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
Navigating Healthcare's Complexities Through Innovation
Lisa Rogalski shares her transformative journey through the healthcare supply chain, highlighting the importance of mentorship, teamwork, and innovation in driving success. She discusses her transition from Genesis to Trinity Health and her focus on enhancing the value analysis framework across diverse regions.
• Lisa's background from clinical roles to supply chain leadership
• The significant impact of mentorship on career development
• Challenges and opportunities in transitioning to a larger system
• Strategies for team building and governance in supply chain
• Adapting to varying maturity levels across different regions
• Importance of innovation in technology assessment and procurement
• Identifying key products and managing potential substitutes
• Goals for enhancing collaboration and standardization in operations
This is Joe Nemeth with St Onge Company, welcoming you to this week's episode of Taking the Supply Chain Pulse, where we chat with leaders from all areas of healthcare to discuss the issues of today's threats, challenges, emerging trends and advancing technologies. Today we'll be talking with Lisa Rogalski, who leads the value analysis function for Trinity Health in Livonia, michigan. Grab a coffee, settle in and let's get started with your host, fred Kranz.
Speaker 1:Lisa, it's great to see you, great to have you on the show. Thanks, fred, it's great to be here. I know that you said you had a great holiday and now you're ready for what 2025 is going to have to offer.
Speaker 3:Well, I guess, whether we're ready or not, it's here, so I'm going to embrace it.
Speaker 1:Yeah well, it's interesting to have you on because I know that over the last year or so you've gone through a lot of organizational changes that are really interesting and we can talk a little bit about that. So why don't we start out by having you tell us a little bit about yourself?
Speaker 3:your background and how you got into supply chain. Sure, well, I've been at this for many, many, many years and started out on the clinical side. My background is in radiology and I actually started out as a rad tech in Galesburg, illinois and was affiliated with the school there, did some teaching through the school and decided that I wanted to branch out. So I actually followed my sister to the Quad Cities and looked for a job there. Interestingly enough, fate played a big role in that and I moved into the cardiology space. I filled a position at the time it was St Luke's Hospital in Davenport, iowa and moved into the cardiac cath lab as a cardiovascular interventional technologist and absolutely loved that world. Did that for about, I would say, 10 years.
Speaker 3:And then someone that you and I, fred, both know very well, afshin Patoli, was the head of supply chain at that organization and about the time that stents hit the market cardiac stents Afshin reached out to me and said hey, we need a presence in supply chain to help us understand the use of the stents and maybe some contracting understand the use of the stents and maybe some contracting.
Speaker 3:So I started doing some side work for Afshin in supply chain related to contracting. That turned into a full-time position, transitioned over into supply chain and then just worked my way up through the purchasing side, contracting to become the director of supply chain for Genesis Health System in Iowa and Illinois and then from there. When Genesis became acquired by Mercy One, which is a Trinity organization, it was about the time when they were doing some restructuring within Trinity, and so I applied for a position as the National Director for Value Analysis and was fortunate enough to be chosen and that's been about a year ago, as you mentioned, so it's been a crazy, crazy last year, but I love it Absolutely, love the role, love the people that I work with and the challenges that it's bringing. So it's been kind of a diverse ride for me, but a great ride and I absolutely love it.
Speaker 1:Yeah, and you're just getting started, whether you know it or not One of the things that you said that I think is interesting and I've known Afshin now for 40 years In fact you don't know this, but I had to teach Afshin how to interview for the job at Genesis, because he had never interviewed for a job before. He'd gotten his jobs by just being good at what he did and kept moving up. The thing that he did that I thought was really really good with you and with other people at Genesis too was he realized that you need to have a knowledge beyond contracting and pricing. You needed to understand how things work. So you had to have people who knew how things work from the various high dollar departments involved in the supply chain process. So if you're looking back at your mentors, would you say that Ashin was one of them?
