Opinion

Supply chain management remains a major health care challenge

Recently, I had the experience of sitting with a family member who had undergone surgery in a large academic health sciences centre.  The staff and the care were excellent.  However, I couldn’t help but notice the nearly relentless quest of staff searching for supplies and equipment.  Supply carts were everywhere – lined up in hallways, with rows and rows of plastic bins full of supplies and devices.  Staff worked their way through each bin looking for items, often asking their colleagues, “Have you seen any catheters?” or, “Do you have a portable pump?  I can’t find one on our unit.”  The constant hunt for supplies and equipment on clinical units is the challenge of supply-chain management in health care – the process that ensures supplies and equipment are available when needed for patient care.

Supply chain management is a complex process that includes everything from procuring supplies from distributors or manufacturers at the best price, to managing and tracing the shipments as they reach health care organizations, and then distributing the supplies to clinical units for patient care procedures.

Supply chain management remains a challenge for health systems.  Progress in the procurement of supplies, drugs, devices, and equipment has been achieved with the development of Group Purchasing Organizations, which use purchasing power to negotiate the lowest price on supplies for groups of health organizations.  However, the dominant focus on price favours large multinational companies that can tolerate narrow margins, and therefore limits access of health systems to innovative new companies with cutting edge technologies who cannot compete on price.

Strategies such as barcoding are used to track distribution of supplies for safety and standardization across organizations.  Although there has been progress, many organizations continue to rely on tracking supplies by hand, which too often result in shortages that can compromise quality of patient care.  The supply chain process that ensures supplies, drugs, and devices get from the loading dock into the hands of the health provider relies on staff to find what they need on supply carts in order to care for their patients.  Imagine the automotive assembly plant relying on workers to run back and forth to supply carts to find each hinge, bolt or wiper blade in order to assemble and manufacture a vehicle.

Retail stores, the automotive industry, even the travel industry have fully implemented supply chain systems that are very impressive. So, why hasn’t the health care sector reaped similar rewards using supply chain strategies?   Supply chain management in health systems needs to focus on creating efficient environments for health providers to deliver excellent patient care.  Cost savings and quality can be strengthened just by redirecting health professionals’ time from looking for supplies to managing patient care. Furthermore, enabling traceability and tracking can reduce errors and adverse events, which also reduces costs.

As I sat in that hospital room and looked out at the numerous supply carts, I wondered, how would Walmart organize this surgical unit if they were in charge?

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4 Comments
  • Belay says:

    health commodities supply chain management is continued to a huge problem for the health care service. though manufacturer may produce quality medicines, regulatory authorities build strong quality management system, donors continue providing supports…the problem found to be sustained. One big reason of this to happen is the length of the chain and its peculiarity. unlike other commercially managed profit driven supply chains, health commodities management consists of suppliers of supplies and consumers of consumers and lots of parties are highly involved. special characteristics of health commodities such as heat sensitivity, shorter life span, demand variability across the glob, diseases distribution variability, increasing trend of anti microbial resistance …requirement of special technical expertise throughout the chain of the supply management..all are directly affecting for the problem faced for the Health commodities SCM.
    One solution to alleviate the problem is donors, suppliers, manufacturers collaboration across the continent and using recent technologies at every component of the SCM.

  • Holisol says:

    Supply chain management is a complex job but technologies like predictive analytics, better visibility over the movement of goods, and robotics that help warehouses and distributions centres keep pace will all play a role in healthcare supply chain as well.

  • Denyse B. Lynch says:

    Certainly agree strongly with Anne Snowdon’s observations & comments; have also witnessed the scene Anne described in hospitals on more than one occasion.

    Implementing effective “Supply Chain Management Strategies” is not rocket science. It begins and ends with thorough consideration as to what constitutes quality patient outcomes, quality employee satisfaction, how these quality issues are measured or quantified and rewarded.

    “Quality, measurements, and rewards” have to be appropriately defined and quantified. That’s what distinguishes the Walmarts and other successful organizations.

    Unfortunately, and again I surmise, hospital leadership must not “perceive” high need to improve SCM implementations, nor, “perceive” high value in the benefits to be enjoyed i.e. cost savings and quality strengthening which Anne Snowdon mentioned. Otherwise, they would already be successful in their SCM.

    From a TQM perspective, I suspect that “how” leadership is measured re delivering “quality” and the “rewards” they currently reap, are sufficient motivation to avoid making improvements. Maintaining the current measurements of quality leadership and rewards, in effect, guarantees the status quo will be maintained.

    These are complex, long standing issues that demand “quality thinking”. We can only hope and support those leaders with this understanding and the willingness, cability and fortitude will take the lead and step confidently forward.

    • Tap Off says:

      Denyse Lynch
      …”Unfortunately, and again I surmise, hospital leadership must not “perceive” high need to improve SCM implementations, nor, “perceive” high value in the benefits to be enjoyed i.e. cost savings and quality strengthening which Anne Snowdon mentioned. Otherwise, they would already be successful in their SCM.

      From a TQM perspective, I suspect that “how” leadership is measured re delivering “quality” and the “rewards” they currently reap, are sufficient motivation to avoid making improvements. Maintaining the current measurements of quality leadership and rewards, in effect, guarantees the status quo will be maintained. ”
      Agreeing with Denyse from a project management perspective, seeing this in the clinical setting more frequently than I like to consider, and not just “supply” management. This *perception imbalance* seems to arise whenever there is NOT a systems oriented quality management approach from the leadership. It stems from a top down approach rather than engaging all parts of the system to help solve the problems that arise, for example when regions or areas cross each other. In such examples “turfology” is more the jargon than TQM.

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Anne Snowdon

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