Capturing Supply Charges in the Emergency Department: How and Why?

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Jennifer Panco
Process Improvement Specialist
Providence Health and Services

An annual loss of $850,000 in supply charges in a 22-bed ED was the focus of a Supply Chain Management project. This project focused on capturing supply charges using Lean Methodologies including A3 Thinking and PDCA cycles. We now capture 100% of charge capture sheets, up from a baseline of zero.

This presentation introduces a successful implementation of a supply charge capture system installed in a 22-bed Emergency Department at a rural hospital. We will explore how Lean Methodologies turned a non-existent process into a successful 100% supply charge capture sheet rate process. Due to previous financial decisions, supplies costing $5.50 or greater were not being charged to ED patients. It had been decided that there was little to no benefit to capturing these supplies. Due to this there was no starting foundation to this project and it had to be built from the ground up. Steps to this project included: 1) Identifying items used in ED thru data extrapolation of the hospital master charge sheet, 2) Creation of charge capture sheet, 3) Staff education which included standardization of work and visual controls, 4) Building crystal reports into the ibex computer-based program, 5) Dashboard design and implementation and 6) A monthly process analysis system. At initial implementation there was a one month charge capture return of over 94%. After additional round table discussions, charge sheets revisions, and staff education we are now at 100% for charge capture sheets. This equates to approximately $850,000 in annual supply charge capture that was not being previously realized.