HOSPITALS FEEL PINCH OF SUPPLY SHORTAGE
Patient care not affected, officials say
Keeping a hospital running with a full complement of needed essentials has been a job complicated in recent months by shortages.
Unlike early in the COVID-19 pandemic when it was tough to find disposable gloves, masks and gowns — known as personal protective equipment — now there are different things that are lacking. And, to complicate matters, it varies day to day.
“”What we’re finding now is that on any given day it’s a different product that there’s a disruption on. It’s really trying to get proactive information and visibility into the full supply chain so we can try to predict what might happen,’’ said Melanie Fisher, supply chain senior vice president at Beaumont Health.
“So it’s different products on different days. Aluminum crutches have been an issue for many across the country. … This week cold packs are an issue, styrofoam cups have been an issue. It’s really running the gamut of where we have disruptions,’’ Fisher said.
Hospital officials in Southeast Michigan al agree. They wake up every morning to potential new shortages. However with their savviness at finding different vendors, planning ahead and problem solving, patients have not suffered.
“Different items hit us differently depending upon the week. I think two items of the hour are crutches and a lot of that has to do with the magnesium that is used to harden a lot of the aluminum in the crutches. There’s been an international shortage of that raw material. We’ve actually managed that — we’ve got quite a decent amount coming in the next week. We haven’t had any disruptions in care as a result,’’ said Bill Moyer, senior vice president of supply chain management at Henry Ford Health System.
“The other item we’re seeing this week is suction containers and liners, but again we’ve never topped out in recent memory where we weren’t able to sub out with an alternative product,’’ Moyer said, explaining that suction liners are used in hospital rooms to dispose of infectious medical waste.
“There really is no product that hasn’t been impacted from the supply chain as a result of this pandemic. It’s everything from basics in food — applesauce, pudding, jello, forks, spoons, bowls — to more important medical supplies to construction supplies,’’ said Frank Sawyer, CEO at 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 work this way and now post pandemic it works differently. So we have to problem solve and pursue different channels to get what we need. Across the board we’re always able to get what we need; it just might take a little more work.’’
At McLaren Oakland in Pontiac they’re seeing issues from all the vendors.
“Even computers — we have a dire need for laptops and desktops for replacement and broken computers. And they’re back ordered. Things you wouldn’t expect, not even medical supplies, we’re finding a lag time or a no time because we don’t have a delivery date,’’ said Margaret Diamond, CEO at McLaren Oakland.
“Our suppliers don’t have staff. Healthcare — we’re down because of our bedside nursing shortages — a lot of the supplier companies who produce wheelchairs and durable medical supplies — their staff is short too which means their production is cut short,’’ Diamond explained.
A shortage of construction materials has slowed down the progress of reconstructing a lab in the basement at St. Joe’s where all the hospital lab testing is done.
“Everything from steel piping for plumbing to wood for case work, tests, chairs, vinyl flooring all of that is impacted. You’ve got to have really good sourcing people that can find alternate products to keep the projects moving,’’ Sawyer said. “At worst the projects are delayed from a timing standpoint, but they also progress towards completion.”
Construction issues have also delayed the construction of a new McLaren facility in Oxford.
“We’re trying to build an entire new clinic on our Oxford site. We have an aging building there. Every building supply is 6 to 8 months delayed. We were supposed to break ground and start building in the spring and we may start building next spring,’’ Diamond said.
All the hospitals learned from the personal protection equipment shortage that hit at the beginning of the COVID pandemic in March 2020.
“We planned ahead quite a bit as far — particularly for our PPE — at Henry Ford we’re incredibly healthy in our PPE supply which as we all know was in the pandemic the big term that everyone learned,’’ Moyer said. “I think the thing we’re seeing internationally is potential supply chain shortages in categories that people didn’t anticipate whether that’s due to raw material shortages, labor shortages, shipping issues, etc. We’ve actually been working on a plan for months to get ahead of any of those issues so we don’t have the same disruption as 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 fill his supply needs.
“We have supply chain opportunities that are much bigger than one site going at it alone. We additionally 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 access to those things and has sheltered us from some of the issues in the supply chain.’’
Early in the pandemic McLaren Health Care announced that it partnered with Premier, Inc., a leading healthcare improvement company, to acquire a minority stake in Prestige Ameritech, the largest domestic manufacturer of PPE products, including N95 respirators and surgical masks.
So getting PPE is not a problem, but Diamond at McLaren has other issues.
“I couldn’t have fathomed the extent of how it would impact daily operations,’’ Diamond said.
These administrators have all proven they can make adjustments on the run. It helps that they get support from the medical staff too.
“What we’ve been working through is finding alternate sources for products, following different protocols, stretching our inventory, really looking at creative solutions similar to what we did in COVID in that vein, where we’re diversifying our vendor portfolio to find other vendors that might be able to supplement our inventory,’’ Fisher said. “For example, with styrofoam cups finding a different size if we can find that available, or a paper cup. We’re trying to work through this to make sure we don’t impact patient care.’’
The administrators hardly work alone.
“We have working teams that focus on these issues literally daily. I have a team of supply chain people at the individual hospital, we have focus groups of leaders all across Trinity that convene to address a plan,’’ Sawyer said. “Additionally the way we manage our inventory we can see weeks if not months out where we might have issues and we start planning and taking action for a potential shortage well before we are out of stock of a glove or a syringe or something important,’’ he added.
All the crystal balls must be stuck on ships in the Los Angeles harbor too because no one knows for sure how long the supply chain shortage will be a factor for hospitals.
“What our sources tell us and, I think everyone has an opinion on this, but we’re anticipating that the international supply chain won’t normalize probably through 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’s seen projections that it will go into the second quarter of next year.
No one knows for sure. “We can place orders all day long, it’s a matter of those orders being filled. A lot of vendors have gone to an allocation method. Meaning they would take our historical demand or our historical purchases they would say we’re putting Beaumont Health on allocation and you can only order 75% of your historical demand,’’ Fisher said.
“That allocation method is different vendor to vendor for time frames they measure, the percentages are different. That’s the way manufacturers are trying to stretch their inventory,’’ Fisher said. “So while that’s the right thing for the global economy and all of healthcare i think that’s where we are.’’
It is the new normal, at least for the foreseeable future.
“The teams are able to problem solve to make sure the quality of care is still given and through all of this, with all the challenges, we are still providing the same high quality care we were before the pandemic, if not even better,’’ Sawyer said.