Keeping a hospital running with a full assortment of necessary essentials has been a task complicated in recent months by shortages.
Unlike the start of the COVID-19 pandemic, when it was difficult to find disposable gloves, masks and gowns – called personal protective equipment – different things are now missing. And, to complicate matters, it varies from day to day.
“” What we’re seeing now is that on any given day it’s a different product that’s disrupted. It’s really about getting proactive insight and visibility across the entire supply chain so that we can try to predict what might happen, ”said Melanie Fisher, senior vice president of the supply chain. supply at Beaumont Health.
“So these are different products on different days. Aluminum crutches have been a problem for many across the country. … This week, cold compresses are a problem, Styrofoam cups have been a problem. It really covers the whole gamut of disturbances, ”Fisher said.
Southeast Michigan hospital officials agree. They wake up each morning to new potential shortages. However, with their skill in locating different suppliers, planning ahead and solving problems, patients did not suffer.
“Different articles strike us differently depending on the week. I think two items of the hour are the crutches and that has a lot to do with the magnesium which is used to harden a lot of the aluminum in the crutches. There has been an international shortage of this raw material. We’ve actually managed that – we’ve got a pretty decent amount coming up next week. As a result, we had no disruption in care, ”said Bill Moyer, senior vice president of supply chain management at Henry Ford Health System.
“The other item that we are seeing this week are the containers and the suction liners, but again, we have never peaked in recent memory where we have not been able to replace with an alternative product.” Moyer said, explaining that suction liners are used in hospital rooms to remove infectious medical waste.
“There really isn’t any product that hasn’t been affected by the supply chain as a result of this pandemic. It is everything from basic foods – applesauce, pudding, jello, forks, spoons, bowls – to larger medical supplies to building materials, ”said Frank Sawyer, CEO of St. Joseph Mercy in Pontiac. . “When I say challenges, it doesn’t mean we can’t get them, but I define challenges as pre-pandemic systems and processes to get what we need to operate this way and now after the pandemic, it works differently. So we have to solve the problems and look for different channels to get what we need. Overall, we are still able to get what we need; it might take a little more work. ”
At McLaren Oakland in Pontiac, they see problems from all suppliers.
“Even computers, we urgently need laptops and desktops for replacement and broken computers. And they’re back in order. Things you wouldn’t expect, not even medical supplies, we find a lag or no time because we don’t have a delivery date, ”said Margaret Diamond, CEO of McLaren Oakland.
“Our suppliers have no staff. Healthcare – we are down because of our shortages of nurses at the bedside – many suppliers that produce wheelchairs and sustainable medical supplies – their staff are also short, which means their production is cut short, ”explained Diamond .
A shortage of building materials has slowed progress in rebuilding a basement lab in St. Joe’s, where all of the hospital’s lab tests are done.
“Everything from steel piping to plumbing to wood for case work, testing, chairs, vinyl flooring, it’s all impacted. You have to have really good people in charge of procurement who can find alternative products to move projects forward, ”Sawyer said. “At worst, projects are time delayed, but they are also moving towards completion.”
Construction problems also delayed the construction of a new McLaren factory in Oxford.
“We are trying to build a brand new clinic at our Oxford site. We have an aging building there. Each building supply is delayed by 6 to 8 months. We were supposed to innovate and start construction in the spring and we could start construction next spring, ”said Diamond.
All hospitals have learned of the shortage of personal protective equipment that hit at the start of the COVID pandemic in March 2020.
“We planned a bit ahead – especially for our PPE – at Henry Ford we’re incredibly healthy in our PPE supply which as we all know was the big term everyone has in the pandemic. learned, ”Moyer said. “I think what we are seeing internationally are potential supply chain shortages in categories that people did not anticipate, whether due to raw material shortages, shortages labor, shipping issues, etc. We’ve actually been working on a plan for months. to get ahead of any of these issues so that we don’t have the same disruption that someone around the corner might have. ”
Henry Ford includes six hospitals in Southeast Michigan and Jackson.
St. Joseph Oakland is part of Trinity Michigan and Trinity International, which helps Sawyer meet its supply needs.
“We have supply chain opportunities that are far more important than a single site going it alone. We also have a regional distribution center in Fort Wayne where we get a lot of high volume products such as gloves and syringes, ”Sawyer said. “Being more vertically integrated allows us to access these things and has shielded us from some of the supply chain issues. “
At the start of the pandemic, McLaren Health Care announced that it had partnered with Premier, Inc., a leading healthcare improvement company, to acquire a minority stake in Prestige Ameritech, the largest national manufacturer. PPE products, including N95 respirators and surgical masks.
So getting PPE isn’t a problem, but Diamond at McLaren has other issues.
“I could not have imagined the magnitude of the impact this would have on day-to-day operations,” Diamond said.
These admins have all proven they can make adjustments on the fly. It also helps them get support from medical staff.
“What we’ve been working on is finding other sources of products, following different protocols, expanding our inventory, really looking for creative solutions similar to what we’ve done in COVID in that vein, where we are diversifying our supplier portfolio to find other suppliers who may be able to supplement our inventory, ”said Fisher. “For example, with Styrofoam cups, find a different size if we can find one, or a paper cup. We are trying to solve this problem to make sure that we do not have an impact on patient care. ”
Administrators hardly work alone.
“We have work teams that literally focus on these issues on a daily basis. I have a team of supply chain managers in every hospital, we have leadership focus groups across Trinity who come together to develop a plan, ”Sawyer said.
“Additionally, the way we manage our inventory allows us to see weeks, if not months, where we might have issues and we start planning and taking action for a potential shortage long before we run out. stock of a glove, syringe, or something important. ” ‘ he added.
All Crystal Balls are also to be stranded on ships in the Port of Los Angeles, as no one is sure how long the shortage in the supply chain will be a factor for hospitals.
“What our sources are telling us and, I think everyone has an opinion on this, but we predict that the international supply chain will probably not normalize by the end of 2022. And then it will normalize. and hopefully we’ll get back to some semblance of normalcy, ”Sawyer said.
Fisher said she has seen projections that will go into the second quarter of next year.
No one is sure.
“We can place orders all day, it’s about filling them. Many providers have opted for an allocation method. Which means they would take our historical demand or our historical purchases, they would say we’re putting Beaumont Health on the allocation and you can only order 75% of your historical demand, ”Fisher said.
“This attribution method is different from one supplier to another for the times they measure, the percentages are different. It’s how manufacturers try to expand their inventory, ”Fisher said. “So while it’s the right thing for the global economy and all of healthcare, I think that’s where we are. “
That’s the new normal, at least for the foreseeable future.
“The teams are able to problem solve to make sure that the quality of care is always given and through it all, with all the challenges, we are still providing the same high quality care that we were before the pandemic, if not even better, ”says Sawyer.