Taking The Supply Chain Pulse
St. Onge’s Healthcare Hall of Famer and industry icon, Fred Crans, chats with leaders from all areas of healthcare to discuss the issues of today's- threats, challenges and emerging trends and technologies in a lighthearted and engaging manner.
ENGINEERING A BETTER HEALTHCARE SYSTEM
We provide comprehensive planning and design services to develop world-class facilities and highly effective support services operations. Our capabilities in hospital supply chain consulting include applied industrial engineering, lean methodologies, systems thinking, and operations research to enable improved patient care and staff satisfaction. We are proud to have worked with over 100 hospitals, including 18 of the top 22 in the US, utilizing diverse design strategies, post-construction implementation, and change management.
Taking The Supply Chain Pulse
Building Authentic Relationships in Healthcare Supply Chain: Insights from Brent Petty
Discover the secrets behind successful relationship-building in the healthcare supply chain with insights from Brent Petty, a leading expert in the field. Brent shares his wisdom on the vital role of non-technical skills, such as people management and understanding diverse mindsets, that drive success in healthcare environments. Understand how engaging with physicians by stepping into their world can transform decision-making processes, especially in light of evolving employment models that have reshaped traditional practices.
Communication is key, and Brent highlights strategies inspired by successful sales representatives that help shift mindsets by tailoring data presentation to audience perspectives. Explore the transition from a supply chain focus to collaboration with facilities, engineering, and design professionals, who approach their work with the same dedication a doctor has towards a patient. This approach offers valuable insights into managing healthcare facilities, akin to maintaining a metaphorical "$1,000 car," revealing the complexities of navigating such environments.
As the landscape of healthcare supply chain leadership changes, so do the challenges. Time constraints, leadership transitions, and generational differences are all part of the evolving dynamics. Despite these shifts, the core competencies remain unchanged. Brent reflects on his return to hospital consulting, emphasizing authenticity and genuine relationships as the foundation for success. Tune in to learn how staying authentic and relatable can drive success and foster strong connections in this dynamic and ever-changing field.
Hello again everybody. This is Fred Krantz from St Onge coming to you with another episode of Taking the Supply Chain Pulse. Today we're going to be talking to Brent Petty, a long time veteran in the healthcare supply chain who's worked in many areas. He's run big health systems supply chains, he's actually worked with consulting companies, he's worked with organizations that put on trade shows and he recently went back to independent consulting and is back in the fray again. So, Brent, welcome to the podcast. Hey, thanks, Brent, for having me. Well, it's my pleasure, buddy. So we only have 45 minutes, so tell us about yourself I don't know if you can do that in 45 minutes, but give it a shot and how you got to where you are today.
Speaker 2:Yeah. So, Fred, you know me, I can do 45 minutes without taking a breath, so but just a 30,000 foot view. You know I've had the privilege, like you said, of serving with in several different roles inside of healthcare. You know, similar to you, I've worked with suppliers, GPOs, as a consultant and, of course, I've had over 20 years as a senior supply chain leader in two different health systems.
Speaker 1:And now you're back doing it all again. So let's go through that. One of the things that you and I talk about a lot is one of the really important things about leading a supply chain and everybody hits on all kinds of technical stuff and knowing purchasing practices and operations and all that stuff, and I think you and I both agree that the non-supply chain aspects of the supply chain managing people and relationships are what's really important. Talk a little bit about that.
Speaker 2:Oh yeah, I think it's the core of health care, not just supply chain. I think managing the people and having a relationship is what health care is about. And I'll be straight up with you, fred, no different than us being colleagues and friends, it's all about relationships. I can tell you where I am today and anything I may have accomplished is because of my relationships. I can tell you where I am today and anything I may have accomplished is because of my relationships. You know healthcare, whether it's clinical side, non-clinical side, you got to know where the people are, not where you want them to be. You got to get to know them. You got to get to, to understand them before anything can move forward. And you know, fred I've learned this with you you never underestimate the value of a good conversation.
