Organization Flashcards
Implementation
To put into effect
Inventory Variance Evaluation
Beginning qty Jan. 1 + # ordered - #sold = calculated qty on hand - physical count = variance
Internal Controls
measures, systems and protocols to prevent errors, waste and fraud
Periodic Inventory
uses data from manual count at the end of a financial period
Perpetual Inventory
- accurate idea of qty’s at any time
- received - added to inventory
- sold/used - removed from inventory
Control Functions
written policies/procedures maintaining security and safety
regular monitoring
needs to be flexible
SOMR
Source oriented Medical Records
- grouped by information, then chronological
(diet tab, medical view tabs)
POMR
Problem Oriented Medical Record
How long to retain medical records?
3-5 years or 3-7 years (in the reading)
5 years from the last entry- CVO
Acceptable variance
1-4%
3 Value Disciplines
- Customer intimacy
- Product leadership
- Operational Acceptance
Traditionals
Generation 1925 - 1945
frugal, work long hours, adhere to the rules
Basic Accounting Equation
Assets = liabilities - Equity
Merchandise Inventory
products for resale to clients
Inventory Control
meet operating demands
frequently used items are always available
Replacement Cost
price to pay to repay an existing inventory asset with same product
Shrinkage
decreased on hand inventory caused by use not recorded/invoiced
ie. broken bottle
Supply and Demand
product availability and the need
Procurement
obtaining/buying goods
Just in Time
receive items just as needed vs. storing the item
- low holding costs, no expired product
high ordering costs, stock outs and back orders
Medical Supply Inventory
Professional Inventory
items used to provide medical/surgical services
Department Lead
identify products needs within their specific department
Inventory Purchaser
places order and identifies needs
Inventory Researcher
evaluates/selects suppliers and products
Inventory manager
responsible for all the tasks associated with the other roles
Inventory Counter
Unpack, account for and stock the shipments
DVM Costs
if paid on production, then a portion of their pay is considered an actual cost of inventory
holding Costs of total true cost
8-15% holding cost of true total cost
25-30% holding and ordering costs of true total cost
Holding Costs
costs invested in keeping inventory ‘on hand’ while waiting to use/sell
(tax, ins., utilities, loss (exp/waste/spoiage), OHSA regs
Ordering Costs
labour related expenses such as employee compensation, including benefits and taxes to perform duties associated with ordering, receiving, unpacking, payment & records
Unit/Product Cost
Total amount paid vendor / # of units ordered
Bookkeeper
chart of accounts
cost of goods data
purchasing budgets
reports
5 Steps - Inventory Control
- Print your lists - delete inactive, duplicates…
- Reprint
- Create list of unconsolidated products - 2 options
- Count Inventory
- Enter/Receive accurately going forward
Mark up
acquisition cost x specific factor
100% mu doubles acuisition
calculating Inventory Turns
(BI + EI) /2 = Avg. inventory on hand (AI)
DMSP / AI = inventory turnover ratio
DMSP - Drug and medical supply purchases
Reorder Quantity
Average daily use x turnover goal (days) = reorder qty
Bluetooth
short range wireless connection to phones, computers…
Ancillary Service Provider
service provider that support the work of a primary physician
Business Liability Insurance
protects the company in the event of a lawsuit or claim
Business Assessment Report Kard (BARK)
Strategic planning process to evaluate veterinary practices
Client Risk Management
identify, analyze and either accept or mitigate of uncertainty in client decision making
Capital Asset
property of any kind.
movable or immovable, tangible or intangible, fixed or circulating
Controlled Drugs
Any drug to include narcotics with a potential for abuse. Strict government control
Consent Form
A form signed by a client to agree to a procedure and is aware of any risks.
Complementary Practitioner
A vet that used healing practices and products that work in conjunction with traditional medicine
Data breach Risk Management
Strategies and procedures in plact to protect confidential data from unauthorized access
Cost of Goods Sold (COGS)
cost of products sold to consumers in the business activity of the practice
Disclaimer
A clause or statement that tries to prevent the creation of a warranty or contract
Depreciation
Systematic allocation of the cost of a tangible asset over time
Efficiency Ratio for Accounts Payable to Sales
Ratios use to analyze how well a company uses its assets and liabilities internally
Economic Risk Management
identification, assessment and prioritization of financial risks followed by coordinated and economical application of resources to minimize, monitor and control the probability of said risk
Economic Order Quantity (EOQ)
most economical quantity of a product to order, factoring in both holding and operating costs
Firewall
designed to prevent unauthorized access to or from the network
Expired inventory
reached the end of its useful life and cannot be sold
Five Force Analysis
Strategic planning that organizes the practice’s evaluation of the external environment and its opportunities and threats
First In - First out (FIFO)
oldest inventory items are recorded and sold first,
Human Resource Risk Management
identifies and understands the risks you are exposed to when it comes to HR.
