Overview

Wentworth-Douglass Health System is relying on open-minded leadership, innovation and collaboration to stay independent. “Overall, our issues aren’t that different from most hospitals: declining reimbursement, the shift from volume to value and more risk contracting,” said Gregory Walker, FACHE, president and chief executive officer of Wentworth-Douglass Hospital. The difference is a valuable partnership with Vizient™ that has helped the health system find new ways to reduce expenses and improve care since 1994.

Member Profile

Wentworth-Douglass Health System includes 178-bed WentworthDouglass Hospital, several walk-in immediate care facilities, multiple testing centers, 26 provider practices at Wentworth Health Partners, The Works Health and Fitness Center and the Wentworth-Douglass Foundation. This nonprofit charitable health care organization serves about 300,000 people. Its supply chain spend is $15 million per year, with use of Vizient group purchasing organization (GPO) contracts at more than 75 percent.

Thinking outside the box

Wentworth-Douglass is not afraid to try something new. Fifteen years ago, leaders hired a nurse for a role in materials management. “My boss had the vision that it would be valuable to have somebody clinical in supply chain,” said LuAnne Burke, clinical manager in materials management at WentworthDouglass. “He knew of this idea from networking with other Vizient members.  He went after it.” The health system’s partnership with Vizient reflects this commitment to innovation. Ideas and implementation flow both ways.

Teaming up with the right partner

“Vizient has been adept at stepping up on some of the things we think outside the box on. They are an untapped opportunity resource,” said Greg Wieder, director of materials management at Wentworth-Douglass. Years ago, he was concerned about freight costs and brought up the topic at a Vizient meeting. Vizient recognized the opportunity and put together a solution for third-party freight payment to reduce costs for members in the surrounding area.

Likewise, Wentworth-Douglass is eager to learn about what Vizient offers and to test new tools. “They got in on the ground floor of our price benchmarking analytics, such as Vizient PriceLYNX™ and Vizient PharmaLYNX™,” said Melissa Szabo, former Vizient account executive. “Last year they worked with us on new product development as well.”

At the core of the partnership between Wentworth-Douglass and Vizient is unwavering support. “If I open up a Vizient supply contract, and I send an email to the contract portfolio executive, I hear from that person the same day. If that is not support, I don't know what is,” said Burke. “That has been my experience for 15 years. The support has always been there.”

Considering new ideas and collaborating with others

Learning from council participation

For Wentworth-Douglass, participation in various Vizient councils offers an opportunity to influence supply contracts and get the best products at the best prices. But the advantages don’t end there. “I serve on the Clinical and Supply Council. It is such an opportunity. You meet remarkable people with the same passion that you have,” said Burke. “There has never been a time when I did not learn at least one thing that I could bring back and use at my hospital.”

Networking across the country

In fact, the networking contacts made at Vizient committee meetings, local events and national conferences help Wentworth-Douglass avoid reinventing the wheel. “You can pick up the phone or email people and say, “We have this challenge. How are you handling it? We need a product evaluation form. Can you share yours?’” said Burke.

“One of the things that I’ve appreciated about Vizient is the camaraderie with the members,” said David Merriman, RPh, MA, director of pharmacy at WentworthDouglass. “In the Northeast, it’s been excellent working with other directors of pharmacy. It’s a very cooperative group that works on understanding the marketplace and where everybody needs to be.”

That geographic connection was strengthened by CEO Walker’s service as board chair of the local Vizient office. “We had a peer group to share ideas with, and we had very good educational sessions,” he said. “We’d sit down and identify three or four topics. Hospitals leading in that area would give a presentation, and then we might have a national vendor  or consultants come in and add their expertise.”

For example, one topic was urgent care. The meeting featured presentations not only by leaders from Cambridge Health Alliance and other hospitals, but also by medical directors from CVS MinuteClinic and Walgreens. “It was a great meeting because we were rolling out our hospital’s urgent care strategy at the time,” said Walker.