Speaker 1:Well, that's true, and the one thing I say that you and I both share and we've joked about this a lot is that I think we're both a lot brighter than we give the appearance of being, which is not a bad thing, because we're not really a threat to anybody, and I know, for example, that you get the most out of that southern down-home good old boy accent.
Speaker 1:So tell us your strategy there when you were working at the system at Wellmont. It is a good size system but when we started there were a lot of standalone community hospitals and in a place like Miami, for example, I was at Baptist and the chief competitor was South Miami Hospital and Doctors Hospital in Coral Gables and the doctors that were on the staffs were on all three staffs, so the doctors had leverage like you wouldn't believe. If they wanted something, they got it just by telling the administrator then that's what they were called, not the CEO what they wanted and they got it and we couldn't do anything because we couldn't control them. How did you go about establishing relationships with physicians?
Speaker 2:Yeah, that's a lot of trial and error. I'll tell you that. But first and foremost, I think we have to understand there's really two parts of physicians it's those that are over 50 years old and those that are under 40 years old. They were trained different, so you got to develop a relationship differently with them. But the common ground is that you've got to get into their world, not have them get into yours.
Speaker 2:They're not going to change what they do based on a financial need, a standardization need, a contract need, anything like that. You've got to go to them and understand how they were trained, and the first thing they're trained to do is figure out what's wrong. So you've got to get to them and let them get that out. Maybe it's data error, maybe it's timing error, maybe it's improper process or procedure. Whatever it is, they're trained to pick up on it. Then you've got to change their mindset to say, okay, let's concentrate on what's right as well, because they're just not trained that way.
Speaker 2:They're scientists, they react to data and they walk into a room and immediately assess what is wrong here. So I think that's the first and foremost is, you've got to get in their world and you've got to talk to them like they're used to being talked to. And the reason I said over 50 and under 40 is, you know, in school the under 40 year olds now are being trained to pay attention to the financials, pay attention to the how you can help manage or run the hospital, and that includes helping supply chain, looking at staffing. The over 50 crowd really wasn't educated that way so they're a little bit slower to develop that relationship with you.
Speaker 1:Yeah, and the other thing is that the over 50 group worked in those situations where they had leverage too, and many of the places now Cleveland, for example. In Cleveland, there are basically three systems there's Metro Health, which is the county hospital, there's university hospitals and there's a clinic. So in most of those places, the physicians are employed by the organizations now instead of being self-contractors, and it's a huge difference in the way you can go about the decision-making process now.
Speaker 2:Yeah, you're right, fred. When you and I started, I don't know that there was very many employed physicians at all. Especially none of the specialties were employed.
Speaker 1:No.
Speaker 2:It is a different world.
Speaker 1:So when you and I, I mean we are old, I'm really old, you're not nearly as old as me, I'm getting there.
Speaker 1:But you know, when we started out there were areas where the doors were totally closed to us. I'm just naming a few Pharmacy OR perioperative, the lab, cath lab and facilities, and we didn't even call ourselves supply chain. First, when I started, it was purchasing and central processing and distribution. Then it became materials management. Then ultimately, someone saw the word supply chain someplace and thought we should start using that. But these other places that I just talked about, the door was closed. I mean, basically what we did was just take care of the stuff that went to the floors, because those people in those places took care of their stuff themselves. So how did you go about burrowing into those areas to get them to work with you when you were faced with that?
Speaker 2:Yeah, you're absolutely right. When, Fred, when you and I started, the barriers were bigger than the silos were more defined. So it might not want to insult anybody here, but might be a little bit easier today. But the key to it is realizing and helping them realize what they need. And I can tell you the two biggest things they need that you have to help them realize sometimes that supply chain can bring is bandwidth and expertise.
Speaker 2:Okay, okay, sometimes they just don't have the bandwidth to do that inventory project, to do that deep dive into general ledger to determine why case costs are different or, you know, site of care is a different one big in pharmacy. The OR doesn't have time to look at the non-clinical side of it. And you can bring that bandwidth in. You can can say, hey, let my analyst come in here and look at this with you, let me put some inventory or buyers into your area to help you manage that. So I think you've got to bring up two key areas, that's bandwidth and expertise.
