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
Elevating Healthcare Supply Chains: Insights with Jane Pleasants on Strategic Collaborations and Global Missions
Jane Pleasants shares her inspiring journey from education to becoming a key leader in healthcare supply chain management. The episode discusses the challenges and opportunities within academic medical centers and highlights the importance of collaboration and patient-focused strategies in transforming the healthcare supply chain.
• Overview of Jane Pleasance's career path
• Insights into academic medical center supply chains
• Importance of leadership credibility in healthcare settings
• Role of SMI in fostering collaborative partnerships
• Lessons learned from the mission trip to Zambia
• Emphasis on keeping patient care at the center of supply chain strategies
Hello again everybody. This is Fred Kranz from St Onge coming to you with another episode of Taking the Supply Chain Pulse. Today, our guest is going to be Jane Pleasance, the Executive Director of the Strategic Marketplace Initiative. Jane has had a distinguished career in healthcare. The Executive Director of the Strategic Marketplace Initiative. Jane has had a distinguished career in healthcare. She was a Bellwether League inductee from the class of 2015, with a long career in academic healthcare, which we're going to talk about today. Jane, thanks so much for being our guest.
Speaker 2:Thank you for inviting me.
Speaker 1:It's going to be fun. Tell us a little bit about yourself, Jane, and your career in health care.
Speaker 2:Sure.
Speaker 2:So I actually started out as a teacher and I had an interesting journey in that I ended up having three children about 18 months apart, three little boys.
Speaker 2:When I went back to teaching I realized having kids in the morning and kids in the afternoon wasn't going to quite work for me. So I stopped and paused for a few minutes to rethink my career which was a challenging time for me, as you can guess and I got invited to be the materials manager for a very small community hospital, about 70 beds, and thought, well, I guess I could learn this. And I was there for about a year and at that point decided maybe I needed to go to a larger hospital and learn a little bit more about supply chain and just be on the staff. And so that's when I started my work at Vanderbilt and that's my entrance into academic medical centers and I totally enjoyed and embraced the values, the culture of an academic medical center and perhaps it aligned with my educational background as well. But that's where I got started, and then my journey has taken me from Vanderbilt to the University of Rochester and then ultimately and finally to Duke.
Speaker 1:Well, you know that's interesting because you started out in academic medical center so you, like, knew nothing different when we talk about this. I came from outside of academic medical centers to doing a huge project at Vanderbilt after you had gone to Rochester. And when you walk into that environment for the first time you're learning that things are often different there than in the normal. The quote normal unquote a non-for-profit community hospital system. But I did the math and it tells me that if you had three children in 18 months, there's got to be a set of twins in there someplace.
Speaker 2:Oh no, Each one was 18 months apart.
Speaker 1:Oh, 18 months apart.
Speaker 2:Yeah, Three children 18 months apart each one.
Speaker 1:Okay, I'm glad we cleared that up. Yeah, so let's talk about your experience in academic medical centers. As I said, norm Ermey, I think, was probably the CEO when you were working at Vanderbilt, and it's like his retirement project. He had two things he wanted to do a deep dive on the supply chain of the medical center and they also needed money, because I learned that the medical center supported the university and I never would have thought that A medical school.
Speaker 1:Yeah, it was a completely foreign environment to me. It was a completely foreign environment to me. So tell us about what you did there and did you think it was strange while you were working there? Have you found out that it was strange later? I don't know.
Speaker 2:Well, you know, my first goal was just to learn supply chain in an environment that I knew wasn't going to be likely bought out by any organization. That was one thing, but also I liked the idea that at Vanderbilt we had responsibility supply chain for both the university and the health system or the hospital. At the time it wasn't a health system, but what I found about the culture in an academic medical center and this is what stayed with me through my tenure at Rochester and then ultimately at Duke is that the physicians that you interact with in your clinical team were all part of one organization and in other words, you sort of all were aligned to the same goal. Now health systems have evolved a lot, they've acquired physician practices and that, you know, has changed a lot. But back at that time your physicians were all community physicians and so gathering them together to try to think about strategy and how you're going to align them to wherever you wanted to go from a supply chain perspective could be particularly challenging.
