Innovation Plan

Running head: TRACKING SUPPLIES IN THE EMERGENCY ROOM 1

Tracking Supplies in the Emergency Room

NAME

College of Health Professions, Western Governors University

D031: Advancing Evidence-Based Innovation in Nursing Practice

TEACHER

12/20/2021

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Tracking and Accounting for Supplies in the Emergency Room

(A)Innovation Proposal

Working in the Emergency Room has its challenges; one of those challenges is not having

enough supplies. This could be from multiple patients with the same complaint, overuse of

product, or supply chain shortages in receiving the product. Due to the 2020 pandemic, there

have been disruptions in supply chain distribution. Healthcare is being directly affected; as

stated by Reed (2021), “Shortage of health care supplies can quickly jump from a nuisance to a

life-or-death proposition. They indicate serious vulnerabilities in the U.S. health care supply

chain.” The supply chain issue has forced healthcare workers to be innovators, thinking smarter,

not harder, becoming creative engineers when the supply is unavailable, and minimizing what is

needed for the desired outcome. Healthcare facilities have been working through short supplies

for over a year due to supply chain disruption and inappropriate or overuse of materials for

specific procedures. In the chaos of the ER, in a critical situation, we are finding too many

supplies are getting opened and not used. For example, a critical patient could need a central line

for certain medications; two central-line kits get opened on accident, one gets used, and one gets

thrown away. This waste is decreasing what is already low and unavailable.

An innovative way to track supplies and decrease unusable supplies is an electronic

tracking system. All items are scanned under the patient’s name before being taken out of the

supply room. Inventory tracking systems would be a costly upfront expenditure. Still, it would

be cost-effective with long-term use by reducing unused materials inventory protection,

improving inventory count accuracy, and accurately charging a patient for materials used

(Healthie, 2021). There will also be a designated procedure supply quick reference flipchart for

staff to gather only the necessary supplies needed. Hoping to decrease the number of supplies

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opened and not used for a procedure.

Role of Innovative Nurse Leader

The seventh provision in the American Nurses Association code of ethics states, “The

nurse, in all roles and settings, advances the profession through research and scholarly inquiry,

professional standards development, and the generation of both nursing and health policy.”

Meaning a nurse must advocate for change. The role of a nurse innovator is to be an agent of

change by supporting technological advancements, continuing education, aiding in the

innovation process with input, as consultants, participating in research, and data gathering

(Thomas. TW, et al., 2016). Characteristics of being an innovative nurse leader are supporting

proactive thinking and facilitating a growth mindset by promoting the nursing process, critical

thinking, experience, and teamwork to provide positive outcomes, such as new models of

efficient care, processes, safety practices, and new policies.

In being an innovative nurse, I propose a better way of tracking the supplies in the

emergency room (ER) where I currently work by installing a bar code scanning system to keep

an up-to-date, accurate inventory in the ER. As well as a quick reference flip chart of supplies

needed for emergent procedures completed in the ER. Due to supply chain disruptions, supplies

are limited; we cannot afford to waste or not use all supplies opened. Yet there is no tracking

system for supplies, and there is no education on what is needed for emergent procedures

currently in the ER. This innovated way of tracking supplies, staff would have to scan each item

required before taking it out of the supply room. The quick reference flip chart of procedure

supplies will have a detailed list of what is needed for each procedure provided and where to find

it in the supply room. The flip chart will hang in the supply room next to the scanner, making it

easier to look up what is needed and scan the item. This would serve anyone in the ER,

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including temporary staff. This would promote efficient care safety practices and support

technological advancements.

An anticipated disruption is staff not scanning the item before taking it out of the supply

room. This would be managed by proper education and explaining why this is an essential step

in the procedure process. Staff would be educated on scanning before removing the item, but

staff could scan items after being used in certain emergent situations. This would not be ideal,

but it is an alternative to getting the items scanned for inventory.

