“ If Logisticians Can Cook” Logistics Assist Visit Concepts

Edlouie S. Ortega, MSM, CDFM, CPFMEquipment and Technology ManagementMedical Equipment and Logistics SolutionsNaval Medical Logistics Command

• Do you believe in key performance indicators (KPI)?• How do you know which KPI to track?• Should all KPI measureable?

How do you measure success?

“Tell me how you measure me, and I'll tell you how I will behave.”

- Eli Goldratt

Who do you agree with?

" Tell me how you’ll measure me, and I’ll tell what damn fool things I’ll do to make the measurement look good."

- Tony Rizzo

• Cash flow. Restaurants are very cash-intensive, forking over money for fresh inventory and tipping out servers and other staff on a daily basis.

• Percentage of repeat customers. The National Restaurant Association estimates that three-quarters of most restaurants' sales come from repeat customers.

• Staff turnover. On average, management turnover rates run around 20% annually for table-service restaurants, while hourly workers turn over at roughly a 150% clip

Forbes.com

Restaurant Industry…What we measure

• Table-turn over rate. How many times table is filled with customer. How fast tables empty and fill during a shift.

• Order-throughput time. How long before a meal goes out to the customer. Drinks – appetizer – main course – dessert.

• Table-turn time. How long did the table remain empty and how long did it stayed filled.

Other KPIs we measure

• Contracts• Outlays• Budget• Regulations• Overall Strategy• Competition• Staff Development

Restaurants Does Logistics Too and More…

• Procure materials• Move materials• Produce materials• Monitor• Assess• Control

It’s all about the…o foodo presentationo timingo customer serviceo dish washero work flow

And sometimes it’s not all about measurable KPI…

What we can learn from a Cook

Front of the House – Back of the House - Expedite!!!

o Assurance: The act of giving confidence, the state of being certain or the act of making certain.

o Control: An evaluation to indicate needed corrective responses; the act of guiding a process in which variability is attributable to a constant system of chance causes.

What we can learn from a Cook

o Quality Assurance: The planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled.

o Quality Control: The observation techniques and activities used to fulfill requirements for quality.

Standard processes/quality products…not to make measurements look good.

What we can learn from a Cook

o Outputs Defined as the goods or services produced (e.g., patient admissions, bed days, work orders, receipts).

o Outcomes Defined as the impacts on indicators arising from the delivery of outputs (e.g., fill rate, turn-over ratio, SOS Due-in rate, maintenance completions rate, unable to locate).

“More focused on Effectiveness than Efficiency”

What we can learn from a Cook

Define Logisticso Logistics

The planning, implementation, and coordination of the details of a business or other material operations.

o Medical LogisticsIs the logistic of pharmaceuticals, medical and surgicalsupplies, medical devices and equipment, and other products needed to support doctors, nurses, and other health and dental care providers. Because its final customers are responsible for the lives and health of their patients, medical logistics is unique in that it seeks to optimize effectiveness rather than efficiency.

Logistics Assist VisitPurpose:

Assist Logisticians to achieve Total Asset Management (TAM) and improve internal management control of accountable equipment.Evaluate the effectiveness of the Equipment, Technology Material Management (ETM) processes from materiel procurement planning to eventual property disposalEvaluate the effectiveness of the Purchasing Management, Acquisition Planning and Requirements Development, and Contracting Officer’s Representative (COR) ProgramsThe Logistics Assist Visit is NOT an inspection, this is strictly an assist visit to help your staff identify strengths and weaknesses and to provide them with the tools that they need to successfully carry out their mission.

Logistics Assist VisitFocus:

Assessment of continued suitability as it applies to aging technology.Assessment of effective use of the logistics information system as a tool for improving materials management operations.Collect information to develop technical criteria for use as basis for acquisition actions across BSO-18.Assessment of accountable equipment records with an acquisition cost of $25,000 and greater.Assessment of Material ManagementAssessment of Acquisition Management

Logistics Assist VisitAssessment Methodology

1. Use of existing data and focus on establishing the baseline between the site and the "Best Practices" in BSO-18 claimancy and in the industry.

2. Incorporate training, database management, material management, technology management and acquisition management site visits.