Speaker 3:I would say and I tell this to anybody that asks he was probably the single most impactful mentor that I had in supply chain and I've had a couple people that stick out, but from a supply chain perspective, single biggest mentor. I learned so much from that man from day one and I think the biggest thing, I would say, a couple big takeaways from him and you touched on one, fred. That's the fact that having a clinician in supply chain was so vitally important and I think that's normal now, but back in the day, if you will, supply chain didn't typically have clinicians within their walls and Afshin was a pioneer, I would say, in that regard. But the other thing that I learned from him was, especially when it came to negotiations, is making it a win-win and I think sometimes that gets overlooked. He had such great respect for the suppliers that he worked with, but also the people that he was supporting internally at the facility, and he pulled me into every single opportunity from day one so that I could learn, and I learned so much from him.
Speaker 3:I will never forget just a real quick story, but real quick story the day that he and I sat in a multimillion dollar negotiation with our perfusion company at the time and we were trying to award a new agreement and my role at the time was pretty much just to support with data that I had helped pull for him but to answer any clinical questions. He really did the heavy lifting. But when we left, I think the company felt that they had kept us as a customer. That was valued. But we also were saving the organization over a million dollars in that negotiation and he turned to me and said congratulations, you did it. It was never I did it, it was you did it. And I think that just how he engaged his team and created that sense of loyalty from day one is what built a strong, strong team under his guidance.
Speaker 1:Who else would you say were your mentors?
Speaker 3:My current boss is a great mentor, d'amica Miller. She is extremely, extremely innovative, very powerful businesswoman, but she also has that same passion knack for creating loyalty in her team and she does that by recognizing when you do something well and calling that out in a group setting. She's phenomenal from that perspective. She's also good because she doesn't hesitate to share your opportunities for improvement as well. So D'Amica has been an amazing mentor for me also. She's innovative. She's obviously learned a lot under Ed Hiscock's direction, but she's extremely innovative in how she looks at sourcing and so she's been a great mentor for me in that regard me in that regard. A really interesting example for that we at Trinity are looking at an inclusive hair care portfolio and a lot of people are doing that now and that's common. But the thing that D'Amica has done that is, to me, very innovative is she's tied in local business that wanted to expand and grow and utilizing this as a way to enhance a local business's product portfolio into the healthcare setting. So she's tying it all together and that's pretty innovative in my book and so she's been a great mentor for me.
Speaker 3:But the one mentor I had kind of outside supply chain and you may find this funny, fred, because I believe you were aware of this person also, but was our CFO at Genesis, mark Rogers. And Mark taught me an extremely valuable lesson that I carry with me today, and it was related to how you share information. Mark was a great storyteller and he could make anybody understand finance and, as you know, that is a very, very challenging thing to do, but Mark always told me. He said I know you know the content, so I'm going to focus on the presentation, the how you share your story. He said so don't get angry when I don't focus on what's inside the story, but how you tell it. And that, for me, was just such a valuable lesson, yep that sure is.
Speaker 1:Tell me, the interesting thing about sharing your stories is, you know, we all see the world from our inside out. What we don't know, and what I've learned over the years with all the stuff I've written and the stuff I've done, is it's at least equally important how the other folks take in what you're telling them and how they process it, and that's why that's very interesting, the way he focused on storytelling. I can't begin to tell you how sometimes you get things back 180 degrees from the way you hoped that it would be heard and you have to go straighten it out. So yeah that is.
Speaker 1:That is very good. Well, let's focus on this, this transition, because I you're one of the one of the people that had worked many years in one place. You knew I I know that you could probably close your eyes and locate anything in any department, in any nursing unit in the two hospitals in the Genesis system and maybe even over in Silvis and up in DeWitt, I don't know. You've been there that long and then, all of a sudden, the behemoth 101 Ministries not hospitals Ministries from Livonia, michigan, now runs the place. That had to be a tremendously difficult transition from a supply chain leader that knew everything and everybody to being a value analysis director for one of the largest systems in the country. So how? How did that? How did the original knowledge that you're going to be merging with Trinity impact you? And then, how did the? How did the new position impact you?
