Good Fences, Good Neighbors

How IDN Sentara Healthcare manages vendor access.

Hospitals attract patients, clinicians … and vendors. Not surprisingly, hospital systems that spend somewhere between $400 and $500 million a year – such as Sentara Healthcare, Norfolk, Va. – attract many vendors.

That’s not a bad thing. IDN contracting and materials professionals understand that vendors keep clinicians and materials management personnel abreast of new technologies. They provide demo equipment and loaner instrument sets. They facilitate product conversions and train providers on how to operate new medical devices and equipment. But Journal of Healthcare Contracting readers know that vendors can also complicate an IDN’s standardization efforts, encourage unauthorized purchases and even impede clinicians and healthcare workers as they go about the business of providing patient care.

Just as good fences make for good neighbors, so too can well-thought-out (and well-communicated) vendor-access policies make for good provider/vendor relationships.

Much-needed balance
Three years ago, Sentara Vice President of Materials Management Carl Manley recognized that Sentara needed to take steps to provide much-needed balance to its relationships with vendors. “We realized we didn’t have a good way of identifying who was in our hospitals and where they were located,” says Manley. Not only did this compromise Sentara’s efforts to control non-labor spending, but it also threatened the IDN’s mission to provide a safe environment for its workers, patients and vendors themselves. “Not only were we concerned about what vendors were exposing our patients to, but what the patients were exposing the vendors to,” he says. “We wanted to establish a process that would ensure the safety of both.”

With seven campuses and a number of inpatient and outpatient facilities spanning a 70-mile radius in southeastern Virginia and northeastern North Carolina, Manley set about developing a comprehensive, multifaceted vendor-access policy. It has three major components:

  • Initially qualifying and screening sales representatives who call on Sentara facilities
  • Monitoring their whereabouts on an ongoing basis
  • Making sure that reps remain qualified from year-to-year.

Qualifying reps
Reps who want to call on Sentara facilities must fill out a vendor profile record with the IDN’s materials management office. Not only must reps provide their “vital stats” (e.g., name, address, company, title, phone, etc.), but they must identify their product line(s), qualifications and training, and (in some cases) confidential information about immunizations and vaccinations. After a review of the forms by the materials management nursing staff, each rep is classified into one of three categories:

  • Those who call on non-patient-care areas. (This category includes pharmaceutical reps, service technicians and med/surg distributor sales reps)
  • Those who call on patient-care areas, excluding the OR, cardiac lab, emergency department or outpatient surgery
  • Those who call on the OR, cardiac lab, emergency department or outpatient surgery.

All reps must wear color-coded badges, which denote the category into which he or she falls. The initial badge is free. But if the rep loses his badge, he must pay $50 for a replacement.

Sales reps who call on non-patient-care areas face fewer requirements than the other two. They must review Sentara’s orientation packet for vendors, sign the IDN’s “Code of Business Conduct” for vendors, and affirm that they are familiar with and will respect patient privacy and confidentiality per the Health Insurance Portability and Accountability Act, or HIPAA.

Reps who call on patient-care areas (excluding the OR, etc.) must meet the above requirements and also provide 1) annual proof of tuberculosis tests and results, 2) proof of measles/rubella immunity, and 3) proof of chickenpox immunity. Meanwhile, those who call on the OR, cardiac lab, emergency department or outpatient surgery must provide all of the above as well as proof of Hepatitis B immunity. Reps calling on patient-care areas must provide their qualifications to train clinicians on the proper use of the device or equipment they sell.

An automated system alerts the materials staff when a representative’s inoculations are due to expire. Sentara advises such reps that unless their inoculations are current, their badge will be revoked.

Sentara does not insist on criminal background checks on sales reps. That said, vendors are informed upfront that they stand to lose their privileges should they violate the IDN’s Code of Business Conduct.

Keeping tabs
Sales reps may visit a Sentara facility by appointment only, and they may only call on areas designated by their appointment. Each time a rep enters a Sentara facility, he must record his presence on the IDN’s automated telephone system. The vendor dials into the Sentara vendor log system, inputs his five-digit vendor identification number and hangs up. He repeats the process when leaving the facility.

Reps who call on the OR must wear distinctly colored caps, so they can be easily differentiated from clinical staff. Only sales reps acting as technical advisors on a certain product are permitted in the surgical suite during cases, and then only for the time period in which the product is being used. At no time can they participate in patient care.

Manley says he believes that the time and effort Sentara has invested in its vendor-access policy has been well spent. “It’s a question of what you get in return,” he says. “If you get quality and safety, you lower your risks. And if you would ever have reason to go back and track who was in a facility in case of an event, you need the kind of detail we have. You know who the vendor is, what he or she was exposed to, etc. So, from a safety aspect, it’s money well spent.”

Compliance to the vendor-access policy by vendors and hospital staff is high, says Manley. Careful planning and communication have helped. For example, when Sentara was drawing up its policy, Manley invited 350 vendors to an open forum to discuss it. When the policy was formulated, he notified vendors of its provisions and dates for compliance. Sentara’s physicians and clinicians were educated on the policy as well, and information was posted on the IDN’s Web site. “We realized the key was the ability of everyone in the hospital to help us manage [the policy],” says Manley.

“It is a positive process for vendors and the hospitals,” he adds. “Vendors are able to make appointments and spend time with the people they want to see. The hospital staff knows when vendors are coming in, and whether they have appropriate inoculations.” Both sides have found that the policy can actually facilitate – not inhibit – the introduction of new technologies, provided the rules are followed. “All new technology must be evaluated and approved by the system,” says Manley. “We have traditional processes for that. Our vendor code of conduct states that technology used without approval won’t be paid for. We’re clear with our vendors about that.”