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The Conference Board of Canada released a report in September called, “Driving Value-Based Health Care through Clinician Engagement.”
The intention of the report is to help “various stakeholders improve the effectiveness and efficiency of their organizations’ clinician engagement processes.”
The clinician engagement and product testing processes of 3sHealth were cited in the report as exemplary practices, alongside those of a select number of other shared services organizations.
As stated in the introduction of the report, “Clinician engagement refers to the involvement of health care professionals in the procurement process for medical devices, pharmacy, services, and other treatments. As front-line users of medical devices and supplies, clinicians…can provide vital insights into selecting products that benefit both patients and taxpayers through improved patient health outcomes and health system efficiencies.”
In the executive summary, the authors of the report state that “Clinician engagement adds value to the procurement process through specialist knowledge, increased clinician buy-in and support, enhanced care pathways, and improved culture and contracting strategies.”
3sHealth’s product testing processes were highlighted first in a section called “Meaningful Input.”
“Tasked with selecting a new type of surgical tape, one Canadian shared service organization (SSO) [3sHealth] engaged clinicians to perform several tests related to the quality of different vendor offerings. Objective measures included the pain, redness and abrasion caused to the outer and inner arm upon removing the tape after a 20-minute wait, its water resistance, how quickly several pre-determined lengths of tape could be unwound, and the overall quality.
The data from these tests formed the product’s quality score, which factored into the award of the contract. An emphasis on quality-related data helps change the perception of clinicians that procurement staff are only concerned about getting the lowest cost products. The data also improves the auditing process for when there are contract or product issues.”
A checklist for engagement
3sHealth’s clinical engagement practices were profiled in another section of the report called, “A Checklist for Engagement.”
“One SSO in Canada [3sHealth] has developed a formal request for proposal (RFP) checklist that standardizes and documents its clinician engagement process. The checklist resulted from a multidisciplinary project team—made up of general practitioners, directors of surgery, nurse leaders, bedside nurses, staff educators, contract specialists, the head of the province’s medical association, and other key stakeholders—that attended several workshops held on clinician engagement in 2016.
The checklist is comprised of 29 distinct tasks, each broken down into varying numbers of sub-tasks. For each item, the checklist defines when to engage which stakeholders, as well as the responsibilities of everyone involved.
Shortly after an upcoming contract has been identified and approved, the SSO notifies their health system counterpart’s materials management advisory committee (MMAC) of an upcoming competition. If the contract is clinical, the SSO’s clinical area will work through the CAC [Clinical Advisory Committee] or MMAC to recruit subcommittee members. If the contract is non-clinical, the contracting area will work solely through the MMAC to recruit members. Depending on the clinical complexity of the contract (graded on a scale of one to four), the level of engagement, time commitment, and trialling required can vary substantially.
After a month’s notice, subcommittee members are invited to a kick-off meeting. Here, clinicians are presented with research and market analysis for context. Clinicians are generally appreciative of the information, but don’t typically get into the details. As such, research and market analysis is best done ahead of time.Importantly, subcommittee members sign a memorandum of understanding that lays out the expectations and requirements of the process. In addition, it includes a declaration for potential conflicts of interest and confidentiality.
The subcommittee meets twice more to build specifications, review and finalize the RFP, and establish an evaluation/trial strategy. Once the RFP has been approved and posted, and proposals have been received, they are distributed to subcommittee members with an evaluation scorecard and are given five days to respond.
Based on the evaluation results, a vendor is chosen to move forward to trials with. The SSO relies heavily on its subcommittees during the trialling phase. Depending on the product and potential end users, each member may have different needs and requirements. As such, it’s crucial to have everyone in the same room so that everyone is hearing the same feedback and concerns.”
Thoughts from 3sHealth
Val Klassen, Director of Supply Chain at 3sHealth, said, “This is awesome recognition for our efforts and it’s an encouraging endorsement of the work that we have done. I am very proud of our team and our engaged clinicians for establishing and working through these processes to select value-added products that best meet the needs of patients and families.”