Steven Littlehale

What tension, you say? Oh, come on, let’s be honest — you know what I’m talking about. 

Clinical leadership evaluates a product that accelerates wound healing. Its evidence-based claims are well substantiated in peer review journals. Yes, it’s costly, but healing time and labor time both would be substantially decreased. The response from financial leadership: “Talk to the hand!”

Admittedly, I’ve never heard a CFO say, “Talk to the hand,” but often their response carries the same gravity. They are not bad people; many want to give clinical leadership exactly what they request. However, it is their job to make sure that the lights remain on, that there is food on the table, and that everyone gets a paycheck. 

I’m purposely being dramatic (it’s in my nature), though no one can deny that this tension-laden dynamic exists. In addition to the resident, who else is caught in the middle? The purchasing agent.

In most organizations, purchasing agents report to a CFO or the equivalent. While they have very clear parameters on total spend and managing relationships with external vendors, they typically have no clinical background or understanding of the care delivery process. The nuances of federal and state value-based purchasing (VBP) initiatives that are based on clinical outcomes and either generate revenue or avoid financial penalties are often indistinguishable to most purchasing agents. 

Yet the purchasing agent is in the catbird seat to resolve these tensions, and in our value-based world we should be singing like a bird!

My colleague Michael Torgan has significant SNF operational and vendor partner experience, all at the senior level. He is uniquely positioned to comment and shared: “Purchasing decisions must be made with an eye not only towards the cost of the product, but the total cost/benefit of achieving a superior outcome.” 

It’s not about finding the “cheapest” product, nor is it about finding the “best.” It’s about finding the right product or solution.

The right product or solution delivers an excellent outcome both clinically and financially. It doesn’t compromise, nor does it apologize. The right product or solution is consistent with the triple aim of the Affordable Care Act: It’s efficient, delivers an excellent outcome, and achieves a high level of patient satisfaction. The right product or solution indirectly or directly supports clinical and regulatory outcomes and is sensitive to staff time. It doesn’t get in the way of excellence in CMS’ Five-Star or SNF VBP. It also satisfies referral partners, aligns with their formularies, and can be used in marketing activities.

Enter SHOPP, the Society for Healthcare Organization Procurement Professionals. SHOPP was created to leverage the unique position of purchasing agents and, through interdisciplinary education, transform them into procurement professionals.

Josh Silverberg, who spearheaded this effort, shared: “Healthcare today has become increasingly complex. New technologies, products, and pricing strategies don’t always align with the initiatives of healthcare reform or ultimately benefit the patient. Purchasing agents must evolve into procurement professionals in order to meet these challenges.”

Anytime we can bring another player to the interdisciplinary table, the resident benefits. Elevating the discourse between clinical and financial leadership is a worthy goal, and resolves that often palpable tension. 

Steven Littlehale is a gerontological clinical nurse specialist, chief innovation officer at Zimmet Healthcare Services Group, and chief clinical officer emeritus at PointRight Inc.