Scanning in the supply room

[elizabeast7]

Greetings!

Our hospital has supply rooms set up for each unit with a scanning system. We are routinely not scanning, and thus not charging for supplies.

Hypothetically, staff will sign into the computer, select the patient, scan the item, hit save and log out of their ID.

This is not happening.

Any suggestions? How does your facility track supplies?

[Pangea Reunited, ASN, RN]

Seems health care in general is a business- catering to "customers", worrying about the bottom line. Heck, we recently got an email where I work about emergency medications that weren't scanned into the EMR (were documented on paper that was then scanned into the EMR but doesn't transfer into the medication record). Was the focus that it wasn't documented in the MAR? No, the focus was the fact that the facility missed out on about $7,000 of income and the calculations of exactly how much each med cost, how much would have been charged to each patient, and the total the facility didn't get reimbursed.

And if there was $7000 missing from my pay check, the $7000 would be my focus, as well. I'd be glad that the patient was taken care of, but...

[Rose_Queen, BSN, MSN, RN]

And if there was $7000 missing from my pay check, the $7000 would be my focus, as well. I'd be glad that the patient was taken care of, but...

And yet, the hospital charges 3x what they pay, so there was only $2,333 missing from the budget. Considering they make a profit upwards of $100 million each year, that could simply be equal to an accounting error in the big picture.

I love my job and my coworkers, but this facility focuses far too much on money, to the detriment of patient care. It's definitely not hurting.

[elizabeast7, ADN, BSN, MSN]

Our expensive items are usually in the Omnicell, and therefore the patient gets charged when we pull it out under their name.

Another great idea! Thanks.

Rose Queen - I'm sorry you feel your facility is that way. I really don't feel that way about mine. I mean, of course, there are discussions on budget and money but as I stated above it's often so that we can obtain new and better equipment to provide better patient care. Much of our focus, meetings, councils, etc are centered on improving outcomes. Then again, that may be from working at such a small, community facility.

[cayenne06, MSN, CNM]

The facility I work at as an RN has stickers on all the chargeable items, which are supposed to be placed on the charge sheet after using the item. I would frequently come home with charge stickers on my scrubs that I forgot to stick on the charge sheet. Sigh. Another facility I worked at kept all billable items in a pyxis, which works very well because you can't access the item without going through the system.

It would seem that the logical solution would be to capture charges based on charting. You chart a foley insertion, and a foley kit appears on the bill. Etcetera. Of course things would be missed, like if you had to use two kits because you dropped the first one or whatever, but it has GOT to work better than relying on staff to remember to scan each individual item! You'd think that since EHRs are built with billing as the top priority, this would be a no brainer. When I do a procedure in the office, the billable items autopopulate on the charge sheet, so I know it is possible!

[nurse2033, MSN, RN]

Putting supplies in a Pyxsis works, as you can't just grab them. Managers need to insist that scanning systems are quick and easy. It is the only way they will work. Unbelievably the nurses where I work are responsible to charge the patient for procedures and supplies, but I'm sure much revenue is lost due to noncompliance. I don't believe this is ethical. That said, being a fiscal caretaker is everyone's responsibility. But managers need to make that meaningful for staff.

[mf299709]

We have a scanning system also, stuff that is used for more than one patient is not scanned to the patient it is scanned to the floor, such as gloves, alcohol wipes, little stuff that comes in bulk like that. The other stuff we scan to the patient. If we are in a hurry we just try to remember to save the packaging or scan it later but we still forget. It isn't just about charging the patient though... When we scan items, it alerts the central supply when we are running low on certain items so they can restock... Yes people always forget to scan but I think knowing it helps keep our supplies stocked it is an incentive to remember to scan.

[RestlessHeart]

Yes - that is how we are, too. Things are grouped in two categories.

Non-scan - syringes, toiletries, etc.

Scanned - wound care, foleys, IV tubing, etc.

We are not scanning those items, though! Secondary tubing and blood tubing are the ones we scan the least - and thus are losing money on. We lost >$25,000 in 2015 r/t to this so I thought I'd see if anyone has advice.

Unfortunately, it's difficult to make staff accountable as we have no way of monitoring who is not scanning what. Supposedly, staff signs in and thus we can track that way but more often staff simply doesn't - or they scan the item using the account that's up on the monitor and so a few people look like they've scanned all the items.

I cant tell you the extreme problems this is causing the patients and their Insurance companies. Patients are getting wiser and reading their EOBs and demanding full billing statements to prove they did or did not "get" what their bill says they did. It's a mess.

[dishes, BSN, RN]

Furthermore, the financial loss to the unit means that we wasted that amount instead of purchasing new equipment, additional COWs/glucometers, etc.

This strikes me as coercion, if a manager is committed to patient safety, they proactively purchase medically necessary equipment.

[Rose_Queen, BSN, MSN, RN]

This strikes me as coercion, if a manager is committed to patient safety, they proactively purchase medically necessary equipment.

Exactly!

[Julius Seizure]

This strikes me as coercion, if a manager is committed to patient safety, they proactively purchase medically necessary equipment.

Sometimes the managers hands are tied by people higher up the food chain

[SubSippi]

Put a fake security camera in the corner.

[MissChloe]

We do not scan supplies. Pts. are charged for procedures and that covers the cost of the supplies used for that procedure. The rest (alcohol swabs, IV tubing, and so on) is just part of the cost of being in the hospital.