Reflection and Renewal

Understanding what we have been going through, how we will get through it, and what steps we need to take to prepare for the next crisis.

I do not imagine that I’m alone in the fact that much time over the past few months has been spent in reflection. The massive amount of information and inaccuracy of the information being reported has been overwhelming and confusing; specifically, as it relates to the healthcare supply chain. I am fearful that finger pointing may result as we begin to reflect upon the process by which we source, procure and manage inventory. Most importantly, I hope that we have learned from this crisis and are willing to renew our partnerships in a more innovative and improved approach to manage our supply chains. 

Let’s break the past several months down into phases and then project what might come next. 

Phase I: Prepare. Most partners, both providers and suppliers, activated an emergency preparedness of some sort. We began to increase inventory levels as the market allowed and, in some cases, might have begun to “hoard.” Suppliers began to ration supplies based upon customer status, contracts and relationships. Providers began to lock down or more closely monitor specific PAR levels, locations and allocation of request by departments. 

Phase II: Frenzy. This may seem insulting, but a frenzy is defined as an intense, often wild, state that is disorderly or agitated; a period of great energy and activity. As I search for a descriptor for the activities that supply chain endured during the height of the crisis, this definition seems to be appropriate. Providers and distributors were sourcing supplies from new and even unknown suppliers, breaking traditional rules and historical barriers of acquisition. All through limited visibility. Manufacturers began to break down barriers to increase or modify production at unheard-of rates. 

Phase III: Support. With the continuation of intense projected needs and unknown timelines we move into a state of sustaining a pace we have no way to understand or predict. We call upon our basic supply chain management skills and adapt them to daily practices that we have never before experienced. We have little-to-no visibility upstream for availability, nor downstream for demand. We are expected to make available supplies that we have limitations in how to source nor any way to know when they may become available. We are woefully ill-prepared to sustain this level of support yet relied upon to do so.   

Phase IV: Reactivate. When stay-at-home directives and quarantines are lifted, we will need to think about the reactivation of our regular healthcare delivery system. Specifically, return to the new normal in our hospitals and care facilities. How do we clean, restock, reconfigure (back to the original designed state) departments? We will need to return the overstock of beds, oxygen cylinders, ventilators, room dividers, tents, trailers and excess emergency technologies; all while continuing to source and procure still limited supplies. We will likely be very conservative in this phase of activities as we “will never want to go through this scramble again.” So what do we keep, store or rethink regarding stock levels (JIT), sourcing and procurement processes?

Phase V: Renew. I am confident we will come out of this pandemic renewed. I imagine that when we can all come together at a conference or meeting, we will be reflecting on this crisis for years.  

Revise our processes

So, at these future meetings, rather than finger pointing and talking about all the issues, problems, and shortages, we must spend the valuable time together to revise our processes for the future. Through lessons we have learned, we need to provide greater visibility into the healthcare supply chain. How do we bring suppliers and providers together in true collaboration to improve? We will need massive postmortem analysis, new playbooks and policies, and enhanced procedures for the entire supply chain – providers and suppliers. 

We must work together as a healthcare continuum rather than individually. We discovered what does not work, so now we must renew and focus on what did work and what can be improved upon so the next time – and there will be a next time – we will be stronger, smarter and nimbler to achieve a healthier supply chain for our clinicians and patients. 

As we have learned through this crisis, supply chain is the backbone of healthcare. We have a responsibility to reflect upon and renew our profession, partnerships and dedication to improve the process for our future. There has never been a better time for supply chain to promote our importance and sell the improvements we will make through the refection and renewal that we have an opportunity to achieve. The time is now, and I sincerely hope we seize the moment.

Dee Donatelli, RN, BSN, MBA, is vice president of professional services, TractManager, and principal of Dee Donatelli Consulting, LLC. She currently serves as chair of the Association for Healthcare Resource and Materials Management (AHRMM) board, is a 2015 Bellwether inductee and serving on Bellwether Board. She is past president of AHVAP.