Walker also participates in a national Vizient affinity group for CEOs. The group provides opportunities for CEOs to collaborate and share best practices.

Collaborating to save more and share knowledge

The Vizient supply network, Northeast Purchasing Coalition, helps members increase savings and operational efficiencies beyond what they could achieve  on their own. As a member of the coalition, Wentworth-Douglass benefits from economies of scale. An early win was reducing spend on physician preference items. But product savings are only part of the story.

“At first, we tried to comply with all Northeast Purchasing Coalition contracts,  and we made a lot of product conversions,” said Wieder. “Then we determined that we needed a better process for communicating and implementing changes. That’s something the coalition helped us with.”

“We set up a structure based on some of the coalition’s recommendations about how you organize your physician leadership,” said Walker. “We now have a physician who is intimately involved in some of the materials management and trial work at the hospital. We have had a lot of success with this model.”

Wieder served as chair of the Northeast Purchasing Coalition for the past two years. In trying to get hospital members to agree on different initiatives, he realized that more clinical information was needed. “During my tenure, resources were added to the Clinical Advisory Committee so that the committee members could do some research and analysis,” said Wieder. “Then they could recommend to the Operations Committee whether an initiative would be worthwhile.”

“We ask a lot of questions: Is this an easy product line we could standardize? What are the challenges? What does the research say? Are there implications for patient and staff safety?” said Burke, who is a member of the Clinical Advisory Committee and clinical liaison for the coalition. “I am proud to say that our goal is always the best product for patient care, and the savings has been our responsibility after that.”

Reducing supply chain expenses

Some of the most common strategies for reducing supply costs may seem suitable only for large health systems. But smaller organizations like WentworthDouglass can enjoy the benefits of large-scale integration without losing their independence. By partnering with Vizient, Wentworth-Douglass can take advantage of economies of scale, analytic tools, standardization and other competitive practices — all facilitated by Vizient experts who provide strategic intelligence and training.

Going beyond benchmarking with Vizient Savings Actualyzer

At Wentworth-Douglass, access to price benchmarking is vital to cost reduction efforts. And a Vizient business intelligence tool offers instant visibility into supply prices. “Vizient PriceLYNX shows where we are in the marketplace,” said Wieder. “I can go into the tool and I can see what I am spending with a vendor. I can look at line-item detail. I can do comparisons around a product. I can see where we may be able to renegotiate prices or improve utilization.”

“Vizient PriceLYNX has a long history of helping supply chain professionals identify opportunities,” said Ernest Bunata, Vizient associate vice president of product delivery. “But we knew we needed to go beyond identification. We needed to help our members keep their cost-reduction goals in sight and show a real, actionable path to return on investment.”

Wentworth-Douglass recently participated in the pilot testing of our newest innovation: Vizient Savings Actualyzer™. Our powerful cost-reduction analytics solution helps identify and prioritize savings opportunities — plus, you can track progress and measure the success of each initiative — all in one application. “By using GPO contract analytics parallel to market-based pricing analytics, our members can now determine the best and most rapid path to value for their organization,” said Bunata. It’s what materials management analyst Jennifer Paquette called a “one-stop shop.” With previous tools, “all the information was in silos,” requiring Paquette to compile information from several different dashboards to make it comprehensible to her requestors. “With Vizient’s new solution, I can go to one place and I can see if a requested product is on contract, as well as other contracts that are available to our organization, and a market share analysis and spend review,” said Paquette. When asked why she made the switch from Vizient PriceLYNX to the new solution, Paquette says, “Because we can now ask ourselves, ‘Is our savings realized? Has the work that we’ve put in paid off?’”

Improving utilization and standardization by collaborating  with clinicians

Lower prices can only take a hospital so far. “We are beginning to run up against the wall in relationship to cost reductions with manufacturers,” said Wieder.“We need to look at utilization and work with clinicians to see if there is better opportunity in supply management.”