Summary of Community of Practice

My innovation plan is to better the process currently used in the Emergency Room to

track supplies. My agency is a small community hospital in a rural outskirt west of Salt Lake

City, Utah, run by Stewart Healthcare and in partnership with physician owners (Steward Health

Care. n.d-a). The hospital is a full functioning, five-floor facility, offering 24-hour emergency

care with onsite radiology, laboratory, woman, and newborn services, both emergent and elective

surgeries, as well as behavioral health. It is a trauma 3, stroke, and STEMI receiving facility and

has been labeled one of the busiest trauma three emergency rooms in the state (Steward Health

Care. (n.d-b). Staffed 24-hours with physicians, nurses, aids, and non-clinical staff.

Located in West Valley City, Utah population just over 133,000, second largest city in

Utah, with the leading population of Hispanic/Latino and Pacific Islander in the county (Biggest

US cities, 2021). The average health care coverage is 52.1% employer coverage, 18.3%

uninsured, 13.3% Medicaid, 6.2% Medicare, 1.2% military or VA benefits, and 8.8% non-

grouped, with the percent of uninsured citizens increasing in the last year due to the pandemic

(World population review, 2021). The average poverty level is 12.5% in the city and has the

highest crime and drug rates in Salt Lake County.

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Identifying stakeholders were those directly involved with the hospital and department

processes and understanding the importance of maintaining an accurate account of materials,

supplies, and equipment. One of the most important and formal key stakeholders is the Chief

Nursing Officer (CNO) for the hospital. This role is essential due to the CNO’s responsibility to

manage budgets, oversee nursing processes, and overall patient care. It is the CNO’s role to

understand how this innovation will affect the Emergency Department/Room (ED/ER) and have

a ripple effect on other departments and patient care. The CNO will need to approve the

innovation funding and be a part of the implementation process. The following key stakeholder

in an informal role are the Physicians. The Hospital is a physician-owned partnership. Thus,

having the physicians involved is crucial to getting funding and approval for the innovation. It is

an informal role due to the lack of involvement the physicians will have in the actual innovation

process. Department directors of materials and ED are key stakeholders that will play an

essential formal part in the innovation. They know how their department operates and

understand where to help provide the best possible patient care. Having the directors involved in

the process will help facilitate the completion and education of the innovation. Charge nurses

have an informal role as stakeholders; it will be their responsibility to help educate the staff on

the new processes and represent the innovation once complete. Lastly, the nurses are key formal

stakeholders. It will be the nurse’s responsibility to maintain the innovation, help with

evaluation of the new process and help make changes as needed for the emergency department.

The number one goal of all the stakeholders is to provide good quality care. Jordan

Valley Medical Center, West Valley Campus’s mission statement reads, “to provide the

community with excellent healthcare.” To provide excellent healthcare, we need the supplies

and materials. This innovation will allow us to track supplies, better understand what is required

for each procedure in the ER, and help the ER be better prepared to provide excellent healthcare

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to one of Salt Lake County’s highest poverty communities. Knowing what is available is key to

learning how to handle a situation when it arises in the Emergency Room. Each stakeholder

understands this and is willing and able to do their part in making sure we succeed as a

department and as a hospital.

As stated at Jordan Valley Medical Center, West Valley Campus, the values they stand for

incorporate accountability - we encourage creative thinking to promote quality and excellence in

healthcare delivery and safety – we strive to provide a culture focused on reducing the risk of

harm, on naming two (Steward Health Care. n.d-a). These two values precisely align with the

goal of the innovation to have an electronic inventory tracking system and a quick reference

procedure supply flipchart. The innovation has promoted creative thinking that will ultimately

help nurses in the ER be accountable for the supplies needed for patient care, decreasing costs,

keeping an accurate inventory log, reducing the risk of not being prepared with what is available

in doing so reducing the risk of harm and promote quality and excellent healthcare delivery.