3. Provide feedback to the site regarding LAV findings and recommendations that will help the site focus on its strengths and immediate improvement.

Assessment Elements

1. Evaluate synchronization of the Navy business practices, policies, and logistics and acquisition information systems.

2. Validation Processes (Management Assertion)

3. Evaluate training requirements and provide just-in-time training as needed.

Logistics Assist Visit

Assessment Elements1.Evaluate synchronization of business practices, policies and systems.

Review current policies. Analyze data; focus on trends. Evaluate site’s business practice. Evaluate site’s appropriate use of business systems. Identify processes requiring BUMED-wide standardization. Identify change requirements to the logistics information systems. Identify change requirements to the policies.

Logistics Assist Visit

Assessment Elements

Logistics Assist Visit

2. Validation Process (Management Assertion):

Valuation. Test all contributing factors (device code, life expectancy, useful life, acceptance date, acquisition cost, etc).

Completeness. Test to ensure that maintenance significant equipment and personal properties are entered in DMLSS.

Accountability. Test if the equipment found on site belongs to the entity. Replacement Plan. Test for proper equipment selection and requisition

process. Due-in Receipt. Test to ensure that due-in materials are properly

receipted and properly recorded.

Assessment Elements3. Evaluate training requirements and provide just-in-time training as needed.

Identify functionality gaps. Identify execution gaps. Identify process gaps. Identify current workload and productivity. Identify additional training requirements.

Logistics Assist Visit

Equipment ReceiptInventory Management/UID

Five Year Equipment Replacement PlanDevice Code Assignment

Property/Item Decrease/LossDocument Control

Maintenance Plan and ProceduresRepair Parts Request and Issue

Service ContractsMaterial Due-ins

Emergency Management Plan/CBRNE/IPPCOR Appointment, Training and Management

ECAT Orders

Assessment Candidates

SWO Workload/MetricsJune 2010 (Before LAV)

July 2010

August2010

YTD as of JUNE 2010 Mean

Beginning Work Order Balance Qty 34 90 29 1477 123

New Work Order Qty 403 372 522 4974 414Reopened WO Qty 12 0 0 25 2

Completed Work Order Qty 321 363 405 4317 360

Cancelled Work Order Qty 38 70 122 812 68

Ending Work Order Balance Qty 90 29 24 1347 112

Carryover 56 -61 5 -130 -11Completion Rate 79.96% 93.72% 95.6% 79.20% 79.20%

Relative Inventory Accuracy 90.57% 81.18% 70% 83.68% 83.68%

Performance Metrics Analysis

Imaging Equipment Portfolio

Total Items: 181 Total Acq Cost: $42M

Total Items: 729 Total Acq Cost: $114M

Total Items: 124 Total Acq Cost: $15M

Total Items: 550 Total Acq Cost: $96M

Modality Qty₁ TotalProcedures₂

ActualThroughput₃

PotentialThroughput₄

Procedures /Day₅ CUR₆

Bone Densitometer 1 3 3  - 0 -

Radiographic System, Mammography 2 4,916 2,458 4,000 20 61.4%

Radiographic System, Mobile 3 2,376 792 -  9 -Radiographic System, Urologic 3 236 79 2,000 1 3.9%Radiographic Unit 3 26,154 8,718 15,000 104 58.1%Radiographic/Fluoroscopic 3 1,357 452 1,200 5 37.7%Radiographic/Fluoroscopic, Mobile, C-Arm 2 115 58 -  0 -