Evaluate risk
Have a strategy to remove risk
Prevent it from happening again
EOQ - Economic Order Qyt Formula
EOQ (sq. root) 2 x A x F / H x UC A - Annual demand in units F - Fixed Ordering Costs H - Holding Cost UC - Unit Cost
FOB
Freight on Board (ownership of product)
FOB Shipping Point - merchandise is loaded on the carrier
FOB Destination - merchandise is delivered
3 Costs in acquiring Inventory
- Unit Cost
- Ordering Cost
- Holding Cost
ASLD (Average Shelf Life in Days)
365 / annual ITR = ASLD
ITR - inventory turnover ratio
Average Turnover
Typically ~ 6 x/ year
Robert F. Roehlich (1987) says 8-10 x/yr
every 35 - 45 days is a good target
Cumulative % of AUV (annual usage volume)
AUV / total cumulative AUV = cumulative % of AUV
AUV (Annual Usage Volume)
volume ($) /yr x average cost = AUV
Cumulative AUV (annual usage volume)
Once AUV is sorted (increasing)
calculate the cumulative AUV
Add AUV line 1, line 2….
4 Inventory Objectives
- Controlling - counting & accountability
- Forecasting - determine reorder pts & qtys
- Purchasing - ordering/receiving strategies
- Selling - training, marketing, pricing
Calculating inventory Turns
(BI + EI) / 2 = avg. inventory on hand (AI)
DMSP / AI = Inventory Turnover ratio
Inventory Turnover
volume of merchandise sold : inventory amount
-short time before sold/used
BEP (Break Even Point)
Amount of revenue that covers all fixed and variable costs
- no profit or loss
Holding Costs (%)
8-15% of the total cost
Combined ordering and holding cost %
~ 25-35% of the total cost
Perpetual Inventory System
Accurate inventory qty’s at any given time. When received, it is added immediately. When it is sold, it is removed immediately
Periodic Inventory System
Manual counts at the end of every financial period.
ABC Analysis Class AA
Controlled Substances
Acceptable Variance on high turn items
1 - 4%
Turnover Goal
one turn every billing cycle. ie. if billing cycle is 30 days, then every 30 days or 12 times per year. Diets - 2 times a month Pareto's products - 1 time per month Others - 1 time per 2 months
Labour Costs
15 - 20% of total product cost
Central Supply Inventory
A working supply of inventory is kept on the shelf where the stsaff has access to it. All additional stock is kept under lock and key where few people have access.
Ration Based Inventory
Central Supply system is already in place. The working supply is rationed to one day based on immediate need.
Usually when shrinkage is high.
Selective Inventory Control
prioritizes inventory based on value and importance
ABC ANalysis
method of sorting inventory into manageable components based on cost and relative value.
- determine volume used in the last year
- calculate annual usage value (AUV)
AUV (annual usage value)
AUV = volume used x average cost
* place results in a table in descending order
ie.
Product Annual Volume Avg. Cost AUV
Clavamox 271 $25.34 $6,867.84
Cumulative AUV
AUV + AUV of all items preceding it Like a running total. ie. 1. 3500 2. 3000 + 3500 + 6500 3. 2500 + 6500 = 9000 4. 2000 + 9000 = 11000 ....etc
Cumulative % of AUV
Determine the total cumulative total
Divide each cumulative AUV by the TOTAL value
This will give you a percentage .
Calculate Annual Usage Distribution
cumulative % of items for each line.
ie.
the 9th line on the chart
9 divided by the total # of lines
gives a % of distribution
Group them based on annual usage distribution
Place them into ABC categories based on % of AUV distribution
CLASS A
ABC Analysis
Top 20% that accounts for 80% of the annual usage value
TOP PRIORITY
Class B
ABC Analysis
Next 30%
21-50% AUV
Account for the next 15%
MEDIUM PRIORITY
Class C
ABC Analysis
remaining 50%
account for remaining 5% of AUV
LOW PRIORITY
Forecasting
measurement of inventory as it is motion Tools include: usage reports purchase history Invoices
Operating Level
expected to be used up between the time the item is received and when it must be ordered next.