Internal and External Factors

External factors that have prompted this innovation are the shortage of healthcare

supplies and the supply chain issues arising across the nation. Low supplies or no supplies

available have forced nursing staff to think creatively about caring for patients. I am not only a

nurse in the ER, but I also do all the ordering and management of supplies for the ER. I am in

constant contact with the materials department. I receive updates from manufacturers on back-

ordered items or how they are not receiving the materials needed to make their products.

Internal factors have changed due to the external factors and what is available. In the ER,

it is essential always to be prepared; it is never known what will come in next. But due to

limited supplies, it has changed how, we as ER nurses, prepare for patients and situations.

Instead of opening all potential items or supplies, we now get the things out but do not open

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them until they are needed. This has decreased the number of supplies going to waste due to not

being opened. It has caused a delay in responding to situations because now we have to open the

item and set it up to use. An example of this would be suction supplies. In my facility,

disposable suction canisters are on backorder from the manufacturer. In the past, I would open

all items and set it all up if there was the potential; I would need to suction my patient. Now I

get it all out and sit on the side until I know I will need it. There have been occasions where I

have required suction but did not have any of the supplies. This puts stress on me as the nurse,

me as the one responsible for ordering supplies, the charge nurse is trying to help gather supplies,

materials department in not having or running allocated supplies to the ER, and the hospital for

not appearing to be fully equipped and ready to take care of patients. Thus, therefore I feel it is

essential for this innovation of a tracking system in the ER to prevent unneeded stress and the

potential for harm.

Innovation Alignment

A part of hospital management is making sure the right product is available for the

patient; there has been an increase in the quality compromising of supplies. The Joint

Commission is a “Global driver of quality improvement and patient safety in health care.” (Joint

Commission, 2022). The goal of the Joint Commission is to make sure all facets of health care

practices are safe, including the supply chain. In 2017 Joint Commission came out with The

Effect of Illicit Supply Chains on Patient Safety, A White Paper, outlining the dangers of supply

chain management and non-regulatory medical devices. In the executive summary, it states,

“Counterfeit, contaminated, adulterated, diverted, quality-compromised, and/or illegally

obtained medical devices and supplies are on the increase… and this reality poses a

significant risk to patient safety and health care organization integrity.”

(Mansur, J., Joint Commission International. 2017)

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This is truer now than in 2017. The supply chain has been internationally affected by the 2020

pandemic global shutdown. Multiple national lockdowns continue to slow or even temporarily

stop the flow of raw materials and finished goods, disrupting manufacturing as a result (Harapko,

2021). Healthcare facilities are in desperate need of some specific medical equipment. There is

a threat that supplies are in danger of being counterfeited, contaminated, adulterated, diverted,

quality-compromised, and illegally obtained, making supply management even more critical and

necessary. For example, at my facility, 10cc saline flushes were on backorder and allocated

throughout the Utah region hospitals. The supplier has been unable to get the materials needed to

manufacture flushes. Being a nurse, that is something that seems simple yet necessary to proper

healthcare delivery. To make our own flushes, the rules and regulations were such that our

facility did not have the right equipment. This innovation will help track the number of flushes

used and keep an inventory of what is left to help manage the quantity for the specific

departments and the hospital while keeping within the Joint Commissions’ guidelines for safe

and proper materials handling.

Purpose of the Innovation

The innovation aims to implement an electronic tracking system for supplies to improve

tracking inventory to ensure the appropriate supplies are available for optimal quality healthcare.

With the goals of limiting the unused supply waste, have an up-to-date account of supplies

readily available, be prepared for supply shortages, and list proper equipment and supplies

needed for each procedure completed in the emergency department.

Goal for the Innovation

The goal for the innovation is to support healthcare workers in the emergency department

with appropriate materials needed to promote positive patient outcomes, increase supplies,

and be better prepared for future supply chain issues. Within a year of the electronic

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inventory tracking system, it will be measured by the increase in supply inventory, amount of

money saved on acquiring priority items when stock is low instead of entirely out, and paying

the premium by having an up-to-date inventory list and decrease patient incidences with poor

outcomes. The challenge of this innovation is the transition time when the electronic tracking

system is being installed, education on the system, and the introduction of the system for use.