Speaker 3:The original information when we first found out we were going to merge when I was with Genesis, obviously it was a little bit frightening because I had felt like I knew all there was to know about Genesis. So that was a little frightening, but it was kind of exciting too. As you well know, you can stagnate very easily if you don't continue to grow and learn. So I was excited about that piece of it and I think what I kept telling the team that I was working with was look at all the opportunities you're going to have. That you know you didn't have when we were just Genesis and that obviously turned out to be key for me in my transition into my new role. So I was trying to embrace the opportunities and so the stars aligned as I shared and the opportunity presented itself for me to grow in an area that I absolutely loved. I loved all of supply chain, but value analysis to me was tying that that clinical piece, to the daily operations but also helping us make our choices better, and I think that it was the piece at Genesis we had grown the most, the most. So I was excited to take that new role on. But oh my gosh, transition was just absolutely crazy. You go from being the person that was the resource for everything to being the person that knew nothing, just even who to call for what. So again, d'amica being the great mentor that she was and is said, I'm happy to share with you whatever I can, but tell me what you need. And I said, well, I need a buddy. And so she assigned me a buddy from our team that helped me navigate.
Speaker 3:Once I got through the navigation piece, which was the most challenging piece, then it was really about building the team, and the blessing that I had coming in was I was given the latitude to rebuild that team, and the timing was perfect. We were going through a major supply chain and really a whole support services restructure at Trinity. So I had the latitude to rebuild in the way that I wanted to build, and D'Amica gave me that latitude. She said you're the expert in your field, tell me how you want to structure this. And so I was blessed with that.
Speaker 3:I spent that whole first year building that team and understanding where they were as a team. So we're separated into nine regions as far as Trinity, and so I needed to understand how each region was from a maturity level. So my whole first year was really about building and discovery, and that's not so different whether you're in a big organization or a smaller organization. The nuts and bolts are still the same, and so, from that perspective, once I could figure out how to navigate, I think it was fairly easy to make the transition after that, because I had the support that I needed.
Speaker 1:So did you do a lot of physical traveling the first year, or did you do FaceTime like we're doing right now?
Speaker 3:I did not physical traveling. As you know, I'm based out of Iowa and I have teams in 28 different states. I would have loved to have traveled, but given what happened with some of the issues that Trinity had over the past year with the change, health care, et cetera our travel budget was essentially wiped out. But that's OK. What we did was we focused on how we could build as a team, and so we utilize teams as robustly as you could. We had a regular cadence of meetings that were fairly frequent during that first year, but again, it was about getting everybody to interact and learn from each other. So we did that by having an every other week value analysis manager meeting and then helping them build their teams out regionally as well. So it's been a lot of time and energy on team building. But if you don't have a sound team to start with, you're not going to be able to create what you want to create.
Speaker 1:So you still have people you haven't met.
Speaker 3:Not face to face. Yeah, that's exactly right.
Speaker 1:That's amazing. I mean, I people can't understand how big that is 101 hospitals, that's a lot, and it's a vast geography. So Do you have focused strategies for each region or do you have an overarching region? Could you just give a little bit of the philosophy behind the value analysis approach there?
Speaker 3:Sure. So I did spend a pretty significant amount of time creating a new governance structure for value analysis at Trinity, and my goal was twofold One, to create a governance structure that goes from the top all the way down through the entire organization and to have that be seamless so that it wasn't siloed so that it wasn't siloed. But secondly, to kind of improve the way we looked at our project management. So Trinity had been very siloed in that we had sourcing, va and operations and my goal was to pull them all together. So as we're launching projects is to pull them all together. So as we're launching projects, we're launching them knowing the resources that are needed by everybody involved and understanding priorities. So we've done a much better job launching conversions or projects that actually come to fruition and get to done. And so those were my two main goals.
