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
Part 1: Navigating Healthcare’s Supply Chain Crisis: Insights from the Inside
Healthcare supply chains face unprecedented challenges amplified by the COVID-19 pandemic. Ed Hisscock of Trinity Health shares insights on managing these crises, focusing on issues like talent shortages and data transparency. Discussion on supply chain issues in healthcare. Examination of workforce shortages and industry demands. Effective strategies for supplier partnership and accountability.
If you have a topic you'd like to discuss or want to be a guest on the show, you can reach out to Fred directly at fcrans@stongecom.
Hello and welcome to another episode of Taking the Supply Chain Pulse. Thanks for joining us. This is Megan with St Onge Company, here to introduce our guest for this week, ed Hiscock, the Senior Vice President of Supply Chain Management with Trinity Health. This two-part episode will cover the supply chain concerns that healthcare practices could experience in the future. Take it away, fred.
Speaker 1:Ed, thanks for having us or letting us have you back on the podcast for a second time.
Speaker 3:Absolutely Happy to be here, Fred. I like what you're doing.
Speaker 1:Well, good, good. Well, I'm glad you do, because I'll probably have you back several times more in the future. Well, hurry up, I'm going to retire pretty soon, probably have you back several times more in the future.
Speaker 3:Hurry up, I'm going to retire pretty soon, so when is that coming, ed? Actually the end of June, so I'll be work. First day of July will be my first day retired.
Speaker 1:Wow, that is terrible. I mean it's good for you, but it's terrible.
Speaker 3:I was going to say I'm not thinking that's so terrible. But, fred, you for us, I was going to say I'm not thinking that's so terrible. But, fred, you know me, I'm going to remain active in the industry, right? So I'll still support a lot of the work that we've been about and a lot of the things we talk about. I'll still be active.
Speaker 1:Well, that's good, and I'll make sure you don't get too far away too, because I've got all your numbers.
Speaker 1:You know how to find me for sure. Okay, so, ed, as we look at I'm sort of in my own thinking labeled 2025, this winter, the winter of uncertainty in health care, because there are so many things going on out there, not just with weather, but with supply interruptions and with the whole political atmosphere, and that just adds to problems that we already had. Ever since COVID, we've had the problem of a shrinking workforce in health care, not just the supply chain, but in health care, people bailing out, retiring early, doing all kinds of stuff, but in health care, people bailing out, retiring early, doing all kinds of stuff. So, as you look at Trinity and for folks that don't know the size of Trinity, I think Trinity has 101 ministries, or, as we would probably call them, hospitals, you call them ministries, and you're one of the largest of your kind in the country. You've got a huge operation, the largest of your kind in the country. You've got a huge operation. What types of challenges, what areas are you finding challenges that you're facing in? I like to hear what they are.
Speaker 3:Number one what is the challenge? And number two what are you guys doing about it? Good, so, you know the challenges are going to be ones that all of us face. I think you know everybody's top of the list challenge in this moment is just dealing with all the shortages and uncertainty, like you mentioned. So that's, that's clearly one. Number two you also mentioned the talent and talent from my perspective, specific to supply chain trained individuals. We've got a lot of work to do to sophisticate our supply chain wherewithal in our industry, and it's going to take people that are technically trained in the profession to move that forward.
Speaker 3:And then the last one and I I'm well you know I've been barking up this tree forever, but it's really we've got to solve our data issues. There are just far too many energy units burnt by all stakeholders in our supply chain around cleansing and normalizing data. That should just be knee-jerk right. It should just be automated. And I know you know that because you dug up an old copy of that EHCR document for me from the 90s, and that's where we as an industry rallied around that particular problem and identified the benefits if we had stripes on packages positive idea of items positive idea. Trading partners positive. By way of example, the UDI, which is now the law of the land. So we now have that, but the fact that we haven't deployed it and are not using that to transact is a missed opportunity. I believe that not only will affect efficiency in our industry, but also safety.
Speaker 1:Okay, well, you've gotten a little deep into that one at the start, but we'll come back to it later. Yeah, I did. We'll go one, two, three. Number one what products are you currently facing a lack of availability for, if any, and what do you anticipate in the future?
