As materials manager at a surgery center for many years, I've come up with dozens of ways to manage the flow of supplies. Here are my top 10 tips.

1. Create a system. Group supplies in some sort of logical order, whether it's alphabetically, by procedure or type of material. In our facility, the drugs are in alphabetical order. In the equipment room, the orthopedic gear is stored together. In bulk storage, all the ABD pads, Ace bandages and fluid pump set-ups are kept together. There's one wall devoted to anesthesia supplies, including tracheal tubes, oral airways, breathing circuits and face masks. We have a whole cabinet devoted to IV fluids, catheters, IV tubing and epidural trays.

2. Ditch the boxes. They take up space and are deceiving. It may look like you have two full boxes of wands for sinus surgery, when in fact you only have two boxes with one wand in each. Remove items from boxes and store them in clear plastic bins. That way you can see exactly how much stock you have of each item and you'll be able to re-order when you see you're getting close to running out. You can get your bins from a medical supplier, at Wal-Mart or at a dollar store. Label the bins so everything ends up in the same place when you restock.

3. Share the burden. Remind staff that inventory is everybody's duty. Everyone needs to keep things orderly and notify the materials manager when you're running out of an item, have too much of another or don't use something anymore. At staff meetings, say "I need your help."

4. Use it or lose it. When a physician requests something new, or you decide on a change, order the new products but first use up your stock of the old ones. Otherwise you'll be stuck with the old stock that takes up space and could expire.

5. Create a "rarely used" area. This is on my wish list. I'd love to have a place where I could store all the things that our staff rarely needs, but has to have on hand just in case. This would be where I'd store rarely used ophthalmic supplies or perhaps IV fluids for the crash carts.

6. Just in time vs. just out of it? If you have the space, reconsider just-in-time inventory. If you run out of something, the cost of overnight shipping will offset the benefits of a lean inventory. Have surgical techs pull supplies as early as possible the day before. That way if you're missing something vital, you can get it in time and avoid placing a rush order or buying some from a nearby center or hospital.

7. Prioritize inventory counting. I have an A-list of often-used items that I check every two weeks. Then I have a B-list of lesser-used items that I check every six weeks. Finally, I check the rarely-used items, the C-list, every six months.

8. Rotate stock. Whether it's IV fluid, orthopedic fluid or gloves, put the oldest items in front or on top in the storage area so that they're used first. When stocking cases, you'll need to put the newest arrivals on the bottom or in the back. As for drugs, designate a box for those that will expire at the end of the month. That way, you're more likely to use what's in the box first.

9. Discourage hiding. It happens in every facility. When backup stock becomes tight, people start stashing things for themselves. People often hide specialty items that are essential to a procedure. It's usually something that might cause a cancellation of the procedure if it's not available. The problem is that not everyone knows where something is hidden and whoever hid it may forget where he put it.

10. Plan to use all the space (then ask for more). If you're involved in building a new center, or expanding an existing one, be prepared to use all the space devoted to storage, even if it seems like so much more than you had before. Trust me, you'll use every square foot.