Speaker 2:And you know there was a time in my career that I talk a lot of these areas that you're talking about pharmacy, surgery, lab cath, lab, facilities, how to read the general ledger each month. You know how do you and I would relate it to their checkbook how do you balance your checkbook? We're going to balance our monthly operating report the same way, and once you start doing that, that's expertise that we have, that they don't. But on the same hand, fred, you know you got to respect that they are still the subject matter experts over their area. So with that, with that respect, and you bring that bandwidth and that expertise to help them, you become in their eyes, the maestro.
Speaker 2:Okay, so you think about a maestro leading an orchestra. The maestro doesn't necessarily know how to play the flute, the drums, the trumpet, all that, but they are leading those who do know. And that's how you have to think about penetrating these areas that are high cost, very strategic, very clinical. So you become that maestro that you're leading them but you're not doing what they do. And you certainly do know when the instruments aren't getting played. You do know when they don't show up for practice and those type things. But you act as that maestro over those subject matter experts and that's how key relationships are developed there.
Speaker 1:So, without naming names, what was the most difficult nut you had to crack?
Speaker 2:Yeah, it was definitely the physicians in, you know, in that area where they were used to walking down the hall. Because when I started in healthcare, Fred, a surgeon walked down the hall, stand in my door and say, hey, I need this for the case next Monday, and I was immediately getting the PO issued. And to crack that nut to say let's talk about areas that are affected by your decisions of doing this case next Monday was the toughest nut. And you know, I saw a physician look at someone in a meeting, a C-suite person, and said, well, you didn't go to medical school. And this person had the best response. He looked at him and he said you know what? I never played in the NBA, but I didn't have to to know what a good basketball is. Yeah, and so it's come a long way, but cracking that clinician's nut to be part of that subject matter expert team was probably the toughest.
Speaker 1:Well, I've heard you and I get our point across most of the time by telling stories. Sure, excuse me and I've heard you tell some stories about some of your battles and successes. Tell us about some of the successes you had in changing the minds of some difficult folks.
Speaker 2:Yeah. So what I learned real quick was two things One was how they viewed data and two, what sales reps did, because you know what you look back in, some of the toughest relationships that we had to conquer was solved by the sales rep, if that makes sense. So I looked at some of these reps and they had these great, just great relationships, yeah, and I mimicked that. So what I did was I watched the sales reps and as they developed their relationships, what they were doing is providing a resource of education, of product knowledge, of process knowledge, those type things. So I started mimicking the same thing that they would do. I would go to their office and set up an appointment to meet to show them something. But also with the data piece of it, I was like man, I'm putting out all this great data.
Speaker 2:I had a, you know, in the old days had big one inch binder we put out every month for them to look at, and I started noticing that where I put that binder on their desk, it was still there the next month. They didn't even look. They didn't even look at it. So I looked at it and I said how do they handle data? And you can look at a lab report that a physician looks at and here's all the tests they performed and here's what's out of whack. So instead of showing them everything, I just started showing them here's the overall financials and here's where you're out of whack, and they're used to addressing it that way. So that was really the way that I had success in those areas, was following other processes that were already successful and just mimicking that, and all of a sudden they started responding brilliantly to it.
Speaker 1:You said about the sales reps being a key to helping solve the problem. I would also say that many of those sales reps were also the key to causing many of those problems.
Speaker 2:They may have created a few.
Speaker 1:One of my best friends that I worked with years later was a Medtronics rep and he would come in to go visit the doctors and he would be outside of materials management in the office. Never talk to me, never say hello. You know, didn't have to, went up, dealt with the doctors, got what he wanted. Boom, fifteen years later we're working together together. Now we're best friends. I said how can we be best friends? You never talked to me before. That's right, never had to. You know that that was that, was it so? So, uh, just going going to them personally and mimicking things to build good relationships with data is what you worked with. Well, well, here's what was interesting is that for the last few years you sort of transitioned away from what I would call supply chain and you were working with an organization that was having trade shows about facilities and engineering and architects and design work. Tell us what was that like when you first started doing that? Was that a whole new world to you or what?
