Epicur Pharma customer Dawn McKelvey has been an inventory manager for five years at Eastern Carolina Veterinary Referral Animal Emergency and Trauma Hospital. She started her career as a technician supervisor on the emergency side of veterinary medicine before transitioning into inventory management, human resources, and equipment management.
We sat down with Dawn to learn more about the critical role she has in these veterinary practices and how new and changing regulations impact inventory management.
Thanks for talking with us today, Dawn. What was it that led you to your inventory management role?
I really like organization and inventory, and after being in the field for more than 20 years, I was looking to get off the floor but wanted to stay in the field. This role allows me to still have the connection to veterinary staff, patients, and clients but in a different way.
It sounds like you wear a lot of different hats in your role—far more than just inventory. Can you give us a rundown of your responsibilities for the two hospitals?
Overall, a big part of my responsibility is ordering and stocking for the two services, making sure that they have all the medications they need—on both the controlled substance side and non-controlled substance side. I do a lot of ordering and equipment troubleshooting, getting it sent off for repair and facilitating that. I’m also pretty involved in the hiring process; I facilitate interviews, disciplinary action meetings, and helping people through their startup paperwork and getting set up with the appropriate employees for training. I do some of the bookkeeping as well.
Then there is facilitating the floor, making sure the day goes smoothly, and helping where needed on days where we have any employees out because they’re sick. I support troubleshooting client complaintsand talking to them if they don’t agree with the way they or their pet was treated. I help reception out somewhat with troubleshooting payment options or problems with an invoice. I tag team with another employee on some of the accounts receivable aspects, particularly things that impact invoicing.
With all of that on your plate—and for two facilities—how do you ensure such a critical practice aspect like inventory management and keep it running smoothly?
I keep a spreadsheet with all of the most popular drugs we use. That way I can go through the cabinet alphabetically to make sure we have what we need on hand. And I’ll usually do oral medications first, then I’ll do injectable, and then I’ll do lab supplies. I also have what we call a “want list,” most clinics do, where if a doctor is going through something very quickly, but I don’t typically carry a whole lot of that product on hand, they’ll put it on that list, and I check it daily.
For example, if we have a 90-pound dog with seizures that the veterinarian starts on Keppra® injectable, I can check the list and get the medication ordered so we don’t run out of it. Similarly, in the spring and fall here in North Carolina, we have snake season, so I know that we use a lot of antivenom. I will carry at least six to seven units of antivenom during those times. Or, I have a certain doctor that likes Proviable®, so I’ll look at the schedule and if she’s on for the weekend, I order extra of that so that she has it.
Wow, sounds like a lot of balancing the overall practices’ needs as well as individual doctors’ preferences, all while making sure the appropriate things are stocked for patients. How do you keep it all organized?
Besides checking the “want list” daily, I do major inventory once a week. I’ll check medications usually on Monday mornings because weekends are typically the busiest. I try to get everything restocked because I know we’re likely low on products like Cerenia® by Monday morning. I’ll get those ordered, so I can try to get them in Tuesday or Wednesday in quantities that will guarantee the doctors through the weekend. Then I do my supply order on Tuesday for things like catheters, needles, fluids.
What do you see as the top challenges for inventory managers?
I think the top challenge is getting the staff to realize that you try to do inventory just once a week, and if they are looking for something or using something to let me know so I can get it ordered. There are times someone will look for a product, and it’s not there, and I’ll get a panicked message late in the day saying we’re out. I jump online at home and order it so we can hopefully get it, and then I go in the next day and there’s a whole box—they just looked for it in the wrong spot. It’s getting everybody on the same page with the rhythm and process that’s been developed.
Are there any added challenges in managing two facilities in one? How does that complicate things like inventory management for you?
I think the biggest challenge with having the two facilities in one building is having cost centers for each one and making sure everyone is pulling from the right stock for the right patient. Because they are two entities with separate cost centers, it’s very hard to try to make sure that I’m stocking for one service and that the staff, or myself, don’t forget and pull from the wrong service when they’re restocking or doing medications inventory.
BUD vs. Expiration?
Beyond Use Dates and Expiration Dates sound similar, but have distinct differences that are important to inventory management and purchasing decisions.
Read more about the differences and how they impact your practice.