Speaker 2:But in an academic medical center, if you could get the cardiology group or you could get the surgical services group together, there were a lot of really great things you could do together because the physicians were so aligned with your mission in that academic medical center, and it was that mission alignment that I found to be so rewarding. The other element of it was just always wanting to do something new and innovative. You know, that's the way academic research, academics are. Research drives you that way, and so you had to be somewhat willing to kind of step out there and do something new and innovative, because that's where your clinical team's heads, you know, go every single time in an academic environment. Again, as these academic medical centers have become health systems, some of the culture has changed, but certainly back then that was the case.
Speaker 1:What was interesting when I got there was that clearly, the hospital supply chain, if you will and it was the hospital reported to the supply chain leader for the university, supply chain leader for the university. And I was about I don't know three or four years, maybe five years ago. I was at a meeting and Teresa Dale was there and as you know, teresa Dale runs Vanderbilt's supply chain now. And she said in a formal setting, she said I really need to thank Fred Kranz. Because of him I have my job. And I said, teresa, what do you mean? And she said well, I understand that when you were here with Accenture, that you got asked by someone what your opinion was of the healthcare supply chain and your response was you don't have a healthcare supply chain, you have a supply chain that reports. You have a healthcare organization organization that reports the university supply chain. If you want to have a health care supply chain you have to establish one.
Speaker 1:And she said because you said that they made the changes that bought George, the fellow from Orlando that she worked with, and then her Did you notice? I found out when I was at Vanderbilt how much money they spent on concessions for the football games. That's the kind of information that we were going through, trying to figure out things about the healthcare operation. Do you think that you know, setting those things up separately was ultimately a good thing for Vanderbilt?
Speaker 2:Well, certainly at the time, given whatever was the driving force of that it was. But what I will? If you take a step back and you think about, you're sitting on a campus and I'm not speaking to Vanderbilt. I can speak to Rochester and also to Duke, and I'm not speaking to Vanderbilt, I can speak to Rochester and also to Duke. You all, your organization, is sitting on a campus and you have vendors that are calling for you and calling on you, and how do they know often which contract, which service they're actually working for?
Speaker 2:And there's this huge overlap. In fact, as I looked at it when I was at Duke, the overlap between the vendors that did business with the health system and the university were huge. In fact, that volume was close to. If you removed drugs and medical devices out of the spend, you would find that there was more spend that was aligned than was not, that there was more spend that was aligned than was not. So if you're thinking strategically and you're trying to aggregate volume and the culture allows and works together as partners, you can do really good things.
Speaker 2:The other element that you have to consider is whether or not you have a shared procurement system or ERP procurement system or ERP, and you know boards, trustees, are always asking how can you have two separate ERPs and the costs that's associated with it? So if you're able to realize and accept that the culture, the procurement and supply chain on a university campus is entirely different than the procurement and the supply chain on the health system side that's research procurement is even different because you've got federal grants you have to comply with. So if you can put on all those different hats and work through the different cultures and still bring them together where they have common interest and common spend, then you can thrive in that kind of environment. But it's not without a lot of work, no doubt.
Speaker 1:Well, you just brought something up that I'd forgotten about, and that was, you know, the way our contract was structured. They were trying to hit a certain goal I think it was $19.5 million. They wanted to save, and so our folks just went at it and one of the biggest savings that they identified conflicted with research. And it was like a huge savings it may have been $4 million, something like that and it got dropped right in its tracks because it was a conflict with the university, with some research agreements that were out there. That was a difficult learning process for me.
