How 4 systems keep supply issues from affecting care

National and global factors like the Russia-Ukraine war are complicating supply chain issues in the U.S., with health systems expecting to see price hikes in certain medical supplies for which raw materials are sourced in Russia. 

COVID-19 shutdowns in Chinese cities also threaten exports and production, and in the U.S., healthcare organizations have been grappling with saline product shortages worsened by the omicron surge. 

These are just a few of the factors disrupting supply chains outside of hospitals' control, making it imperative to have plans in place to handle the potential worsening of existing shortages or for new shortages to surface. 

Becker's asked supply chain leaders from four health systems what actions they've taken to prevent medical supply shortages from affecting patient safety: 

Editor's note: Responses are lightly edited for brevity and clarity. 

Carlos Aguilar. Vice President of Strategic Sourcing at Kaiser Permanente (Oakland, Calif.): Kaiser Permanente has proactively reached out to our suppliers who might be affected by current global events to ask if their operations are being impacted and if they anticipate any disruption in supply. At this point, our suppliers do not expect that to be the case. In addition to proactive outreach to vendors and monitoring daily orders, we have identified clinically-approved substitute items where available for items that potentially could be in short supply at some point in the future. This will help us ensure we avoid running out of those supplies whenever possible. 

Steve Downey. Chief Supply Chain & Patient Support Services Officer; Amrit Gill, MD.  Associate Chief Safety Officer at Cleveland Clinic: Cleveland Clinic has shifted from a reactive to proactive approach. This includes identifying where product is made and what the risk in supply is, identifying substitutes, measuring supplier performance, adjusting inventory based on risk and track record, and improving communication to caregivers when something does happen. When there is a shortage, clinical leaders work collaboratively with the supply chain team to ensure there is a robust mitigation plan and safe, acceptable substitutions. Daily tiered huddles create awareness of supply chain shortages or substitutions and their impact on operations at the front line. Caregivers are encouraged and empowered to be stewards of our resources as well as report supply-related safety concerns in our safety event reporting system.

Motz Feinberg. Vice President of Supply Chain at Cedars-Sinai (Los Angeles): Cedars-Sinai has created a data-driven collaborative planning and execution model, informed by real time visibility to demand and supply variations. Category specific teams meet daily to review actual and projected usage, then incorporate available and inbound supply to develop and execute tactical support plans. Clinicians and supply chain team members are further informed by predictive models that help us home in on the truly critical items for patient care.  Strategic and tactical partnerships with key suppliers are invaluable in ensuring that planning and replenishment processes are appropriately tracked and escalated when needed. The collective efforts of these teams have helped Cedars-Sinai maintain necessary supplies and equipment, avoiding potential disruptions to patient care.

Sharon Fried. Vice President of Supply Chain Management at Hartford (Conn.) HealthCare: At Hartford HealthCare, patient safety is our true north. Before COVID, like many organizations, we had about a three month supply [of personal protective equipment]. Everything changed after COVID, as we realized we could never be in that situation again.

About a year ago, Hartford HealthCare's supply chain team committed to ensuring we would have supplies lasting 365 days a year at current usage rates. The team established an international strategy with direct relationships through factories in Asia — China, Korea, Vietnam, Malaysia and Thailand — with production lines solely dedicated to Hartford Healthcare, connecting raw materials suppliers with manufacturers throughout Asia. 

Through these established connections, we opened a warehouse dedicated to stockpiling a critical supply of life-saving PPE (e.g., masks, gloves, face shields) to counter any potential future shortages. Because of the commitment from our entire supply chain team, we are much better off and much better positioned today to ensure our colleagues are well protected to safely provide world-class care to our community. Hartford Healthcare supply chain and infection prevention leadership also created standard work and communication across the system, aligning subject matter experts from key areas including pharmacy, nursing education and labs to quickly identify appropriate substitutions and develop alternative workflow options as necessary.

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