(B) Relevant Sources Review

Table 1: Relevant Sources Summary Table

Reference Citation Relevant Findings Evidence Strength

Evidence Hierarchy

Sardar M. N. Islam. (2020). Digitalization of Supply Chain Management and Firm Performance: Structural Equation Modeling and Empirical Findings. Nova. https://eds.s.ebscohost.com/eds/e bookviewer/ebook/bmxlYmtfXz IyNTY5NDlfX0FO0? sid=20c37627-3302-424d-b0ff- a9e36d5d0675@redis&vid=9&h id=http://eds.s.ebscohost.com/&f ormat=EB

This book examines whether digitalization in supply chain management is adequate and the impacts on the organization. The author developed and tested a framework model that proposes supply chain capabilities using information technologies from researching different information technologies available. A quantitative methodology was used to examine other information technologies for the supply chain management. The results indicated that electronic integration had a positive impact on the organization. Thus, this study further proves that the proposed innovation will positively impact the hospital, staff, and patients.

Level V Meta- syntheses

Dharmapalan, V., O’Brien, W. J. (2018) Benefits and Challenges of Automated Materials Technology in Industrial Construction projects. Proceedings of the Institution of Civil Engineers – Smart Infrastructure and Construction 171(4): 144–157, https://doi.org/10.1680/jsmic.19. 00009

Even though this article has to do with construction sites, I was interested in the positives and negatives found with the use of automated materials locating and tracking technologies (AMLTTs). The benefits were accurate and timely material information, reduced misplacement, and optimized logistics. Some challenges are data integration, data management, maintenance costs, lack of implementation, and process knowledge. I gained some new insight into some

Level VI Qualitative research method

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challenges I did not think of. Harris, A. M., Harris, C. M. (2019). Methods for Improving Materials Management. Physician Leadership Journal, 6(4), 55-60. https://eds.s.ebscohost.com/eds/p dfviewer/pdfviewer? vid=26&sid=20c37627-3302- 424d-b0ff- a9e36d5d0675%40redis

The title caught my attention, and I feel like this is a very similar problem that the proposed innovation will fix. In this article, a multidisciplinary team of OR staff was put together to come up with a solution to fix the inventory problem in the OR. A timed delivery Kanban card system (TDKCS) was used to improve support the material management. Flowsheets were used to educate OR staff on the new inventory process. It reports advantages such as minimal cost for implementing and maintaining, improving financials, decreasing expedited freight, and increasing staff presence with patients, potentially increasing patient safety and satisfaction. The most significant disadvantage mentioned was the rapport and trust between the two departments, materials management and OR. I feel this disadvantage is also concerning to implementing the proposed innovation. To help manage this disadvantage was small integration at a time. Unfortunately, that will not be the case with this innovation.

Level VII Quality Improvement Projects

Francis, J.R. (2020). Implications for Supply Chain Management. Frontiers of Health Services Management, 37(1), 33-38. https://doi.org/10.1097/HAP.000 0000000000092

This article explains how the pandemic affected the supply chain to the Mayo clinic. It describes how task forces were created to figure out how the Mayo Clinic would get supplies to care for patients, how the was an enterprise collaboration with standardized practices, conservation of PPE, and new sources of PPE such as making face shields from 3D printers. It explains how the lessons learned from the pandemic have shifted the preservation of supplies. How having an innovative culture has proven beneficial, and how all healthcare needs to acquire new innovation skills. It states that investing in inventory management technology is imperative, creating a balance of inventory and distribution is necessary.