Safety Stock
inventory cushion in excess of lead time qty to help avoid stock outs if shipment is delayed or back ordered
ASLD
Average Shelf Life of Inventory in Days
useful calculation in determining the efficiency of inventory management
365 divided annual ITR (inventory turnover ratio) = ASLD
Economic Order Quantity (EOQ)
calculation of optimal order quantities Recognizes 3 specific costs incurred in ordering and holding 1. Unit Cost 2. Fixed Cost 3. Holding Cost
`Mark up
cost x a specific factor
100% doubles cost
200% triples cost…..
Margin
amount of profit desired that is added to the cost
Mark up considerations
- products with high turnover rate have less mark up (140-175%)
- products with lower turnover rate (4-6x) have higher mark up (200 - 275%) helps cover potential expiration
- Competitive categories - lower mark up
Pricing Strategies
Aging Inventory Pricing Model
cost + mark up + disp fee
Modern
cost+ hidden costs + profit + DVM pay
Regular
Total cost + 50% profit + 15% DVM pay
Competitive
Total cost + 20% profit + 10% DVM pay
Online
cost + labour cost + 30% profit
Break Even analysis
determine when your business will be able to cover all of its expenses and begin to make a profit.
Break Even Point
amount of revenue that covers all fixed and variable costs, without profit or loss
Break Even Point formula
SP = FC + VC + Profit SP = sales price FC = fixed costs VC = variable costs P = Profit
According to Pareto’s 80/20 rule to inventory, helps in
prioritizing inventory time investment. Since 20% of our products bring in 80% of our product revenue, we should concentrate most of our efforts on that 20%
Ideally the top 20% of inventory items should be ordered…
monthly
To maintain tigh internal controls, the inventory purchaser should always be a separate individual from
Receiver
Documenter and tracker
Capital Inventory
Any equipment throughout the life of the practice
Equipment Break Even Analysis
price of equipment / client price - cost to produce the service = # of times the service must be performed to break even.
Lenders 3 C’s
- Cash Flow
- Credit History
- Collateral
Budget to reinvest for equipment
1% of gross
Monthly Equipment Expense
cost,tax and all fees / equipment estimated useful life /12
ie. $50000 / 5 years = $10,000
$10,000 / 12 months = $833.33 /month
Depreciation
Also called Capital Cost Allowance (CCA)
explains the loss of value of products/goods
reflected as an expense
Declining balance method used for most assets
Practices should plan to reinvest around ____% of gross for replacing or acquiring equipment annually.
1%
Is the digital radiography unit in your practice considered Capital Inventory?
Yes, if it is in usable condition.
Forecasting Functions
ability to signal when an item needs to be reordered
Operating Level
amount expected to be used up between when it’s received and when it needs to be ordered next
Safety Stock
Desired inventory cushion in excess of lead time to avoid stock outs if delayed or back ordered
Which details are considered a benefit of using logs in vet med?
- comply to legal requirements
- Provide evidence in the event of malpractice
- Convenient for quick data analysis and auditing
The most common medical format is?
POMR
Problem Oriented Medical Record
Ideally, no less than ____ of on site training for software conversion.
1/2 day
3 Value disciplines are 3 ways businesses deliver superior value to their customers:
customer intimacy, product leadership, operational excellence
What are 2 common reasons for complaints from pet owners regarding referrals?
- failure to mention the availability of specialty care
2. procrastinating so long in the treatment process that a specialist can no longer help
When it comes to negligence or malpractice cases, plaintiffs must prove that a reasonably close causal connection exists between the conduct of the Dr. or practice and the occurrence of the injury. What is the term for this element of the case?
proximate cause
The method of recognizing revenue when goods are delivered or services are provided, regardless of when cash is received:
Accrual accounting
Common Sizing
expenses are stated as a % of gross.
- consistent, easily identifiable measurement of performance
Regarding financial statements, which is more detailed and provides the greatest level of assurance?
Audited financial statements
Reservoir
a place where an infectious organism survives and replicates
Host
the organism that provides the environment for the maintenance of the organism but may not be necessary for its survival
Direct Transmission
requires close contact between the reservoir of the disease and the susceptible host
Indirect Transmission
more complex and involves intermediaries that carry the agent of disease from one source to another
Vector
a living organism that transports infectious agents (fleas, ticks, mosquitoes…)
Vehicle
A mode of transmission of infection from a reservoir to a host (food, water…)
Where are Fire Extinguishers placed in a practice?