All of our patients are in one ICU, but if they’re from the surgical service, they have a separate cabinet that they draw drugs from than if they’re emergency patients. But also, one of the best advantages of having two cost centers is that I sometimes have a little buffer. If one service runs out of something, they can just grab it from the other one.
Have you been affected by stock shortages and backorders with certain drugs?
Yes, we’ve had some issues with certain drugs that kind of go on and off. Recently, euthanasia solution was one of those drugs that we were having problems with. Luckily, we did okay through that kind of scare. But, every once in a while, there will be a random drug we can’t get at all. Famotidine 10 mg was very difficult to get six months ago, but we could get 40 mg or 20 mg, so we just had to make adjustments there.
When you do experience a shortage like that, do you stick with the same supplier and make adjustments, or do you check with other suppliers to see if it’s in the dosage you need?
I am on Vetcove, which is a very neat app or website for veterinary medicine, and it’s free to sign up. You log all of your account numbers with all of your different vendors, you type in the drug you need, and then a little sidebar will come up to let you know which vendor has it in stock and how much it is from that vendor. A green cart means it’s in stock, a yellow cart means limited supply, and a red cart means it’s backordered. Within five or ten minutes, I know which vendors have it and which vendors don’t.
I’ll usually try to shop around; we have a couple main vendors that we do deal with, but then I will look at other options for things. Luckily, with an emergency side to our practice, I think the doctors are very used to running on the fly. So, if something’s not available, they just go to plan B.
We’re glad Epicur has made it onto your vendor list! How did you choose to add Epicur as a partner?
They were already set up with us when I took over inventory, but I started ordering from them quite a bit when buprenorphine 0.6 mg/mL was hard to get. Epicur had it in 0.5 mg/mL, and the doctors liked it because it is easier to do math for dosages with 0.5 mg/mL instead of 0.6 mg/mL. And then as I started ordering more and more, I just found how easy and simple they were to work with. They’re always there. Customer Service has always been great with me.
Plus, I really like that they are 503B. It’s been amazing for drugs that we would normally consider compounded because Epicur actually manufactures the drugs. We can be sure we’re not wrongly dispensing compounded medications, which is against the law in North Carolina.
As inventory manager, did you already have a good understanding of 503B and what it means to veterinary hospitals?
It was our Epicur rep Sam that helped me out a lot with that. She did a luncheon for the staff and gave me a nice educational version of what being a 503B means. After that I went back through the website to look at all of the drugs that I thought were compounded medications that I ordered and found out they were all manufactured! My orders have definitely increased!
Being directly involved in the purchasing of inventory, you were probably one of the first in the practice to be familiar with 503Bs. Do you think the doctors and staff are in tune with the different impacts 503A and 503B products have on patients?
Yes, they are now! Once I was in tune with it and understood it more, I shared the information with them; they were very excited that they didn’t have to worry about dispensing legalities anymore.
What are some of the key qualities that you look for in a supplier or an inventory partner?
I personally like how easy they are to get a hold of for clients, their customer service, and how well they answer questions. Cost is always kind of up there too, but sometimes even if it’s a little more expensive, good customer service goes a long way. And I like the speed with which I can get things. When I order from Epicur, I typically get my products in two to three days. That’s very quick. I’m used to compounded medications taking much longer.
I have not had a bad experience with Epicur. Any time I’ve called, they’ve always been very helpful. They’re quick on delivery. Anybody that I’ve talked to on the phone is always professional and pleasant and answers questions. There’s never been anything that I’ve ordered that Epicur hasn’t had; there has been a time where I have ordered something, and they let me know that it had a short shelf life because of the lot number, so instead of ordering say 10 vials, I just ordered five because it did have a short shelf life. I can’t think of a time where I’ve ordered something that they haven’t had or haven’t been able to special order for me.
What is your advice to a veterinary hospital struggling with inventory management?
It’s a big job and a lot harder than it looks. It’s not just unpacking the products and putting them on the shelf. It’s checking expiration dates, making sure we have the appropriate amount of a drug in certain times of the year, which is also dependent on where you’re living, and it’s knowing the preferences of doctors and staff.
Luckily, I have a very good relationship with the staff and the veterinarians that I work with. I let them know when things are backordered or if there is a product I had to get in a different brand. I know when I say something’s out of stock, they trust that I’ve tried to find it any way I could, but I just can’t get that brand. Inventory management gets more difficult when doctors are particular on certain brands over others.