Speaker 2:I mean, I would never have considered that working in just regular private health care, Well, I think that's I mean, that's a great example and at times that does come into play. But if you have one head of the supply chain, you can manage through those particular nuances that you're faced with. But it does go back to the fact that those cultures are very, very different.
Speaker 2:Yep, so so you're a kind of tool doesn't. Supply chain tools don't necessarily work in an academic research environment. You don't have perpetual inventories very much in research and in the university. So you have to think about, as you're developing out your tools, how are they meeting the procurement and the supply chain needs of each of those groups?
Speaker 1:Yep. So you sort of had a building block career. If you think about it, you went from Vanderbilt to the University of Rochester. So how did you take what you learned at Vanderbilt to Rochester and what were the challenges there?
Speaker 2:So what I have to say is the cultures are very, very similar.
Speaker 2:Each one of those academic medical centers have their uniqueness, but at the end of the day, you've still got the medical school, you've got academic research going on, you've got academic research going on, you've got medical research going on. So I think getting the exposure to a lot of different kinds of technologies when I was at Vanderbilt was huge. I'm not sure, fred, if you remember, but they had a major partnership with ESI and we had co-developed different kinds of point of use technologies back then together, and so I had learned an enormous amount while I was at Vanderbilt From just in time, we implemented a stopless inventory system to all of the technology that we implemented. So when I went to the University of Rochester, I had that background and that experience. I think what was the experience I gained at Rochester that helped me when I went to Duke was that it, rochester, was one of the very first academic medical centers that actually became a health system, and that was almost unheard of, as you know, because most academic medical centers in the hospitals were standalone.
Speaker 2:And the University of Rochester, you know well, before most all other academic medical centers decided to become a health system while I was there, and so I got the experience of merging and acquiring community hospitals with academic medical centers, acquiring community hospitals with academic medical centers, and when the call came for Duke, that was the experience that I was able to lean on when I came to Duke, because it was I think I was the second health system employee at Duke when it became a health system.
Speaker 1:So once again, you're building blocks where you learn. You learn different things at rochester. You actually what you, what happened at rochester? And, by the way, I'm I was born and raised in upstate new york. I'm from corning, new york, which is about 60 miles from rochester, um, but you uh, you sort of learned system this, uh, for the first time at rochester.
Speaker 1:And then you went to Duke and you know, without being overly complimentary, you built a real powerhouse at Duke. I mean, you came in there and built that into a prestigious healthcare supply chain operation. How did you go about building? And I'm thinking back to Vanderbilt before Teresa and I'm thinking I don't know about Rochester, but at Vanderbilt the supply chain was pretty much a transactional support service. It wasn't a C-suite operation and I don't know what it was like at Rochester. But during your career at Duke I know you built the organization to where you were an integral part of the C-suite. A lot of people want to use titles to sort of substitute for actually having credibility. You built credibility. How did you go about building credibility to the point where the supply chain got elevated to a C-suite level operation?
Speaker 2:Well, thank you. Thank you for the compliment, for sure, but it was a team effort from day one. I think that back in that day you're right it was hard to get even a vice president title. So you were, you hired as a director, or maybe an executive director during those years, and I will tell you that I had a strong feeling, in a sense, about the need to be able to report to a very senior executive if I was going to be empowered to do the work that I knew I was going to have to do, because it was a brand new academic medical center trying to become a health system. So, on one level, I thought a lot about the reporting relationship, to be sure that it would be right for me to be able to get done the work that I needed to do. And I shared that with the executive team when I interviewed for the job and I said who I report to is going to make a difference, I believe, as do how people will pay attention to me starting something brand new in an organization. They've never shared contracts before or built anything from a health system point of view, and so they listened to me, fortunately, and had me reporting to the executive vice president when I arrived, both the executive vice president on the university side and the executive VP on the health system side. That was enormously helpful.
Speaker 2:And then the next thing that I think got the C-suite connected was I immediately created a governance board, if you will, of the COOs of each of the hospitals that I knew were going to be impacted.