No more than 75 feet from any location. 32 - 48 inches from the ground.
What is the process for using a fire extinguisher?
P.A.S.S. P pull the pin A Aim low S Squeeze S Sweep side to side
Chemo Agents
used supplies disposed of in yellow biohazard container
- bedding must be washed separately
- contacts should never be worn
- client education is critical (eliminated in urine & feces)
Anesthetic Gases two classes
- nitrous oxide
2. halogenated
How often must staff have anesthetic safety training?
Annually
Active Scavenger
energetic collection - fan that creates an active vacuum **BEST
Passive Exhaust
Channels waste through a tube to an acceptable location for evacuation
- short distances
- lung pressure expels gas
Absorption Scavenger System
uses charcoal to remove halogenated gases, but not nitrous oxide
- replace after 20g or it will overflow
How often does the anesthetic machine need to be inspected?
Annually
Exposure Limits for Halogenated gases
2ppm/yr
Exposure limits for Nitrous
25ppm/yr
Anesthetic Spills
- all other team evacuated
- windows open, exhaust fan on
- cat litter on spill, once absorbed, swept up
Liability Coverage
damages the vet causes to other persons, pets or property
Property insurance
damage to the insureds property
Malpractice
Tort ( a civil wrong or wrongful act)
injury occurs
requires proof of 4 essential elements:
1. Duty - practice within the standard of care (VCPR)
2. Breach of Duty - failure to act in the standard of care
3. Proximate Cause - connection between the negligent act of the Dr. and the harm to patient or client
4. Damages - harm incurred as a direct result of the negligent act
Standard of Care
in regards to malpractice, established by an expert witness
higher for specialists
local standard - same level of competency as geographocal peers
Duty to treat
NO legal duty to treat until a valid VCPR is established - not even emergencies
No legal duty, but an ethical duty does exist
If you have an Established VCPR, treatment must continue until:
the animal recovers
the Dr. completes all treatment as agreed
the animal dies
the client terminates the VCPR
the responsibility is transferred to another Dr. with the consent of the client
Contributory Negligence
Can show the client was also negligent
Proof of any degree may eliminate awarded $$ to the client
Comparative Negligence
similar to contributory, except recovery is determined by the % of negligence on the part of the client. If client is 25% negligent, they will recover 75% of total damages. If client is over 50% there will be no recovery of $$ damages.
Assumption of Risk
Animal bites include an assumption of risk, therefore no damages will be recovered
Statute of Limitations
Filed within a certain period of time
Risk Assessment Equation
hazards + vulnerabilities = risk
4 Priorities of general emergency management
- Mitigation - strategies that decrease the likelihood of a threat
- Preparation - planning and training
- Response - action taken
- Recovery - process or returning to normal
Mitigation
Insurance is key component
selection of types of coverage
maintain building safety and structure soundness
Preparation
Evacuation considerations
communication considerations
patient care considerations
operational infrastructure considerations
How many disease are curently known to be zoonotic?
1400
What is the first step in creating a business contingency plan?
risk assessment
If a client fails to confine a dog after surgery, it may eliminate financial recovery for the client in a lawsuit. What term supports this theory?
Contributory Negligence
Business Life Cycle Phases
- Introductory - vision, innovation, energy
- Growth - efficiency, discipline & talent
- Maturity - manage risks, problem solve
- Decline - decrease demand for services. Revisit strategic plan to revitalize
Phases of strategic planning:
- Formulation - a) mission, vision, values
b) SWOT
c) Gap analysis - compare current
performance w/ desired performance - Development Phase - use the formulation phase to create a plan to achieve goals
- Implementation - specific plans of action
- Evaluation - measure the success
Adult Learning Theory
information must be used immediately to be retained.
Adults have 3 learning styles for best retention, sight, hearing and touch
Push Learning
lecture delivery
Pull Learning
students research data and ‘pull’ info to themselves.
Pull learning increases retention
Budgeting positions - Formula to determine how many team members needed for the following year
current # staff x avg. annual practice growth = estimated # staff needed for next year
Which of the 4 phases of strategic planning is focused on how the practice will get from point A (now) to point B (future)?
- Development
Leadership fatigue can be experienced by both owners and manager and usually results from lack of communication, lack of delineation of job duties and feeling they are constantly haggling withthe team to carry out policies and procedures. Which element of the strategic plan addresses this dynamic?
Organizational design
How long can it take to prepare a team member for a leadership position?
12 - 36 months