Speaker 3:But our structure really is not extremely unique from a governance perspective other than it ties all of that together. So we do have a system office very small team and really our goal is to support value analysis in the ministries and to create standard work and processes that help support that, but also to have a an escalation pathway outside of their region region. And so we do have a system office value analysis steering team that we are blessed with having a supply chain CMO and I don't think everyone has a supply chain CMO. Mark Pinto he's an orthopedic surgeon serves as our supply chain CMO. We also are fortunate enough to have the system CMO Tammy Lundstrom sit on our steering team as well, so we have the credibility and the support at the highest level.
Speaker 3:But then that team is the ultimate escalation Within each of our regions. What we're doing is building out regionalized VA teams so that we don't have repetitive processes at all of our ministries. So for a region that would be all the hospitals or ministries in that region. They would have three value analysis teams a peri-op team, a MedSurg team and a cath IR procedural team. That represents the whole region. But they'll also have their own regional steering team which is their executive leadership from the region. So we've taken that and broken it out by region within Trinity to make it manageable. But then each of those regional value analysis managers reports to me, and so that's that connection within the system office and that's the difference.
Speaker 1:I think so is there a lot of variation in product mixes among the regions or not.
Speaker 3:No, and that's been the beauty of this, we're actually quantifying that now as to what the restructure has provided as far as a benefit. So we had a system standard list, if you will, but it was not all-encompassing, it was mostly commodity-type items. What we've done is tried to take it to another level. So, because we have that close tie to sourcing, now we can actually work with sourcing and say what makes sense to be a standard or to try and optimize a contract for all of Trinity or even within a region, because every contract is different. So sometimes a regional approach makes sense, sometimes a whole system approach makes sense. A regional approach makes sense, sometimes a whole system approach makes sense. But because we have that close connection now we're able to do that more appropriately.
Speaker 1:And would you say that? You know, with that number 101 just keeps jumping in there, because with 101 organizations there are a lot of people that probably would have resentment and all this other kind of stuff. What is the general air of collegiality and cooperation? Has it been good, or have you had to fight through some of those people that don't like to be part of a bigger unit?
Speaker 3:Well, I think the thing that's interesting is we have nine regions. Every region is at a different level of maturity, and so what I did was spend my first year determining where that level of maturity lies in different dimensions and putting that out there for them to understand. This is how you can grow and this is the area you need to grow in. And for those that are more mature, their challenges are different than those that are less mature, and so you look at a region such as Michigan, which is our biggest region, and they act completely independent of each other within that region. So your work there is much different than your work in New York, for example, where that region acts as a region and all the hospitals function together there. So the work is different and your customer base is different and your challenges are different. And your customer base is different and your challenges are different.
Speaker 3:So I would say, in Michigan, for example, we have a big uphill battle to try and move them to a region and functioning as a region. But that's where you enlist the help of the senior leadership within that region, and they've been phenomenal. So I think if you can start getting support at the top within your region and then creating that burning platform. That's how you do that. So the battles are different, but the ultimate goal, I think and they see, the ultimate goal is really to get us to function more as one versus multiple.
Speaker 1:That's interesting and I would say that you know. You've mentioned D'Amica as your mentor. I would say that, when it comes to knowing how to navigate the political waters and complex situations, the ultimate mentor that you could talk to is Edward Hiscock, because Ed's the smoothest guy in the world on the outside, but he knows how to handle the stress on the inside, and I think you couldn't be working with a better person than Ed. That's my opinion.
Speaker 3:Amen to that. Amen to that. And Ed's really good because he's great at relationship building, so he's very supportive in getting me to the right connections if I don't have them. So you're absolutely correct, that's good.
Speaker 1:So what are uh? What are your current challenges or goals for 2025?