Scanning System, Computed Tomography 1 7,330 7,330 8,000 29 91.6%

Scanning System, Gamma Camera, (SPECT) 2 730 365 2,000 3 18.2%

Scanning System, Magnetic Resonance Imaging 1 3,341 3,341 4,000 13 83.5%

Scanning System, Ultrasound 4 9,577 2,394 -  38 -

Capacity Utility Rate

Projected Cost AvoidanceModality Section FY 11 FY 12 FY 13 3YR Total

Radiographic/Fluoroscopic System 4.2.3. $700 $0 $0 $700

RF Service Contract Cost 4.2.3. $42 $42 $42 $126

Radiographic Unit 4.2.4. $240 $0 $0 $240

RU Service Contract Cost 4.2.4. $6 $14 $14 $34

Radiographic/Fluoroscopic System, Urologic 4.3.5. $210 $0 $0 $210

RFU Service Contract Cost 4.3.5. $13 $13 $13 $38

Imaging System, Computed Radiography 4.3.7. $160 $80 $0 $160

Total PCA   $1,371 $149 $69 $1,508In Thousands

Region UIC Unit Name BWO NWO RWO CWO XWO EWO Risk 1 UTL Risk 2-4 UTL UTL % PMCR

NME N32185 NHC New England 0 196 0 191 5 0 0 5 2.55% 100.00%

NME N39163 USNH Sigonella 1 127 3 127 4 0 0 4 3.15% 100.00%

NMW N68095 NH Bremerton 2 240 1 234 9 0 0 9 3.75% 100.00%

NME N66094 NHC Cherry Point 0 26 0 20 6 0 0 6 23.08% 100.00%

NME N00232 NH Jacksonville 109 731 9 847 1 1 0 1 0.14% 99.88%

NME N68084 NHC Charleston 35 114 0 143 4 2 0 4 3.51% 98.66%

NMW N66097 NH Oak Harbor 1 95 2 88 8 2 0 8 8.42% 97.96%

NME N00211 NHC Great Lakes 0 153 3 145 7 4 0 7 4.58% 97.44%

NMW N68292 USNH Yokosuka 16 304 4 294 21 9 0 21 6.91% 97.22%

NMW N66095 NH Lemoore 1 128 0 114 11 4 0 11 8.59% 96.90%

NME N66096 USNH Naples 0 114 0 110 0 4 0 0 0.00% 96.49%

NME N00183 NMC Portsmouth 63 1064 2 995 87 47 1 87 8.27% 95.84%

NME N68093 NH Camp Lejeune 18 341 1 321 24 15 0 24 7.04% 95.83%

NCA N00168 Walter Reed NMMC 188 1542 45 951 685 139 44 685 47.28% 92.17%

NMW N68096 USNH Guam 33 152 1 169 1 16 0 1 0.66% 91.40%

NME N00285 NHC Corpus Christi 0 21 1 20 0 2 0 0 0.00% 90.91%

NMW N00259 NMC San Diego 85 1109 49 1001 103 139 3 103 9.56% 88.82%

NME N66101 USNH Rota 22 55 0 62 6 9 0 6 10.91% 88.31%

NMW N68470 USNH Okinawa 65 355 1 315 44 62 3 44 13.24% 85.27%

NME N00203 NH Pensacola 48 300 2 245 50 55 0 50 16.67% 84.29%

NME N61337 NH Beaufort 3 317 2 257 14 51 0 14 4.42% 84.16%

NMW N68098 NHC Hawaii 70 100 0 100 39 31 0 39 39.00% 81.76%

NMW N68094 NH Camp Pendleton 278 362 1 504 14 123 12 14 7.18% 80.81%

NMW N35949 NH Twentynine Palms 1 172 0 95 27 51 0 27 15.70% 70.52%

NCA N00162 NHC Annapolis 198 0 0 0 198 0 0 198 100.00% VALIDATE

NCA N00231 NHC Quantico 39 0 0 1 38 0 0 38 97.44% VALIDATE

NCA N66098 NHC PAX River 2 0 0 0 2 0 0 2 100.00% VALIDATE

  TOTAL BUMED-WIDE 1278 8118 127 7349 1408 766 63 1408 18.12% 91.96%

Echelon 2Echelon 2

Echelon 3Echelon 3

Echelon 4Echelon 4

Navy Medicine Support Command Support

Functions MOU

Related Sessions

• LO-T-3-B Equipment Management Self Assessment - Conduct Your Own LAV

• LO-T-3-C Material Management Self Assessment - Conduct Your Own LAV

• LO-T-3-D Maintenance Management Self Assessment - Conduct Your Own LAV

• LO-W-3-C Automatic Identification Technologies (AIT) /IUID and RTLS

• LO-W-3-D Equipment Management Process• LO-W-3-E Annual Inventory Process and Requirements

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