Speaker 2:And so I had the COOs all around the table for all of the design, the ideas, bounce stuff, everything we were going to do to be sure that I had their buy-in as they went back to the hospitals and to their CEOs. And that went a long, long way because, again, I was working with fabulous leaders who had no experience in health system integration at the time and so, by bringing them on board to know the strategy, be part of the development of it, and then they would tell their folks and lead their organization to say, hey, you need to be a part of this supply chain group that's going to be doing this work. So I escalated the strategy and the work at the highest level of the organization before I started out on it, to gain their buy-in and, frankly, to also understand where the barriers might be of some areas maybe I shouldn't step right into because of course I was brand new there as well. So having a governance board to help you I kind of called it of chief operating officers or very senior executive leaders is super helpful.
Speaker 1:Well, what's interesting is that, you know, I always think that the reason that leaders become C-suite level leaders is because they create personal credibility with the senior leaders at their organization, and I know a lot of bright people that never bothered to do that, and I know other people that did it and couldn't live up to it once they got there. They didn't really have the skill set. You managed to do things right. Who were your mentors? And what kind of? Because none of us can do this on our own. So who were your mentors? Who helped you learn how you needed to do the right things to gain that credibility?
Speaker 2:So very interesting question, fred, because when I arrived at Duke, tom Hughes and Concepts in Healthcare had been there to do a GPO analysis.
Speaker 2:They were already going through that process when I arrived and, as you know, tom, when he would finish up a project, you became a part of his IDN group, if you will, and it was really through Tom's group that I began to meet people like John Guida, who was at Partners he was trying to bring the Brigham and Mass General together and I developed the relationships with people who were doing this work, who were just open and sharing with me what worked, what didn't, and I relied heavily on, again, that SMI group that came together at the very beginning.
Speaker 2:Now I was already three years, four years into Duke, but Tom had introduced me. He had the Network of Networks group and he immediately introduced me to them and I was a part of that group. And then the ones that were in academic medical centers and the ones that were already trying to work on integration, which was very brand new back then in 2000,. They openly shared with me their mistakes as well as their wins, and really I'd have to say there was a good number of them, zonglaida being one who really shared with me a lot about what was going on in Boston at the time.
Speaker 1:Yeah, and you know, if you look at the Bellwether League, I think Tom Hughes put more of us in the Bellwether League than anyone else out there. That's just my opinion. He, he was, he was, he was a brilliant person in knowing who had the skill sets and and if you got promoted by Tom, if you were, if you were given a push by Tom, that meant that you should feel pretty good about yourself, you know, I mean, I mean, and that sort of takes us to the next step, which is that you know, since 2004, you've been active in SMI and we know that Tom and John Guida, among others, and Carl Manley and a few of those folks were the founders of SMI. Tell us about SMI, its origin, its membership and its mission, if you would.
Speaker 2:Sure, and yes, I have to. When you were asking about mentors I'd have to go back and say Carl was one I leaned on a lot as well. And you know that group was called the Network of Networks and I don't know. I guess there were probably about 100 folks in there. They were all people that Tom and Fred, you were there. They were all pretty much organizations that Tom had done consulting work and you know, as you know, it was all providers and I was thrilled to be a part of that group because I learned so much from all of them.
