Dream On

Lessons learned from the Dreamliner
By Gary Fennessy

Earlier this year as I watched the evening news, I looked on in amazement as the Boeing 787 Dreamliner took off on its commercial maiden flight. I could not help but be impressed by how far the aviation industry had come. I am not even sure the Wright brothers could have envisioned an airplane of such magnitude. That ultimately led me to start thinking about the monumental efforts that had to go into designing and building the airplane and what lessons could be applied at Northwestern Memorial associated with our value and supply chain management.

A little background on the Boeing 787. The airplane’s airframe is comprised of composite materials manufactured in six single-unit components. As a result, the final assembly does not require any huge cranes or large tools. The pre-assembled components are built in multiple countries as far away as Japan and Italy, and shipped to the final assembly plant in Everett, Wash.

In 2007, Mike Bair, the vice president and general manager of the 787 program, summarized the accomplishment: “We’re seeing increased use of composite material for airframe structure, one-piece fuselage sections, advanced systems capabilities, and global partnerships. The Boeing Company is leading the way in leveraging these new technologies and business models for both our airline customers and passengers. By focusing hard on the right technologies and working with the best partners, we’re delivering an airplane with breakthrough economics for airlines, and a passenger experience superior to any airplane flying. The plane offers a pleasing interior, unmatched fuel efficiency, and a 30 percent reduction in maintenance costs.”

Congratulations to Boeing, and the value chain team that supported this initiative.

Parallels with healthcare
So, you are reading a magazine on healthcare contracting and asking, “What does this have to do with healthcare supply chain, contracting or operating a hospital?”

From my perspective, looking to industries outside of healthcare can provide insights on how we formulate strategies on best practices. Core value chain functions are similar across industries: sourcing, contracting, distribution and logistics, transaction management, manufacturing and assembly (e.g., our operating rooms), quality, and customer satisfaction. Every industry has unique challenges; however, core value chain functions are very much alike. As an example, the challenges of moving product from point A to point B in a cost-efficient manner are core to distribution teams everywhere.

I can imagine that the vision for the Dreamliner began many years ago, with a team of aviation engineers and designers bringing ideas and different approaches to building this future state airplane. Parallel to that would have been a supply chain team, most likely pulling their hair out along the way, listening to ideas about pre-assembly in foreign countries, shipping to a central manufacturing plant using all forms of transportation, contracting for supplies on a global basis in an unstable economy, and creating new technologies, some of which had yet to be developed and that required extensive testing in a heavily regulated industry. In the end, a final design was approved and tested for safety and efficiency, a standard manufacturing process was built, logistics and contracting came together, and a group of employees in multiple countries built hundreds of parts and pieces to specific and tightly controlled standards.

Pilots were extensively trained and tested, and then re-trained. Finally, the airplane went through extensive flight testing to ensure that passenger and pilot safety would never be compromised.

Every industry, including healthcare, has unique challenges. However, I often ask if we utilize the “uniqueness of our industry” as an excuse rather than a valid difference. Healthcare struggles with the concept of unified and standardized process controls, as compared to other industries. We have come a long way in the past decade, yet each of us can likely rattle off reasons why we cannot standardize or why specific quality metrics are unattainable.

Imagine if the airline industry operated in the manner that our health system operates. Airline executives would justify the importance of balancing safety and efficiency under an umbrella of individuality. Standardization would be the goal, but many exceptions would exist. Pilots and support teams would develop individual approaches to flying; equipment and parts on the airplane would be tailored to individual preferences; flight times would be variable based upon different approaches to navigation; and cockpit design would vary. The impact would be increased variability, along with errors and rising costs. Supply chain teams would face significant changes in the way they approached sourcing, distribution, contracting, and support and maintenance functions.

In my opinion, the next significant advance in quality will take place when healthcare systems apply rigorous approaches to standardization, which place measurable value at the core of decision-making. Uniqueness is often embraced in healthcare, but the real test should be creating new approaches and technologies that are adopted by all practitioners within a health system. As executives driving the value chain in healthcare, we must continue to work with our comparable “architects, designers, and pilots” to ensure that the care we provide to our patients is safe, effective and free of error.

It is difficult to argue with the culture of safety that the airline industry has embraced. The record of aviation safety over the past several decades speaks for itself. There are some valuable lessons to be learned.

Gary Fennessy is vice president of operations and chief supply chain officer, Northwestern Memorial Healthcare, Chicago.

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