A woman in the grocery store who happened to be in line in front of me realized an item she was buying from the frozen food section was past its expiration date by about a month. She came to this realization perusing her items and just in time to bring it to the check-out clerk’s attention. The clerk admitted she didn’t realize frozen food even HAD an expiration date, and called a stock boy over to replace the item. The woman turned to me to apologize for the delay and said something about how the quality control in the store wasn’t what it used to be.
Being a quality improvement nerd, that exchange got me thinking about the relationship between “quality control” and those little and sometimes innocent issues that come up when an organization doesn’t pay attention to the details. Mistakes start to happen. Small mistakes can pave the way for much bigger, more serious mistakes. And, soon enough, a company isn’t what it used to be! We see how some chain stores, hotels, and restaurants are extremely consistent and others vary a lot from location/city to location/city. The difference is the corporate quality control and how it extends to far flung locations and franchisees in various places. Quality control is important and sets the standard for your organization. When quality is NOT in control, we see evidence of it in operational processes. We see it in attention to detail or a company not paying attention to detail.
Expiration dates matter. They matter in a grocery store, in a drug store, and certainly in a DME. I remember being a clinical manager in a DME in Ohio many years ago and always reminding staff about checking expiration dates. To me, being “caught” with product or supplies that were expired was a mortal sin—not only because of the importance of not using expired product, but also because it was so simple and straightforward to monitor and control. In my mind, there was just no excuse for failing at something so simple to comply with.
Expiration dates in DME are found throughout the organization. They are found in products we use within the organization and also in products that we dispense to customer/patients. Places and products include:
RETAIL SHOWROOM & PATIENT READY AREAS:
- Diabetic testing supplies (both test strips and various reagents used in calibration
- Catheters, trach care kits, and other pliable soft goods
- Wound care products and even bandages that contain “wet dressings” or ointments/salves
- Products and supplies that includes sterile water or normal saline
- Food products (parenteral and enteral)
- Fire extinguishers – most have an expiration date (either on the tank or on a paper tag attached to the tank indicating date service/check due)
- Oxygen cylinders. Pay careful attention here: both the gaseous contents and the tank itself have expiration dates
- Eyewash stations
- First aid kits, depending on contents of the kits
- Hand wash solutions
- Eyewash, first aid kits, and hand wash solutions (same as the warehouse)
- Curbside cleaners and disinfectants.
Expiration dates may be mandated by an agency such as the FDA (Food & Drug Administration) or CGMP (Current Good Manufacturing Practice, which oversees oxygen tank standards) or they may be mandated by the manufacturer of the product or supply. HQAA standards require compliance with both law & regulation as well as manufacturer’s guidelines. Noncompliance with this issue can set your organization up for liability, lawsuits, and a bad reputation in the community.
A common best practice in the industry is to conduct an audit/inspection of the facility on a regular basis. Include in the inspection any and all of the above products, supplies, and equipment that have expiration dates. Checking for expiration dates on a quarterly or even monthly basis is not overkill and should not take a great deal of time or manpower. It is also important to instruct staff to check items they are dispensing or selling or delivering to customer/patients. Even when the items are checked on a regular basis, expired product can still slip through the cracks. There’s nothing more embarrassing than noticing that some product is expired in front of your customer/patient. It just doesn’t look good.
Finally, a very simple best practice that works well is to rotate stock and use a “first in/first out” inventory management system. Primarily, FIFO (First in/First Out) refers to a style of accounting. But the FIFO system rotates stock and uses the oldest products up before new product is dispensed. This helps ensure that product and/or supplies is used up according to age, which usually maximizes the chances that you’ll use up products before they expire (at least compared to other methods). You’ll still want to check dates and do your audits, but this system helps move items through the pipeline before they expire.
Incorporate all these procedures into your routine. This will help you avoid scenarios like my grocery store line incident. Your organization will be stronger, more compliant, and more efficient for your efforts.