Inside Duke Medicine

The key to success was teamwork

It was teamwork every step of the way.

As part of the expense management initiative over the last year, teams of physicians and hospital administrators worked together to identify millions of dollars in savings by examining how much the health system pays for the supplies it buys regularly.

Just as in a critical examination of a household budget, it’s not easy to cut expenses by buying something with a different price.

Consider just one area that was examined—surgical supplies. Not every medical device works the same. There are honest differences about which devices lead to the best outcome.

To ensure all interests were heard - and that ensuring quality patient care remained the top priority - the effort in this area could not be a top-down process.

Physicians partnered with procurement officers to examine a long list of different supplies and devices, and developed a strategy for making choices that maintained quality care but also produced savings.

“We went case-by-case, working right along with the physicians,” said Jane Pleasants, assistant vice president for procurement and supply chain management.

Working with Pleasants was Steven A. Olson, M.D., chief of the Section of Orthopeadic Trauma , chairman of the Perioperative Executive Committee, and chief medical officer of Duke University Hospital.

“The key was sharing data,” he said, “and then examining it together.”

Data was shared on the patient outcomes, days of treatment, total spending on an item and spending per patient. It was an intensive effort to see what things really cost and what results were really gained. With that information, the group, together, was able to make decisions about which makes of items- from spinal implants to joints to implantable cardiac devices - Duke faculty physicians would use and which they would not.

The choices made also fit into the larger goal of negotiating with vendors and suppliers to get the best possible price for those items.

While data and effective negotiating skills did their part, Olson and Pleasants credit teamwork for the success of the project.

“A lot of people had ownership in this process,” Pleasants said. “That made the difference.”