Level VII Specialist Opinions

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Sarkis, J. (2020). Supply chain sustainability: learning from the COVID-19 pandemic. International Journal of Operations & Production Management, 41(1), 63-73. http://dx.doi.org/10.1108/IJOPM -08-2020-0568

This article provides insight for a sustainable supply chain in post covid pandemic conditions. It explains how the supply chain has been affected internationally and how it has turned to a buy local focus. But with buying local, there are concerns about how it will affect the economy and ecosystem, focusing on being green for the environment. It talks about how technology has been transformed, more people working from home, and more technology used to help decrease the number of people, thus promoting social distancing. Companies need to focus on circular economy and sharing economy to positively impact supply chain sustainability and resilience.

Level VII Specialist Opinions

Synthesis of the Literature

I reviewed several sources concerning supply chain management and the effects of the

covid pandemic. Sources revealed a pattern of how preparation is a key in preventing supply

chain disruptions. Whether relationships with multiple supplies, innovated thinking, better

storage capability, buying local, and a more efficient way of handling and tracking supplies. The

trends focus on more technology and fewer people involved with materials management, such as

using an automated handling system and tracking system. Yet also focused on how healthcare

workers need to innovate with supplies available, not wasteful, and accountable. I feel the gaps

in some articles are how it was presented that healthcare workers need to be more responsible for

supplies. I agree with that statement; some of the articles do not understand what it is like to

work with patients and need supplies. The proposed innovation is to help with this situation.

Still, it is being handled by individuals who work with patients and understand what needs to

happen to be both accountable for supplies yet not being detrimental to the patient. I felt some

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articles were written by individuals who do not work with patients and have unrealistic

expectations of handling supplies.

Recommendations for the Innovation

The article Methods for Improving Materials Management talked about how the OR staff

was affected by low supplies and how staff would hide supplies in lockers for a “just in case”

situation (Harris. Harris, 2019). That is something that is happening where I work. They could

find a solution by including the OR staff in using a Kandan card system. Staff was educated on

the system; small steps were taken to implement the plan until a successful and less stressful

transition. I recommend the proposed innovation take the same approach with small steps in the

transition of the supply room tracking. First, introduce the procedure supply flipchart to the

staff. This gives the staff opportunity to become familiar with what is needed for the standard

procedures in the emergency room. Then reorganize the supply room; when that is complete,

allow staff time to get used to where items are located before implementing scanning. Allowing

staff time to become familiar with procedures and where supplies are located in the newly

reorganized supply room will help decrease staff stress with all changes happening at once.

When the scanning is implemented, the staff can then focus on scanning because they will

already have confidence in the supply room.

(C) Methods

Process to Generate Ideas

A meeting was held with the stakeholders of the emergency room, including the head

medical physician, the ED director, ED leadership team, both day and night shift charge nurses,

and chief nursing officer for the hospital. Each stakeholder presented a concern for the

emergency department. After each concern was discussed, it was concluded that each concern

centered on supply availability and materials management. Stakeholders presented a further

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discussion on how the problem could be fixed. It was discussed that the solution must be easy to

use, readily available for days and nights, keep an up-to-date inventory of supplies and notify the

appropriate individuals when supplies are low. Using the consensus decision-making process, it

was voted that an electronic scanning system was needed. This would be an easy, always

available, and automatically update the inventory. An ED procedure flipchart in the supply room

was also discussed with what is needed for standard procedures done in the ED to prevent

multiple items from being opened and unused.

Examples of Big and Small Data in the Organization

Big data is a term used to describe large, fast, or complex data that is difficult or

impossible to process using traditional methods (SAS Institute, 2021). In the emergency room,

about materials and supplies, an example of big data would be the number of alcohol prep swabs

used in a day. The amount is large, accumulates fast, and is impossible to count without

technological help. Small data is data in a volume and format that answers a specific question or

addresses a particular problem. An example of supplies in the emergency room would be the

number of central lines placed. That small data is specific to a type of patient and is easily

accounted for. Both the big and small data are relevant to the emergency room's inventory needs.