Speaker 2:And I got a call one day from John and Carl and said hey, jane, come up to Richmond. We got a concept for you. And they started to explain to me that the idea of we're going to we're not going to have the network of networks any longer. We really feel that if we're going to make a difference in the industry, we need to have the industry partners there with us. And of course that message resonated in a big way. It was also that it was not going to be a transactional environment, meaning no one's going to be selling to each other, and of course I totally related to that being more strategic relationships with our suppliers than that transactional world and removing the selling out of the environment. How might that change for the interaction between industry and providers? So I said it sounds fabulous. I was a little skeptic because I thought who's going to pay dues and be a member of an organization when they can't have a booth and can't sell? Because we didn't know any other concepts. So I drove to Richmond and there were what eight of us or so and you know they shared with me the idea and I said Duke is all in in and, yes, will be one of the founding members. And I loved the idea that we could have, you know, these great conversations without feeling like we had to sell in that moment. Now what I will say is the respect in the trading partner relationship transcends past the in-person forum Because, as you mentioned, we started in 2004. It gave me an opportunity to get to know my peers on the provider side. I knew every time I would go to a meeting I was going to see my colleagues and my peers On the flip side. I also got to know all of the industry executives in an efficient way, but also in an environment where we weren't trying to sell to each other. So we got to know people at a whole different level and I leaned on and relied on those relationships with those industry partners throughout the entire time I was at Duke because in between forums, when we did need assistance, when Iional and we would be more strategic about the things that we did and that just carried over so well.
Speaker 2:The mission of SMI was to drive change in the industry around processes and the business aspect. I also feel that its mission was to change the transactional nature of the trading partner and if there's anything that we've done, I hope that it has been that has built respect for each other, that we are more strategic and less transactional. For ultimately, we get to the win when we're strategic and generally those transactional things clear. We get to the win when we're strategic and generally those transactional things clear up. It's amazing how the transactional things get cleared up in a strategic relationship. Yep, and so, yes, the mission of SMI is to create tools and to make improvements in the industry, but it's also, I think, to continue to hold that bar high for the trading partner relationship between providers and suppliers. Yeah, I think prior to SMI.
Speaker 1:Well, even today, it's today no different. Really Many providers are happy to partner with and collaborate with the suppliers, as long as they themselves come out ahead, and that's not the way it is with SMI. With SMI, it's creating. I always looked at it as your role was to create tools that other folks in the industry could use, and that's a very noble mission. I believe you know that was Tom and that was the founding group. I had been on the Network of Networks boards when Greg Firestone was still involved, before John Kelly took over and changed that, so I'm very familiar with the Network of Networks. John Kelly took over and changed that, so I'm very familiar with a network of networks no-transcript.
Speaker 2:Well, what I hope to accomplish is to inspire the next generation to embrace the values and the principles of supply chain within healthcare. That's really important. You know, fred, when a lot of us got to our upper end of our career journey, if you will, we began to wonder would us and my resonate with the principles, the guiding principles we had? Would that resonate with the next generation? Because we had sort of all grown up into health system integration together and you know I've been so pleasantly surprised to see this next generation pick it up and run with it from leading councils to being on the board. So my vision, my goal here truly is to leave this in the hands of the next generation and that we find ways to add value in this next generation. And with that comes a lot around.
Speaker 2:I still am a believer in data and the importance of data. It is underpinning even AI. So, as we continue to look to the future, how do we balance out the need of good, clean data, udi standards and moving forward in an AI world? And when you think about this generation that's here now, they're used to just looking up on their phones right and seeing Amazon. They don't necessarily worry about all the stuff that went on behind what drove that Amazon experience. Yet we all know 20 years ago we were still working on UDI, right.
Speaker 1:Right, absolutely.
Speaker 2:So it's finding the value and building up that next generation so that they carry forward, and I think the Advancing Women Leaders Program, the councils we've implemented have been intentional the co-chairing of those councils, putting the ownership of the strategies to some extent back into the hands of the members as we continue to look forward to the future.
Speaker 1:Well, that's great. I know that recently, you and several other healthcare luminaries took a trip to Africa. Yeah, tell us about that.
Speaker 2:Yeah. So you know, we had a lot of things we seemed to do, come from just one seat and an idea. And at the board level we were having a conversation around what could we do next. We had been excited about starting the Advancing Women Leaders program, but it was like, okay, what's next? And someone suggested that we try to give back again in another way and let's how.