Speaker 3:well, the challenges become the goals right, and I mentioned the different maturity levels. So my major goal for this next fiscal year for us is to get all of my teams at least regionalized and have functioning regional value analysis teams and a regional steering team. Regional value analysis teams and a regional steering team and so I mentioned a maturity grid. I think that for me, comes full circle back to that storytelling. How do I help my team build their goals if they don't understand what, where they are and where they have to go? So we used one model for everybody and just showed them where they were within the model to help them build out. To where do I want to be next year, the year after, the year after? Get everybody regionalized and functioning as a region that's my ultimate goal for this next year and then just to continue to build out that maturity level each year.
Speaker 1:That's great. Did you get much pushback from the people where you had them graded at all?
Speaker 3:You know what that's so funny, fred, that you mentioned that? Because my very first thing I told all of my managers when I met with them was do not look at this as anything negative. Look at it as this is what cards you were dealt in your new role as a manager and this is the opportunity you have to change. And because of the fact that they knew they weren't responsible for where they were, but they are responsible for where they go, they all took it very well as far as as where we are. I think, um, as years two and three come about, to see where they go, then they're going to begin owning that a little bit more.
Speaker 1:But yeah, yeah, but you know, if you take it the way you just framed it, then I'd like to be the person that's running the place that has the need for the most improvement, because I got the biggest opportunity. Exactly exactly biggest opportunity, exactly exactly and if, and that gets once, once again gets back to the manner in which something is framed to the person that's receiving the, the story, so that's pretty cool. So, uh, lisa, was there? What did I forget to ask about? That you'd like to talk about?
Speaker 3:I don't think anything, fred.
Speaker 3:Um, the one thing I think that I would say, one of my biggest, um, biggest achievements in my new role for this past year, or one of the things I think, maybe that I feel we do uniquely at Trinity, is the work our steering team has been able to accomplish, not just in changing our governance but in changing how we look at product entry or clinical efficacy of product.
Speaker 3:And, to that end, one of the things that we have implemented at Trinity in this last year that I am uniquely proud of, I guess, is an innovative technology process where we're actually trying to triage innovative technology at the steering team level and utilizing the clinical framework that we have in place to help us do that, so that we're not looking at new technology throughout all of Trinity as one-offs. We're trying to look at it and bring it in, doing our due diligence at the highest level and utilizing the resources we have. So I would say that was the one thing I wanted to mention is I feel like we're making some big strides in looking at our work differently and how we can do it more effectively, and that was just a very good example of how we're able to do that in a large scale and a large organization to try and make things more efficient.
Speaker 1:That's great. Well, a terrible thing just happened. A thought came into my head and that can be dangerous. Thought came into my head and that that can be dangerous, but with, with the recent issues that we've had, say with Baxter, with the IVs and with, have you identified key products that you need to have in your mind an acceptable substitute for in the value analysis process?
Speaker 3:We have been working on that. Do I have something beautifully laid out and done? No, but we've been working on that. Do I have something beautifully laid out and done? No, but we've been working on that along with our sourcing partners in key categories and with key suppliers, just because of the potential with cyber attacks and systems going down, et cetera. So, yes, and I'd like to say we've made great strides in that. We're not as far along as I'd like to be, but I think we're going to utilize our GPO partner a little bit in that regard too, to help us with product identification as well.
Speaker 1:Well, you've identified the need, and I think that's the key first step. That's great.
Speaker 1:Well, you've identified the need and I think that's the key first step. That's great. Well, lisa, it's been great having you on as a guest. I am so impressed with you and your new position. Ed had told me that you were doing a good job. See, ed used to be my boss, you know. For a few years we worked together and he's one of my best friends in the world, and I told him that you know he had a good person there and that, yeah, I think you're going to do very well and I know you will. And I talked to our friend Ashene a couple days ago. He's got some challenges, but he said to say hello and I just want to wish you folks all a happy and prosperous new year.
Speaker 3:Well, thank you, fred, and I appreciate you taking the time to sit down with me today. And please pass my regards on to Ashin, and I agree with you 100% on that. He's a great, great guy.
Speaker 1:Okay, well, hey, thanks again, lisa, and we'll talk to you later. All right, bye, fred, Bye.