Speaker 2:Oh yeah, I had no clue what I was thinking when I got into that piece of it, because you know all those 20 years that I walked the halls of the hospital. You know I spoke to those guys on the elevators. You know I've sat at the lunch table with them. I was in the big leadership. You know I've sat at the lunch table with them. I was in the big leadership meetings with them. But I really didn't know our facility leaders. I didn't know our architects and our our clinical engineers. I didn't know them from a business perspective. So that was the other side of the hallway, right. So I jumped into this, this association that that really worked with these folks and what I really learned is their challenges and their processes are very unique inside of healthcare. You know, the big picture of caring for the patient really hits home with these people.
Speaker 2:And you know what I learned, fred was really neat that when these architects in these facility plant operations, clinical engineers, when they look at a building, it's like a doctor looking at a patient.
Speaker 2:That's how they look at these buildings and they have to assess them and they see that you know, hey, this is a newer building.
Speaker 2:Doctor may say, this is a younger patient, this is a newer building, with, you know, hey, this is a newer building. Doctor may say this is a younger patient, this is a newer building, with, you know, certain upgrades and they don't necessarily need this kind of proactive care or preventative care. But then there's the older side of it. You've got these architects, the facility guys, plant operations engineers going hey, this is an old building and she needs some tender, loving care and this is how we need to address it, how we need to update it or upgrade it. You know, I really learned a lot on that side of the hallway because these guys really see the building and what they care for the design for the patient and the staff, whether it's old or new. They really handled it like it was a human and very much like a clinician handles a patient, and I was shocked about how diverse they really were with handling every type of facility, just like a doctor would handle every type of patient. It was really unique.
Speaker 1:Yeah, what, what, uh. Yesterday I was thinking about this and uh, there's I don't know if you listen to country music or not, but there's a there's a group called the Bottle Rockets and the Bottle Rockets had this song called $1,000 Car. And I look at these IDNs that are expanding and they'll go acquire a system to just gain those covered lives. But they're getting 10 buildings that are at different ages and all this stuff they bought a $1,000 car in. There is what they've got and what they have to do is decide what you just talked about.
Speaker 1:Are these things usable? How are we going to use them? How is this new acquisition going to fit into our overall strategic plan? And do we just raise the buildings and take the covered lives or what? But they have to make those decisions and it falls back on the facilities people to come up with solutions and make whatever they decide work. And I think you hit on that a little bit. But I just can't imagine that, because I can close my eyes and think that I don't think there's a health care system in this country. I don't think there's a health care system in this country or a community hospital in this country that you could acquire that didn't have a sterile processing operation. That was in need of upgrade.
Speaker 1:I can't think of one, and these guys, the facilities, folks, are stuck with that. So how would they relate that to you? Did they look at it as a problem or an opportunity?
Speaker 2:Well, it's a problem with an opportunity behind it and but. But, fred, I'm happy to say what I've learned with working over with the facility guys the architects, engineers, designers, uh, all those folks over the past several years um, you know their fortitude to get what needs to be done done. But what I have proudly discovered is the C-suite has determined that this internal team facilities designers, engineers and their supplier partners have to be part of every strategic plan. That is something that is changing. I think supply chain has made a little bigger or an earlier leap, but I'm seeing this team now being included in that strategic planning, those forward-thinking C-suite ideas that they're leaning on these facilities engineers, designers and all that. The architects included much more and earlier in these plannings than they ever had before. So that's the good news that has come out of this.
Speaker 1:Yeah, and I think the fact that we're talking with each other now as peers and colleagues is important too. I really enjoyed going to those meetings, cause I knew next to nothing about what they did, you know sort of like you, you know. So you were. You were the leader arm for a year. You've had heavily involvement, heavy involvement, there. How did, how was your experience with arm and and what do you think its future is as far as fostering and developing the new leaders for the discipline?