Tracking utilization

For Wentworth-Douglass, it all starts with having the right information about usage and spend. That’s where Vizient offers a strategic advantage, starting with tools such as Vizient Savings Actualyzer, which provides insightful reports and actionable dashboards that integrate analytics, data, contracts and advisory services.

“With Vizient Savings Actualyzer, we can view benchmarking and validate usage and spend,” said Burke “We can give our clinical teams good information: You are using this, you are using that. What is the best product? How can we work together? Do we need more than one product because of a clinical need?”

For example, when Burke was asked by clinical staff to look into usage of bath wipes, she discovered that many unused wipes were thrown out due to the way the wipes were packaged and that there was another wipe with a barrier cream in it. The skin care team also recommended the use of a unit-dose barrier cream product from a second vendor. Her solution — developed with clinicians’ input and agreement — was to work with the supplier to reduce the number of wipes per packet and discontinue the extra wipe with the barrier cream. (The unit-dose barrier cream product was more clinically effective.)

Providing accurate and sufficient data on physician preference items is a particular challenge for Wentworth-Douglass. “The doctors we work with are incredibly smart. They know what they’re using. They know why they’re using it,” said Paquette. “If you want doctors to consider changing products, you have to compile a lot of credible information to catch their attention, and you get one shot to do that.”

“Vizient Savings Actualyzer gives us meaningful data to discuss with physicians: This is what we are seeing in the last month. This is where the trend was six months ago or a year ago. This is what we are doing now,” said Wieder. “Is this where we want to be? Are we getting off mark?”

Finding the right product at the right price

Standardization is another way for Wentworth-Douglass to balance clinical needs and supply costs. But standardization doesn’t pay off without high-quality products that staff in all areas of the hospital will actually use. That’s why the health system relies on the Vizient Impact Standardization Program. “There are certainly the clinical cases where you need it because you need it and that product has to be here just in case,” said Paquette. “But the Vizient standardization program helps us capture savings and isolate vendors that we can count on.” Wentworth-Douglass participates in 10 of the 11 Impact Standardization Programs and received about $114,000 in rebates in 2015.

Burke makes sure that the hospital uses the standardization portfolio to the fullest extent. “Let’s take personal protective equipment. We will look at our data and say, ‘Are we getting these products from the company on contract?’” said Burke. “We may find out that we are purchasing 10 items — three on one contract, six on another, and a single one somewhere else. I look at that as an opportunity to collaborate with clinicians.” She then goes to the clinical floors and asks if products are used for a special reason. If the answer is no, she gets samples of the standardized products for clinicians’ approval and then moves those products to one contract.

In fact, the best products aren’t necessarily name brands. Wentworth-Douglass looks for the best product at the best price — which often means turning to the Vizient Novaplus private-label contracts for supplies and pharmaceuticals.  In 2015, Wentworth-Douglass received more than $520,000 in returns on $2.3 million in spend on Novaplus products.

“When they see a Novaplus  contract, they try to immediately address it with their clinicians. This is where LuAnne Burke plays a huge role because she is a nurse,” said Szabo. “She is highly respected, so it works really well when she talks to clinicians about Novaplus contracts or products.”

The Wentworth-Douglass pharmacy team also recognizes the value of standardization. “We try to maximize our use of the Vizient standardization program and Novaplus because overall they are going to produce larger savings,” said Merriman. “On a quarterly basis we’re usually hitting around $7,000 to $8,000 in rebates.”

Dealing with skyrocketing drug costs

Tracking pharmaceutical prices

As pharmaceutical costs rise and reimbursement becomes more complicated, it’s never been more important for hospitals to have an accurate view of their drug prices and spend. For help in benchmarking drug prices, Wentworth-Douglass looks to Vizient for expertise and another useful business intelligence tool: Vizient PharmaLYNX.

