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this was a safe product for them to use. After a little bit of time and conversation back and forth, the physicians agreed to trial this. We had a conversation after the trial process and asked if they would be willing to convert. The physicians said yes. We switched vendors and everything was going well, we were saving money.

Then six months down the road, we were getting reports from the physicians that the implant was de-bonding on not just a couple patients, but more. We got that feedback from the physicians and then changed back to the original bone cement vendor. Interestingly, in working with the original vendor, we were able to make some large bulk buys and ended up with the same amount of savings as we did with the vendor that we had switched to in the conversion. Sometimes conversions go well, sometimes they don't. I think that was a good example of getting to know the physicians involved, showing them the data, and letting them make the decision on whether or not we should convert. Unfortunately, it didn't go as planned, but the end result was that the institution saved money and the patients (and physicians) got a good product in the end.

SS: That's what builds trust. It builds relationships. And none of this can happen without that, without us sharing our perspectives and why we do what we do. I think that it’s really important to be able to go back to the physicians and say, “We didn't make the right choice here, and we're going to make a different decision.” That really did build trust with that physician group. Our physician champion chaired our Orthopedic Value Analysis Committee for many years and was a wonderful person to work with.

Funny story: A vendor called him about a new product, and he said, “Oh no, you can't talk to me. You have to first talk to Suzanne Smith about this.” What that told me was that we had gotten to the point where he understood that for any vendor to bring in a new product, it had to go through supply chain and value analysis first, not to the physician first. That was a huge moment. It really was. It seemed small and I laughed about it, but the vendor knew too. That is our process.

HVAUM: Who are the key stakeholders that you normally deal with in value analysis and how do you work with them to gain buy-in and collaboration so that you can drive successful and sustained change?

KP: It depends on what the initiative is. We consider whether this is a commodity that is affecting the whole organization, whether you're going to want a physician lead who might be the service line chief, and whether it's something that is specific within a certain service. If it's something that crosses over between service lines, you might want to pick one or two physician leads to be stakeholders for that specific initiative. The thing that's really important, and Suzanne has said this too, is that data is key. Showing them why we're doing this, what the market share is, and what the savings are is very important.

SS: You have to also consider other stakeholders who we would consider non-clinical. You've got your VP of supply chain, your finance team, your reimbursement people, quality, safety, risk, infection prevention, etc., and we make sure that those perspectives are also considered when we do some of these larger initiatives. Because I love the word sustain. I always say that anyone can get a single win on a contract, but can you sustain that over time? And I think that's why Carrie and I really wanted to share that project with you around the gloves because it has sustained over many, many years. The other thing that I'm seeing a bit more involved with value analysis is folks who are doing process improvement at their organization.