Speaker 2:Oh, wow, we finally got to a tough part here. So I really enjoyed my time that I spent on the armed board. You know, I was a member of the board for three years before I became the chair elect and then I did, like you said, serve as the chair of the board for a year and then they have an honorary position afterwards that's a past chair for a year. So I spent six years on the board of directors of ARM and I can tell you today ARM is re-imaging itself because the stakes are a lot higher. You know, right now we're all sort of trying to figure it out that what are the biggest stakes that are higher, and what seems to be coming up is two things. One is time. You know it comes up all the time. We just don't have enough time to do what we need to do. Well, my thoughts is you need to get the subject matter experts involved, which lots of times are the supplier partners. They're really the subject matter experts. So get them involved and get their advice to helping you. But I'm trying to dig in right now, and Arm is too, about the time. Is it because we have so much more to do or is it because what we're doing is taking more time and I think we've got to get to that. But, fred, the big thing that Arm has got to address is the change in the leadership that's in supply chain.
Speaker 2:Today, in the healthcare supply chain, you and I came up the ladder with experience. We walked the hallways, we talked to the doctors, we had lunch with the facility guys. You know, we were standing outside the OR, we were through the ER. We knew where the loading dock was and what times the distribution truck got there. Our new leaders aren't coming up that way. They don't have that experience. We knew where the loading dock was and what times the distribution truck got there. Our new leaders aren't coming up that way. They don't have that experience.
Speaker 2:I mean, I went to a very well-known health system not long ago and was helping a company do a glove project and we were going to write a white paper on it and I looked at the director and I said you know shooting the bull before the meeting started and I said how long have you been here? And he said about two years. And he said are you going to tell us how to glove? And I'm like no, no, no, no, we're going to observe how you all glove and write a white paper on it. And he's like, oh, and I said, do you know how they glove up in the OR? And he said no, I had never been up there. And I said, oh well, a couple of years in, it's about time to get your feet wet. I'd call the OR director and say, hey, I want to come and see what you all do. And he said no, I didn't mean I hadn't been up to the OR. He said I haven't been up to the hospital.
Speaker 2:So there's a whole new strain of leadership that's coming in that hasn't worked and that's very different than a lot of the leaders that have the experience. Like you and I did, we were in a hospital at one point in our careers. Oh yeah, so that's a whole different management perspective, a whole different avenue. When I talked about setting up PAR levels, I had an image of an inventory in a procedural area in my head. The new leadership hasn't been exposed to that, so it is a little bit different. And of course, you know what arms got to face too is what the challenges of that. The experience is different, but also the resources and the technology that's available that you and I didn't have as we came up through the ranks.
Speaker 1:That's available that you and I didn't have as we came up through the ranks. Yeah, that's something else. The other thing is I think it was last year I went to the young professionals presentation at ARAM and I think it was you that told me that at any given point in time in any organization there are six different generations that are working.
Speaker 1:And you have to understand how each of those generations sees the world in order to deal with them. And the interesting thing about the young professionals was some of the things they got upset about were things that if we had gotten upset about that when we were working, we would have been outside the building in about two minutes wondering what the hell happened to us.
Speaker 1:No, I know yeah, right yeah but uh, but, but they are they. They are much more formally trained than we were, you bet, but I could close my eyes at baptist hospital miami and tell you if I was out of something, on which floor and which storage cabinet I could find one that was already there and they can't do that.
Speaker 2:Yeah, at Russell County Medical Center I knew what the OR was before I went down there. I mean what they were out of. I knew the ICU medical or the ICU department at Holston Valley. I knew what they needed before I looked. Yes, I knew what they used, I knew where it was, I knew space constraints. I knew where it was, I knew space constraints, par levels and all that. I'm not saying it's good or bad, it's just different. Yeah.
Speaker 1:And you know we go things like linen management. Well, suppose we only change the bed every other day. This is scientific. We'll save X amount of dollars. I was a nursing assistant going to college. I would go in. They all knew I was going to college. They say uh. I'd say uh, um, mrs jones, you want your bed changed today. Well, how are you doing, freddie? Well, I got it. I got a final coming up this afternoon. I got to start. Oh no, I don't need my bed changed. I save more money by by talking them out of it than anything else, right, but anyway. So on that note, in recent months you've gotten back into the groove. You've become a consultant, working in a real hospital with real patients again. How does that feel and how tough was it to get back in the groove?