A Vizient advisor serves as an extension of the Wentworth-Douglass pharmacy contracting team, providing market insights, therapeutic alternatives and ad hoc reports. “Gabe Seifu, our Vizient PharmaLYNX advisor, has been instrumental in helping us understand how to use the tool to identify where the opportunities are. Now when we go to the manufacturer, we can say, ‘Why are we paying X dollars more than this other hospital?’” said Merriman.

“Vizient PharmaLYNX has aided us in identifying and working through price discrepancies,” said Merriman. “Most of the time it has been errors at the distributor level, such as incorrectly entered prices or the wrong version of a generic.” In the three years since implementing the tool, the WentworthDouglass pharmacy saved nearly $300,000.

Paying lower prices as part of a group

Another avenue for pharmacy cost reduction is the Northeast Purchasing Coalition. “Vizient formed the Northeast Purchasing Coalition pharmacy program in 2014. It has already made a huge impact on contracting and pricing,” said Merriman. Pharmacy clinical and contracting initiatives provided 13 percent savings — more than $345,000 — for Wentworth-Douglass in 2015.

Once a year, the network members vote to focus on six or seven initiatives —  such as antibiotic stewardship, insulin or anti-fungals — and work on reducing the costs of products in each category. Although Wentworth-Douglass may not have the spend required to participate in every initiative, the Vizient connection still adds value.

“Sometimes Wentworth-Douglass may want to use a different medication instead of going with the choice of the Northeast Purchasing Coalition. So the hospital supply chain team takes the coalition pricing information and works directly with the manufacturer,” said Seifu. “Other times, Wentworth-Douglass takes our benchmark data, which is very rich, to the Northeast Purchasing Coalition representative and says, ‘Why aren’t we getting this price? This price is excellent and you’re giving me another.’”

Improving quality and the patient experience

Wentworth-Douglass faces a lot of competition in the marketplace. “How do we distinguish ourselves and provide what we hope is the best service? Can we provide better services or better outcomes at better value?” said Wieder.  The health system’s partnership with Vizient provides access to experts on quality of care and the patient experience.

Improving care with clinical design sessions

When Wentworth-Douglass wanted to improve care in several specific areas, nursing leaders turned to Vizient. Jane McCarthy, MS, RN, CPHQ, senior director of programs in the local Vizient office, helped them identify action steps for improving performance in each area.

A few years ago, McCarthy worked with the critical care unit staff on designing a process to reduce pressure ulcers. The outcomes were quite impressive. After implementing the new process, the unit had a decrease in hospital-acquired pressure ulcers, which translated into a shorter length of stay for patients.

Nursing leaders were so pleased with the outcome that they invited McCarthy to come back and lead another session on preventing falls with injury throughout the hospital.

Networking about clinical care

Wentworth-Douglass clinical leaders also benefit from opportunities to attend Vizient conferences and learn from peers and industry experts.

“I love the networking at Vizient conferences. For example, we were in Boston three or four months ago. We are thinking about putting in a video monitoring system so that we can reduce the need for patient watches. Greenwich Hospital was there and shared their solutions and strategies for cameras,” said Sheila Woolley, RN, BSN, MPH, vice president of patient care services and chief nursing officer at Wentworth-Douglass.

“Probably one of my most memorable events was a Vizient conference on palliative care. We were working with our primary care physicians to have the conversation about end-of-life care with patients and families,” continued Woolley. “The conference was excellent. They brought in great guest speakers from the Institute for Healthcare Improvement as well as other experts.”

Wentworth-Douglass benefits from the following Vizient programs, products and services:

  • Vizient Savings Actualyzer
  • Vizient PriceLYNX
  • Vizient PharmaLYNX
  • Novaplus® products and services
  • IMPACT Standardization Program
  • Pre-Commitment Program
  • Clinical and Supply Council
  • Northeast Purchasing Coalition Supply Network
  • Northeast Purchasing Coalition Pharmacy Network
  • Supplier Diversity Program
  • CEO Affinity Group
  • Chief Nursing Officer Network