How Big Data Supports the Innovation

Being responsible for the supplies in the emergency room, I must pay attention to the big

and small data about supplies and inventory. After assessing the increase in big data, increase in

patient volumes, and the stakeholders’ concerns, I realized how important it is to implement the

proposed innovation in electronic inventory tracking. The big data has been increasing with the

increase in patient volumes, yet it has become imperative to have an accurate inventory due to

supply chain disruptions. It would be impossible for me to count and manage alcohol prep

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swabs, but an electronic system that automatically counted and distributed the appropriate count

of swabs is necessary to maintain adequate supplies for the emergency room.

Technology Enhancements for the Innovation

An electronic tracking system for the emergency department supply room is an easy way

to keep an accurate and up-to-date inventory. Material management uses a similar approach to

manage the supplies for the hospital. The same concept would be used in the ER for supplies,

including specialty items. The proposed innovation would use a computerized system integrated

with the hospital system to automatically charge the patient for the appropriate items and send

alerts when supplies are running low. The amount of money saved with decreasing the number

of duplicate supplies opened and unused, charges to the patient, and money saved on rushed

items is a plausible justification for the up-front cost of the tracking system, installation, and

maintenance.

(D) Interprofessional Collaboration and Disruptive Innovation

Disruption of Innovation and Impact

Disruptive innovations cause radical changes, using technology to disrupt the usual

market to the extent that it creates a ripple effect throughout the industry to create a new market

(Twin, 2021). Over the years, healthcare has had positive disruptions in technological

advancements that have changed how healthcare is performed, documented, financed, and

supplied. This proposed innovation will be one of those positive disruptions for specifically the

emergency room but also the hospital organization. It will change the inventory process for the

ER staff and materials management and affect the operation of charges and payments for

supplies to both outside vendors and patients. ER staff will become responsible for scanning

supplies under the patient’s name, thus creating an account for the item in the patient’s chart. At

the end of the patient’s visit, there will be an itemized list of supplies used and charges. Also,

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when scanning the item, the system automatically updates the inventory list and alerts when

items are running low, preventing supply depletion.

A concerning challenge is noncompliance from staff not scanning items appropriately. A

buffer will need to be integrated into the system to manage charges of supplies set forth by the

hospital administration and financial team. This buffer would contain what items would be cost-

effective to charge for and those not. Also, inappropriately scanning the up-to-date inventory

will be inaccurate and could cause supplies to run out before more are ordered. Weekly checks

would be necessary to verify inventory. These checks would be fast and efficient compared to

the current process.

Strategies to Address the Challenges

To reduce noncompliance with ER staff, preparation and education are essential. With

the slow changes to the supply room and integration of the new system, staff will have education

opportunities to explore the supply room and the new tracking system process before

implementation. If an employee continues to have noncompliance, one on one education will be

conducted by ER leadership to reinforce the importance and necessity of the new process.

Benefits of Disruptive Innovation

The proposed disruptive innovation will be financially inconvenient with upfront costs of

the system, materials, set up, implementation, and maintenance. The anticipated financial gains

from maintaining supplies by having an up-to-date inventory, not paying premium prices for

rushed items, and decreasing the amount of opened wasted supplies will not be immediately

seen. As the ER staff uses the tracking system, there will be a slow incline in savings but will be

cost-effective over time. Positive patient outcomes will have an immediate response by having

the appropriate supplies available to treat patients. This will allow the hospital to admit more

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patients increasing revenue, rather than transferring to other hospitals losing the potential

revenue.

(E) Pre-Implementation Plan

Diffusion of Innovation

E.M. Rogers developed the Diffusion of Innovation Theory in 1962. Originating to

explain how, in communication, an idea or product gains momentum over time and diffuses or

spreads through a specific social population or system. Resulting in the adoption of a new idea,

behavior, or product. (Singer, 2019). Adoption is a process influenced by the persons or social

system apt to adopt the innovation. To promote an innovation, behavior, or product, it is

essential to understand the proposed adopters' characteristics or apt of adoption. There are five

established adopter categories innovators, early adopters, early majority, late majority, laggards.

