29 Jun Are blanket purchase decisions at the corporate level hurting you and your patients?
Purchasing decisions are made at different levels in any organization. Take for instance advertising space in a publication. The purchaser of that ad space would likely be a manager, or marketing associate, or agency working on behalf of a company.
Buying pens? Well, the office administrator may be that purchaser. New cloud services for a multinational organization? That one is likely going to involve several c-level executives and a cross functional team of other high-level executives.
In addition, there are often many decision makers involved in purchase decisions. In fact, an estimated 7 people are involved in purchase decisions in a B2B sales environment.
But what about those instances where purchase decisions are made at a high corporate level, but have a direct impact on the employees far down on the food chain? Are the right people at the table in that group of 7?
Today, many hospitals belong to Integrated Delivery Networks (IDNs) or large health systems. Each operates differently and each hospital has different levels of autonomy within a health system. As such, purchase decisions are made differently within a system and at each facility.
Each purchase decision is likely going to have an impact on someone. And it probably will never be the case that everyone is going to be happy if bringing in a new product or solution means change of any kind. But the point is to discover if making these decisions could introduce other risk factors.
It’s probably easy to think of an instance where a product was unceremoniously removed from your hospital with little to no warning. In some instances, there may be little difference or impact when switching one product for another. Gauze is just gauze after all.
But what if a healthcare organization was looking at something much more complex or more critical in patient care. One example that comes to mind is sequential compression devices or better known as DVT sleeves. These are sleeves attached to pumped that go on a patient’s calf post-surgery to reduce the risk of developing a blood clot that may result in a pulmonary embolism. They are a critical device and ubiquitous in hospitals.
As one can imagine, because the device is so widely used with so much utility, there are a significant number of companies that make the devices and compete for hospital business. Without getting into too much detail the sales cycle of each differs and as with any medical device, the purchase decision involves a number of stakeholders across various levels.
To further complicate the matter the purchase decision is going to take a different form depending on if a single hospital or a health system is looking to buy DVT sleeves. And this is where it gets potentially problematic.
Imagine that you are a nurse who has been using the same DVT sleeves for 20 years. And one day you come to work and there is another type of DVT sleeve available. In a previous article we discussed the morale issues with blind siding teams with new devices. Well the importance cannot be over-stated. The impact associated with low moral amongst your teams can affect burnout rates, lower productivity, and cause good employees to leave. Typically, one instance may not drive someone out, but it is always hard to tell when the final straw falls on the proverbial camel’s back.
In addition to morale, what a corporate buyer may not know may just potentially hurt the bottom line and the patient. While every device on the market follows strict testing guidelines and registered with oversight bodies including the FDA, it is well known that some products are more effective than others. Some DVT sleeve systems “work” better because they are designed in a way that promotes patient comfort and thereby compliance. There are prophylactic devices that have more evidence than other devices, proving they work better.
While we would like to think that all medical devices are the same in terms of the outcomes they will produce, that just is not always the case. The one area, we can be certain there is a different is price. And price is often what drives a corporate level purchase decision. It is not the case that health systems do not understand the clinical value of devices or supplies, its simply that when looking at the trade-offs, perceived clinical efficacy may not override price differences. But again, if a hospital sees relative clinical equivalence and a lower price, it seems like an easy decision.
Only, one key dimension has been left out, the input of the nurses or doctors who use the product day-in and day-out. Their input is critical. Additionally, who are the people supplying the information and evidence supporting the clinical efficacy of the new product? The device manufacturer. It is sort of like having a car salesman test drive the car for you and then let you know how it handles and how much you are going to love it.
Daily users are the ones who can articulate why one device may be better and worthwhile despite a price difference. They may be able to prove why a device at a lower cost is just as good, justifying the change. It is those people that are a critical component of the decision. While it may be complicated to coordinate in a large system between 5 or more hospitals, it is an important aspect when evaluating new devices before making those types of purchase decisions.
Purchasing is not a straightforward task. Price is only one minor aspect of a purchase decision. Total cost, switching cost, personnel impact, patient impact, user preference, and more go into making these decisions. Beyond that it is almost impossible to have 100% buy-in on any purchase decision. People are always going to have opinions and preferences. However, despite these challenges it is paramount to involve the staff that uses the products in evaluation. They will be able to uncover critical areas that can be challenging to identify when evaluating at higher, corporate levels. In a hospital, what some buyers may not know, may hurt the bottom line and put patients at risk.