Speaker 2:Hey, fred, you know as good as I do that. It's in your blood. You know, once you've done supply chain in a hospital, it never leaves you. It's like being in the military. You're always part of that family, forever. And same thing with supply chain. So get back in the groove of putting my elder years behind me here.
Speaker 2:The fundamentals and the core competency of supply chain remain the same, fred. They do. The resources are different, technology is different, training is different, how they get into leadership roles might be different, but that fundamental core competency part of supply chain remains the same. So it was like riding a bike. You know I wasn't as good as I was I once was but I'm still. You know I'm still there and you know you're still supporting the clinicians and understanding what it takes for them to treat that patient.
Speaker 2:So, with the fundamentals being the same it was. You know I got the pedals turning on the bike a little slower than I used to, but I'm up to speed now. Are you enjoying it? I love it, fred, I really do. You know to look over and you know the team I'm working with is young I've been in health care longer than some of them have been in live and to see and explain how these hospitals work. With a new team I'm building a team, we're going to have a team of seven I've got three so far, got four more to go and to educate them on those true core competencies and the fundamentals that need to be there to support that clinician, whether it's, you know, to the patient side of it or just making the staff satisfaction better.
Speaker 1:It's very rewarding and you've had that experience, you know it's very rewarding to get those things accomplished yeah, and I think that one of the big advantages that you have and I say it because I think I have the same advantages we talk to people at their level, we are not overwhelming to them, we're not intimidating to them and because of that, they listen and want to participate, and that's a cool thing. Yeah, you know you said that you've been in health care longer than some of those folks have been alive. Next year, 2025, will be the 60th year that I've been in health care, because I started as a Navy hospital corpsman back in 1965. So I've been in health care longer than most of the people in my company have been alive. It's sort of sad, but it's true.
Speaker 2:Well, the alternative, you know.
Speaker 1:So, anyway, you know what did I forget to ask about that? You'd like to talk about Brent.
Speaker 2:You know what, fred, I appreciate you allowing me to share. First and foremost, Thanks for doing this, thanks for getting this message out here. Like I say, a good conversation, never underestimate a good conversation. This is what you've allowed, fred, and I appreciate it.
Speaker 2:But the only thing I would bring up that we may have not completely got touched on was investing in yourself. You know, staying relevant, and I don't know if we're doing that as much as we used to or as much as we should. You know I see you at some of these trade shows. You have branded yourself and I'm jealous of it. You know everybody knows Fred Krantz. When they see Fred, they know you as your brand. But you're also there staying relative, keeping up to date, getting further educated, getting very knowledgeable about the core competencies, the fundamentals and how they change. But also you spoke about the generations. You now you understand there's multiple generations that we have to deal with. You know those are just things that you're keeping up to date on and that's called investing in yourself. I think that's probably one thing that, if I were you, I would get out across. Your messaging is let's keep investing in ourselves and staying relevant, and that'll make us better as a whole in health care.
Speaker 1:Yep, that's true. It's like Yogi Berra said. You know, you can observe a lot just by watching. You know?
Speaker 2:Yeah, that's true.
Speaker 1:Hey. Well, brent, as I knew it would be great to have you on here. I really think that I think you have something that you really could get across to people that's valuable, and that is you're able to get over yourself. You're down to earth, you're for real, and if you're for real, that comes across. You know, I, I, I get away with a whole bunch of stuff because I'm who I am and people know it. But, and, and if you could teach people that, along with the skill sets they need, I think I think that's, I think that's the gift you have. It's something I learned from you a lot. I mean, I picked up an awful lot from you and I appreciate it. So, thanks for being on the show, and you're going to be at ARM, yes, sir, okay. Well, we'll see you in about a week or so. Whenever that is, yeah, I'll buy you breakfast. Okay, brother, have a great weekend, have a great day.
