to the Medical Department after being signed and agreed by the department director.
B) The Medical Department will demonstrate and approve the feasibility of the project from a medical point of view.
C) The Equipment Management Office collects product information, reviews the qualifications of products and suppliers, and reports to the competent dean for approval.
D) The Health Bureau uniformly invites bids to purchase high-value consumables and implements the bidding results; For the varieties of high-value consumables that have not been purchased through unified bidding by the Health Bureau, according to the purchase application put forward by the clinical department, the surgeon, the person in charge of the use department, and the audit, finance, discipline inspection and supervision shall be organized to negotiate according to the procurement principle of high-value consumables, and the negotiation results shall be implemented.
E) When the high-value consumables used in emergency surgery (single case) are reused, they should be purchased from the equipment management office, and a copy of the informed consent of the patient (or family member) for surgery should be attached.
3. Procurement method
For the high-value consumables purchased by the hospital, the application department, equipment management office (including engineering and technical personnel) and audit supervision office should participate in and demonstrate the procurement decision. If possible, there should be more than three similar products (brands and suppliers). In order to meet the clinical needs and cost-effectiveness, determine the procurement principles, and archive all original materials.
4, the secondary warehouse workflow
(1) Designate a special person to manage high-value consumables.
(2) Set up a special warehouse to store high-value consumables.
(3) The surgeon should apply to the secondary library for preparation of high-value consumables 2-3 days before operation.
(4) Make statistics and analysis on the variety and quantity of general high-value consumables every week, and set up safety stock; Reasonably estimate the purchase quantity next week and apply to the equipment management office for stocking. (Purchase Quantity = Expected Quantity+Safety Stock Quantity)
(5) Consumables are sent to the warehouse (main warehouse) of the warranty center, and the warehouse keeper is responsible for acceptance, signature, storage and distribution.
(6) The secondary warehouse picks up the goods from the central warehouse (primary warehouse) and checks the product name, model and quantity.
(7) Check the remaining amount of consumables every day. In case of shortage or special circumstances (such as emergency operation), contact the equipment management office to place an order in time, or inform the surgeon to replace the appropriate consumables.
(8) Register the variety and quantity of high-value consumables of undergraduate course room (arrival quantity, use quantity and remaining quantity).
(9) Record the charging information to ensure that there are no missed charges and repeated charges.
(10) Record the registration form of high-value consumables in detail and feed it back to the equipment management office every week.
5, warehousing process
(1) The equipment management office shall notify the supplier to issue an invoice according to the Registration Form of Use Information of High-value Consumables fed back by the user department, and sign it for confirmation.
(2) The warehouse keeper of the warranty center warehouse (first-class warehouse) shall check the invoice and the Information Registration Form for the Use of High-value Consumables, and request that the ticket face correspond to the relevant contents of the Information Registration Form for the Use of High-value Consumables one by one, and sign for confirmation.
(3) Check the signed invoice and the Information Registration Form for the Use of High-value Consumables, and hand it over to the accountant for warehousing formalities.
(4) The high-value consumables use information registration form shall be filed by the warehouse and submitted to the equipment management office for the record every quarter.
Second, how to improve the management quality of medical consumables
In view of the problems existing in the purchase and use of medical consumables, in order to improve the management quality of medical consumables, it is necessary to introduce the "three refined" management methods of lean recruitment, precise control and precise analysis in the field of hospital medical consumables purchase and sale:
1, lean recruitment
"Lean" refers to the use of modern management science and means, based on giving full play to people's role, based on actual needs, effectively allocating and rationally utilizing resources, and seeking maximum benefits. Lean recruitment is a scientific tool to select more suitable medical consumables through bidding. Lean recruitment, through the means of economic evaluation, changes the cost performance evaluation of consumables from subjective qualitative to objective quantitative, and achieves the best medical effect, the best medical effect and the best medical benefit with the lowest medical cost.
2. Precise control
Precise management and control is a management and operation system based on quantitative management and continuously improved by the project team. The "refinement" here mainly refers to simplification and easy operation, and constantly reduces the time cost, capital cost and risk cost between the goal and the result, thus improving the management efficiency and marketing efficiency and the quality of the result. The "quasi" here means that the result is clear and the operation can be quantified and refined. Refined management is an effective method from experience management to standardized management. Specifically, the precise control of medical consumables is to solve the problem of the use of medical consumables in the secondary library of clinical departments, and to build a related system of application, planning, collection, consumption and billing of medical consumables. Finally, through the technology of flow direction supervision and flow control, a transportation and management system of medical consumables with high circulation efficiency, accurate billing, no loss and no waste is established.
3. Accurate analysis
Accurate analysis is to analyze and evaluate all kinds of information and data, and form a complete loop of effect feedback and quality improvement through the analysis of consumable components, consumption statistics, standard mastery and evaluation.
With the development of information technology, network information and artificial intelligence have become important means to solve social operation and governance. With the help of modern information technology, through the "three refined" management, the scientific acquisition, reasonable storage and standardized use of hospital medical consumables are realized, and the PDCA cycle is established, and finally the control goal of reducing the "consumption ratio" is achieved.