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Smart Purchasing Requires Homework
Making wise purchasing decisions is important all the time, but it takes on a new significance during an outbreak or pandemic. Often departments react to new situations and make hurried purchasing decisions to meet a need or fear, which can result in buying expensive equipment that’s not necessarily needed. This can be avoided by the use of a team to assess products and aid the decision-making process.
The team approach to purchasing came into existence in an effort to cut costs. For many years such teams were referred to as the product evaluation committee (PEC) or something similar. Currently a variation known as the value analysis committee (VAC) has emerged.1 The VAC functions differently than the PEC in that product sales representatives are included; they supply product information to the committee before it makes its purchasing decision. The VAC first analyzes the value of the product by conducting a cost/benefit analysis and then works with the sales representative to determine pricing. The VAC approach has evolved into a profession, and there are now certified healthcare value-analysis professionals.2
Do Your Homework
One key element of product evaluation is often neglected in the VAC process: the homework needed to determine whether the product truly meets the needs of the department. Many departments make the mistake of relying on the information sales representatives provide for the product being assessed. Sales representatives often supply studies to support their claims, but in some cases the company paid for the study, and it is biased in favor of the product.
The necessary homework involves conducting a search of the available literature regarding the product in addition to the information provided by the sales representative. A literature search should unearth all information—both supporting and nonsupporting—regarding any product claims. You may learn a product does or doesn’t match the information on its safety data sheet (SDS) or current Centers for Disease Control and Prevention (CDC) recommendations.
Homework is an essential step, especially during the time of an outbreak or pandemic. Many products quickly appear to meet current emergent needs, and many departments make the mistake of impulsive purchasing decisions. For example, the EPA recently approved two Lysol products with a label claiming they killed COVID-19,3 and this was widely reported in the mainstream media. This might fool you into thinking homework regarding these products is unnecessary—that is not true. More digging would reveal there are many other products available that might make more sense from a cost-benefit standpoint.
The CDC has clearly said any EPA-approved disinfectant will kill the COVID-19 virus.4 That’s because SARS-CoV-2 is an enveloped virus. When an enveloped virus lands on a surface, its envelope opens, and the virus becomes susceptible to many disinfectant agents. Other viruses in this group include Ebola, HIV, hepatitis B, and influenza. In addition, the EPA has published guidance for emerging viral pathogens because novel viruses are typically not immediately available for laboratory testing. This guidance lists many common cleaning agents that kill SARS-CoV-2—in fact, more than 400 products.
Reading product labels also is important in the decision-making process. For example, there is a difference between Clorox bleach and Clorox Splash-Less bleach. Although both use the words Clorox and bleach, they are not equal: Clorox Splash-Less bleach does not disinfect.5 The label states only that it whitens, brightens, and deodorizes surfaces and clothing—and that it’s not for sanitation or disinfection. A key question, therefore, is how often users read product labels and whether doing so has been incorporated into the evaluation process.
Advertising materials also may be misleading. For example, the product materials for one particular new spray for killing COVID-19 show a person in street clothing spraying in what appears to be a waiting area of a medical office or hospital. However, the product’s SDS looks very different: It lists the EPA pesticide registration number and reports no information available under “uses advised against.” Also noted: a statement that “this product is considered hazardous by the 2012 Occupational Safety and Health Administration (OSHA) Hazard Communication Standard (29 CFR 1910.1200).” Toxicity of the product is listed as unknown. Recommended PPE when using this product includes fully enclosed eyewear, an N95 respirator, gloves, and protective clothing.
This is quite different than the picture used in the marketing material! In this case, had the SDS sheet not been reviewed, an employee using this spray device could have sustained an exposure requiring medical care and treatment.
An additional point is that cleaning must always be performed before disinfection can be achieved. This was reinforced by William Rutala, PhD, MPH, CIC, who is recognized as the leading expert in cleaning, disinfection, and sterilization in the United States. In a recent interview Rutala noted, “The rationale for rigorous manual cleaning before the use of UV technology…is that organic material can interfere with disinfection technologies. Thus, surfaces must be cleaned/disinfected prior to use of automated disinfection technology.”6 One becomes aware of this type of information by doing the homework. The Internet is quick and useful in this process.
Conclusion
Is the VAC process the best approach for fire/EMS departments? Or should the old PEC approach be revisited, as it allows for independent review and evaluation without the involvement of sales representatives? Whichever approach is utilized, obtain input from the users of the products. As departments learned with the selection of sharp-safe devices, input from the users is essential. There needs to be buy-in, or the product may not be used appropriately, or at all. Nonuse of expensive products purchased during the Ebola outbreak should serve as a reminder.
An outbreak/pandemic instills fear. Fear can lead to panic buying and unnecessary expenses. Let two quotes from Warren Buffett serve as an important reminder: “Be fearful when others are greedy, be greedy when others are fearful,” and “Risk comes from not knowing what you’re doing.”7
References
1. GreenLight Medical. A Quick Guide to Understanding the Hospital Value Analysis Committee. Medium, 2018 Jan 29; https://medium.com/@GreenLightMedical/a-quick-guide-to-understanding-the-hospital-value-analysis-committee-4d6df8866661.
2. Value analysis: An evolving profession. J Healthcare Contracting, 2020 Jul 1; https://www.jhconline.com/value-analysis-an-evolving-profession.html.
3. Environmental Protection Agency. EPA approves first surface disinfectant products tested on the SARS-CoV-2 virus, 2020 Jul 6; www.epa.gov/newsreleases/epa-approves-first-surface-disinfectant-products-tested-sars-cov-2-virus.
4. Environmental Protection Agency. List N: Disinfectants for Use Against SARS-CoV-2 (COVID-19), www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19.
5. Clorox Company. Safety Data Sheets: Clorox Commercial Solutions Clorox 360 Total Disinfectant Cleaner, www.thecloroxcompany.com/sds/clorox-commercial-solutions-clorox-total-360-disinfectant-cleaner4/.
6. Healthcare Hygiene. Automated Room Disinfection Technology: A Q&A with William Rutala, 2020 Jan; www.healthcarehygienemagazine.com/monthly-issues/.
7. Jiang E. Here are the 21 most brilliant quotes from Warren Buffett, the world’s most famous and successful investor. Business Insider, 2020 Feb 12; https://markets.businessinsider.com/news/stocks/warren-buffett-21-best-quotes-2019-2-1027944381#.
Katherine West, RN, BSN, MSEd, is an infection-control consultant with Infection Control/Emerging Concepts in Clearwater, Fla., and a member of the EMS World editorial advisory board.