Innovators and early adopters are leaders; they do not need to be convinced of the change; they

embrace change opportunities, are aware of the need for change, are willing to learn, and take

risks on change. Early majority adopters are rarely leaders, they will adapt to new ideas, but they

need to see evidence first. The late majority are skeptical of change will only adopt after others

have tried and adopted. Laggards are the “old school” mentality, bound by tradition, wary of

change, and the hardest to convince. After understanding the adopter type, there are stages or a

process by which an innovation is adopted. Stages are knowledge, persuasion, decision,

implementation, and confirmation. The knowledge stage is where innovation is introduced.

Persuasion is when a person is ascertaining and exploring the innovation. It is critical in this

stage that the innovation is perceived as beneficial. Decision is when it is decided whether the

innovation will be accepted or rejected. Implementation is putting the innovation into practice.

Confirmation is the evaluation of the innovation.

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The emergency room where I work is staffed with nurses who have less than five years’

experience. This new generation of nurses are early majority adopters; they embrace changes

and technology. They see and understand how new innovations and technology will help with

the workload, patient care, and positive outcomes. This is the key population target during the

knowledge and persuasion stage of implementing the proposed innovation. Introducing them to

the innovation, allowing them to see and use the scanning and tracking tool, will help persuade

them of the necessity of the innovation. The stakeholders will need to know how the staff

promotes or declines the innovation to decide to go forward with implementation. Inviting

stakeholders to participate with staff as the innovation is explored will concrete the decision to

implement. A barrier to the decision stage is influenced by the late majority or laggard nurses are

communicating with the stakeholders during the persuasion stage. It will be imperative to ensure

the stakeholders see both the early and late majority point of view. The implementation stage

will be a slow process not to overwhelm and allow the ER staff time to integrate the system into

their care routine.

Innovation Action Plan

Table 2 - Innovation Action Plan

Responsible Person (Role) Responsibilities Timeline

Martha - CNO Approval of innovation, provide financial support. 1 month

Dawn - Materials

Management manager

Set up Vendors 1 month

Zak - Information System Set up new system and integrate into current

system.

6 months

Allan - Maintenance Install devices into the supply room 1 Month

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Dawn & Meghann Learn and educate staff on the system 3 months

Financial Implications

My innovation plan may be expensive upfront with the cost of the system, equipment,

and set up; however, over time, the tracking system, inventory managing, and positive patient

outcomes will prove beneficial not just for the emergency room but also for the hospital the

community. During the planning stage, there will be minimal costs. Vendors will be invited to

meet with stakeholders to discuss different tracking systems. Once a system is decided,

implementation will be the most expensive part of the plan. Equipment will need to be obtained,

installed, and programmed. The computerized tracking system will need to be integrated with

the hospital’s current charging system and the new system installed in the emergency room. In

my ER, we have a “superuser” for the different systems and processes; their job is to help

educate and troubleshoot when needed. It is a voluntary position and has no pay increase. I

would volunteer for this position as I am already in charge of supplies and ordering. Staff

education would happen on preplanned department meetings and skills day. This will eliminate

the cost of paying staff to come in and learn the system. Reinforced training will occur at shift

huddles. Extra expenditure on staff will be in the first few weeks of go-live when myself, other

super users, and vendors are there to help as needed.

Evaluation of the system will come six months after the implementation as completed

with minimal to no monetary expenditure. An accurate inventory list will be up-to-date and

verified; the amount spent on special rush supplies will be decreased due to ordering the item

before it is out and a rush is needed. The amount of unused supply waste will be down. The

return on investment will show a profit after a year, with most of the return coming from patient

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admission because the supplies needed to care for the patient will be readily available. This will

have a positive financial gain for the hospital, the patients, and the community. If patients are

transferred to a different facility, there is an increased cost to the patient with travel, time off of

work, and cost of the new facility. Keeping the patient close to their homes and families will

promote more people in the community to use the hospital and services.