Speaker 2:About a mission trip? And my first. I love the idea, but I said you know, we just can't show up over in some place and say we're here on a mission trip, but how do we get back globally? Is there a possibility? Again, it's thinking outside the box. And so I had a conversation with Justin Freed, who's one of our members and you know he's the chief supply chain officer at Adventist Health, and I said, justin, I know you travel a lot. The suggestion has come forward Could we do a mission trip? And I don't know where SMI will go with that, but this is an idea. And Justin said, hey, let me go back and think about this. I can really put some things together here. So he came back with a great strategy for us and a recommendation on going to Zambia.
Speaker 2:And Zambia, selected because of our members have been had a presence there. They've got some NGOs that are on the ground and they've also got a big focus on empowering women and they've got some great stories to tell about that. But they also are looking to be much more strategic and targeted around equipment and supply donation and so we went over there, had no real expectations, but we came away with, you know, our hearts touched as well as our minds thinking about the potential of SMI as an organization. What can we do in a partnership sort of way, and what are the best practices around how we give away all of our equipment and our supplies? Where do they go? How do we know what happens to them? So again, that was certainly not the intent. But after we visited, we visited the most rural communities where they have one table for the OB delivery table and that has a little vinyl on it that's all torn up All the way to what was considered the, what was considered the tertiary care, the most leading best practice hospital we went in.
Speaker 2:It was a children's hospital. I didn't see a single electronic IV pump there. All of the IV bags were gravitated with those kids and so, you know, people tend can have to ride on the back of a motorcycle for for an hour to get to a hospital if they're having complications with delivery because there are no ambulances that come out that far. So it was just, it was amazing the need that was there, but the people on the ground, the boots on the ground, really trying to be very deliberate and very intentional about what they're doing. So you know, we're in the process of putting the video of our journey out on our website and we have a small group that's coming together to start to think about best practices around what we do with all of our used medical equipment and supplies. And how do we know for sure they're going anywhere in the world, that we really want them to go and that they're being used to the best as a resource in the very best way possible. So we'll more to come on that wow, that's great.
Speaker 1:you know I uh recently I just I did a podcast with brent johnson and when brent uh retired at um interountain, he and his wife did an 18-month mission in Oaxaca, mexico, and you know you really have to admire folks who care enough to do that. So you guys have my admiration and anything that we can do to support. I think I may have some information on a company that uh wanted to uh work on donating equipment someplace, so I'm I will get that to you so well you know it was a, it was a, it was a.
Speaker 2:Uh no, we had no company sponsorship. We all paid our own way. Um, paid for the, the trip there, paid for the, the hotels where we stayed, because we all, personally, were invested in it and wanted to see something happen. So, anyway, I just share that with you. Well, that's great so what?
Speaker 1:what would you like? Finally, what would you like to talk about?
Speaker 2:that I didn't ask um, I think I at first. Fred, thank you so much for having me and giving me an opportunity to share my thoughts. I think my, my last word would just be as, as our world is changing so rapidly and as you see so much, so many difficulties of people getting along, so many difficulties of people getting along, I feel like health care has an opportunity to come together and set an example, because we have one mission, and that's patients and taking care of our patients. And that's the beauty, in my opinion, of the health care supply chain is that, whether you're a vendor of services or goods, or you're the provider providing patient care, the patient's at the end of this, and if we can continue to stay engaged in working together in ways that support each other, we'll consider to really keep the patient at the center of everything we do.
Speaker 1:Well, Jane, I agree with you. We are a mission driven industry. The folks that work in our supply chains are not being paid as well as the folks that work in industry supply chains. So we do the work because we realize that the folks that are at the receiving end of our finished product are people that need to have care. Jane, thanks so much for joining us. This has been a great conversation. I'm so glad that you took the time out to talk with us, and be sure to join us next week when we will be talking with Lisa Rogowski from Trinity Health. Lisa runs the value analysis program and I'm sure you'll get some great insights from our conversation with her.
