The power of influence
Article Outline
DONNA S. WATSON
In the current health care environment, decreased reimbursement fees have resulted in significant cost control changes for health care facilities and surgeons. This has led, in turn, to group purchasing agreements and some product decisions that resulted in less than optimal outcomes because they were based on cost rather than quality. Additionally, an increase in the number of freestanding ambulatory surgery centers and physician office surgical units, fewer hospitals, advanced technology, consumer demand for the newest technology, and the nursing shortage continue to change the way business is conducted in health care, and specifically, how perioperative equipment and supplies are purchased.
THE ROLE OF THE PERIOPERATIVE NURSE IN PURCHASING
In the past, perioperative supervisors were considered key decision makers when major OR purchases were being made. A 1974 study of procedures for purchasing equipment and supplies in the OR says. “The OR supervisor is the major buying force, no matter what the size or the type of hospital.”1 A 1984 study designed to identify the role of the RN in influencing equipment and supplies purchases concludes
Nurses, and especially OR nurse administrators, play a central role in deciding what is purchased for the hospital and freestanding ambulatory surgical centers.2
The role of surgical services administrators (eg, vice presidents, directors, supervisors) continues to remain an influencing factor, but a major new player in influencing product buying decisions is the perioperative staff nurse.
In the past, perioperative nurse administrators were responsible for surgical service areas (eg, surgery department, post anesthesia care unit). Today, however, most surgical services administrators are responsible for more departments, and they generally have fewer resources and less time. This has created opportunities for nursing administrators and front line managers to delegate many aspects of purchasing analysis, decisions, and recommendations to perioperative staff nurses. AORN's Congress is a prime example of this. Often a surgical service administrator will send staff nurses to research and make recommendations about products that will be considered for use in their facility.
The purchasing power of staff nurses always has been an influence; however, given the present climate in health care, it is stronger than ever before. AORN recently commissioned an independent research firm to study the purchasing influence of staff nurses.3 The study results continue to be analyzed for a final report, but they indicate that the purchasing influence of staff nurses has increased. Staff nurse respondents were asked several questions, including
Would you say that as a perioperative nurse your overall purchasing influence has increased, decreased, or stayed the same over the past three years?
Eighty-seven percent of the random sample of clinical staff nurses responded that their influence either increased or stayed the same.
These data are no surprise. I have first-hand experience of the influence of the staff nurse in purchasing decisions. Perioperative staff nurses offer knowledge, clinical skills, and expertise when using supplies and equipment necessary for positive patient outcomes, and they can offer their voices and views as end users of a product. It is this influence and involvement that balances product cost, quality, and patient outcomes.
USING YOUR INFLUENCE
There are number of ways we as perioperative nurses can use our influence in the choice of equipment and supplies used in our health care facilities. These include
Introducing new products (eg, equipment, supplies). Talk to industry representatives about their products and how their products improve patient safety and quality of care. Interactions with representatives can occur in a variety of venues, but the focus should be on learning more about the products, education, patient safety, and influence on successful patient outcomes. AORN's annual Congress is the ninth largest medical trade show in the United States.4 Congress provides a unique opportunity for perioperative RNs to talk with industry representatives about how their products make a difference in surgical units and improve patient outcomes. Inform industry representatives about your position as a stuff nurse and the influence you have in the decision about which products are used in your facility.
On several occasions, I have heard from industry colleagues that some staff nurses are more interested in promotional give-aways than products being demonstrated at Congress. As perioperative nurses, if we want to consume to exercise our voice and power as decision makers, we may need to adopt the perspective that promotional items are an added bonus, but it is the information, education, and product that nurses need to influence buying decisions in their health care facilities. By obtaining as much product information as possible, we can use our knowledge and power to influence decisions about products used by the surgical team.
Using your knowledge about the product. Take advantage of education programs offered by industry representatives. We should never tire of obtaining more information about a product and its impact on patient safety. Many industry representatives are eager to present education program at facilities, local chapter meetings, and state council meetings, which provides another opportunity to learn more about various products and services. Perhaps it is time for us to encourage companies to put the money spent on promotional and other goodwill items toward education and nursing scholarships; the impact could be significant and far reaching. Look at the advertisements in the AORN Journal closely; these are wonderful sources of product information. New product information is featured in 33% to 35% of the advertising in the AORN Journal.
Building relationships with industry partners. The development of a mutual trusting partnership with industry representatives is essential to success. This is a powerful relationship, and the information that is shared results in improved quality care for surgical patients. Our industry partners are interested in more than the final sell; they are interested in doing what is right for patient safety and improving patient outcomes.
Building relationships with members of the materials management department. Staff nurses need to build relationships with the materials management department relating to equipment and supply purchases. Using safe, high-quality products that are cost effective results in a positive situation for both patients and the facility. Highly successful facilities are those that recognize the positive outcomes that come from using a multidisciplinary approach to making product decisions.
Participating in product procurement. Many perioperative nurses have experienced the nightmare of a product that was purchased because of its low price but that did not meet the demands of the surgical services department. Not only does this waste time and staff members' energy, it generally results in added cost to the facility. Take any opportunity to actively participate in the decision-making process for product procurement. Participation may vary from working on a committee to actual product evaluation. Be open and honest when evaluating any products, and become informed about product costs and their impact on the department's overall costs. The voice of the end user (ie, the staff nurse) should be heard when a final determination is made about clinical products that impact the delivery and quality of nursing care to the surgical patient.
Creating a new position. Many facilities recognize the influence of staff nurses on product purchasing and have created unique positions for them. Putting an RN into the acquisitions loop as a clinical supply analyst saved one hospital $400,000 during the the first year of the program.5 A clinical cost containment specialist, who was a nurse with an OR background, was projected to save a facility $500,000 in six months.6 These examples exemplify the contributions of staff nurses in containing costs. These are end users who have first-hand knowledge about the complexities of implementation and outcomes on safe patient care.
CONCLUSION
The debate about who makes final product decisions (eg, materials managers versus nursing staff members) will continue; however, it is clear that the influencing power of staff nurses can make or break a new product as it relates to usage and implementation. Fortunately, an increasing number of health care facilities are recognizing this and are using an integrated approach with input from the end-user—the perioperative staff nurse.
NOTES
- In: Hospital Purchasing Agents Evaluation of Operating Room Supplies and Equipment Purchasing Influence . Los Angeles: Wilson, Wechsler, & Associates; 1974;p. 4
- . “OR nursing purchasing influence: Results of a recent survey,” . AORN Journal . October 1985;42:498–505
- In: Purchase Influence Study . Denver: Rocky Mountain Market Research; 2002;p. 3
- Tradeshow 200 Directory . Los Angeles: Trade-show Week, Inc; 1999;
- . “Nursing the product purchase process back to health,” . Materials Management in Health Care . May 1995;4:62–64
- . “Building networks: OR nurses are allies in standardization effort,” . OR Manager . November 1997;13:28
PII: S0001-2092(06)61651-7
doi:10.1016/S0001-2092(06)61651-7
© 2002 AORN, Inc. Published by Elsevier Inc All rights reserved.