Interprofessional Communication Plan

The interprofessional communication plan will consist of communication with the

project manager and leadership members from the different involved departments such as

materials management, information systems (I.S.), emergency room, education, quality and risk

management, and stakeholders. It will be decided ahead of time if meetings will be in person or

via Zoom. Monthly meetings will be held during the planning stage to allow sufficient time to

plan for the implementation stage. Once implementation has started, weekly meetings with

updates will be necessary to keep the plan on a timetable, address issues or make changes.

All communication will be conducted through the department leadership members; it will

be up to them to determine how to get the information to their staff. During the installation and

integration of the tracking system, staff education will start with an online introduction to the

system. As installation is near completion, ER staff, super users, and materials management will

receive hands-on training and educate their departments. Before go-live, all staff in involved

departments will have an opportunity to use the system and will be required to have a proficiency

pass off. During go-live, a vendor representative will answer questions and assist staff as

needed.

Evaluation of the Innovation

The purpose of innovation is to support healthcare workers in the emergency department

with appropriate materials to promote positive patient outcomes, increase supplies, and prepare

TRACKING SUPPLIES IN THE EMERGENCY ROOM 20

for future supply chain issues. To evaluate the effectiveness of the innovation, data will need to

be collected over a year. Data such as financial records of materials for the department, number

of admissions, number of transfers with indications as to why transferred, up-to-date inventory

list matches current ER inventory, and a survey to ER staff getting their opinion if inventory has

increased, the ER procedure flipchart is helpful and if there is unused waste. All data will be

compared with previous years’ pre-pandemic and during a pandemic to see if the new system

saves money, increases supplies, and has positive patient outcomes. After analyzing the data, we

will evaluate if the tracking system was a success.

(F) Conclusion

I choose to implement an electronic supply tracking system for the Emergency Room.

Due to the supply chain issues and lack of material happening globally, my proposed innovation

will keep an up-to-date inventory list, allow ample time to order new supplies when there are low

item counts, decrease unused items, increase staff knowledge on items used for procedures in the

ER and in so improve patient outcomes.

I am responsible for the supplies in the ER where I work, and as such, I have to keep a

list of items on short supply and or back-ordered. This list has been growing over the last two

years, and there is no end in sight with the current state of the supply chain globally. I have had

to work closely with the materials management department to find alternatives for saline flushes,

Coban, and chest tube suction devices. While discussing with my stakeholders, supplies are the

central thesis of many issues in the ER. I proposed an electronic tracking system that would help

manage supplies and education for the staff on what is needed for procedures in the ER,

eliminating duplicate items opened, unused, and wasted.

The process of implementing the innovation was lengthy and required multiple team

members. One of the challenges was finding the appropriate program that met all the

TRACKING SUPPLIES IN THE EMERGENCY ROOM 21

requirements to work with the current charting program and was affordable. It was a valuable

experience for me to sit through vendor meetings to watch and listen as the CNO, CFO, and

materials director would ask questions on the different systems and discuss the pros and cons.

The strengths were working with the team at the hospital to get the necessary equipment installed

and educating the staff. Participating in skills day and educating the ER allowed me to have a

better relationship with my co-workers. I feel it has been a success. I have seen a decrease in the

number of orders I am putting in and the number of opened and unused supplies. Staff have told

me how helpful the flipchart is and decreased items they thought were needed for a procedure.

This process has helped me appreciate all that goes into new processes in healthcare.

Many factors must be accounted for, multiple people that need to be in agreeance, how it is going

to be financially supported and what the long terms effects will be. I feel I was able to make a

positive impact with this innovation for my department, hospital, and community. I have learned

what I need to do to foster innovation in myself, but I feel innovation needs to be promoted more

readily in healthcare. With the variety in nursing positions, the changes from evidence-based

knowledge, lack of supplies, and a new generation of nurses coming into the field. As I work

towards furthering my education and my position in healthcare, I want to instill the basic

understanding of innovation and encourage nurses and healthcare workers to think outside the

box.

TRACKING SUPPLIES IN THE EMERGENCY ROOM 22

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