Speaker 3:Well that you know I could answer the question right now. But it ebbs and flows, right, there's. I mean we most recently just had the issue with IV solutions. Fortunately we dodged that bullet. We had moved a lot of our business and found ourselves in a good position with the supplier we chose and we chose that supplier largely because they had redundant manufacturing here in the US and turned out to be a good decision for us. But I know a lot of my peers were really really struggling with IV and I know that because we were able to help them out in a few instances.
Speaker 3:Right, so that's just the latest in a series. But I mean, there's, there's some of the specimen containers that we're using in the laboratory right now are running containers, right, little bottles, plastic and glass bottles. I was really concerned when Texas had that cold snap again because that shorted us on resins and some critical materials a couple of years ago. Fortunately, I didn't have the same kind of deep freeze for the extended amount of time this year that they did a few years ago. So it just it ebbs and flows, like you say, with weather, with geopolitical situations, and and it just there's. There's no clear end in sight. It's just something we are going to have to continue to attend to and sophisticate our wherewithal in that kind of risk mitigation side of the supply chain practice.
Speaker 1:So let's take a look at one aspect of that.
Speaker 1:You know, prior to 2017, I'm going to go right to Hurricane Maria I would say that most people did not know where any of the products.
Speaker 1:They know where they came from, but they didn't know where they were manufactured from, and that's a different thing. And then, in 2017, it turns out that, no matter what name is on the box, all the mini bags in the world were manufactured in one place, in Puerto Rico, and when the storm came in and blew things away, there were all kinds of struggles to find alternative ways to deliver key medications. I mean, the mini bag and the mini drip really saved time and labor for people. It was a more efficient way to deliver drugs in a safe manner and all of a sudden, people had to revert to having a nurse come in the room with an IV push and manual intervention, and I know that that woke you up, because I was one of the people that introduced you to a company that does horizon scanning and risk mitigation. I know that woke you up to starting to take a look at where your stuff is coming from and taking a look at key things and seeing what you could do about them. Is that fair?
Speaker 3:It's fair? Yeah, absolutely, fred, and I think the whole industry, you know, and all the good work that Herc is doing is evidence of the fact that there was a big wake-up call there and COVID just exacerbated it because now we learn what percentage of all of the product that we buy PPE in particular and APIs for drugs comes out of China. So, you know, shame on us for being asleep at the wheel and not paying attention to that sooner. And it's really really nuanced, right, when you stop and think about it. I mean this risk management, supplier quality and performance management is a discipline in other industries and it's a supply chain discipline that's resourced with fleets of people, and most of us didn't have that wherewithal just a few years ago.
Speaker 3:So, so when I talk about it being so very nuanced, it really gets down to making decisions for supplier partners that are being responsible for the decisions they make. Right, you were talking about earlier, you've got a responsibility to make sure that there's redundancy in your manufacturing, especially if the plant is located in an area that guess what hurricanes happen, right? So it just that's irresponsible decision-making to, for whatever reason, right, to drive costs down to for whatever business reason it's. There's a responsibility for a supplier to make better decisions in service to their customers. So when we think about making those decisions for vendor partners, we do so with an eye towards redundancy, with an eye towards responsible business making, business decision making.
Speaker 3:So there's a lot of nuance to it and it does take time and energy, as well as access to the data, which not all suppliers are willing to share. And that's the first red flag, of course. If you're not willing to share where you're manufacturing or where your stockpiles are, you probably have something you don't want to share. If you were proud of the decisions your organization was making and where things are manufactured and the redundancy, you'd be happy to share it because it would differentiate you. So, yeah, there's a lot of nuance to that, but I think it's one of those areas that I mentioned. We've got to kind of ramp up the sophistication in our supply chain wherewithal.
Speaker 1:And you said one time to me that you have a small but mighty team that just focuses on that. Is that correct?
Speaker 3:Yeah, a team of two and you know they get pulled in a lot of different directions, but for all of Trinity we've got two people that largely their roles are to assess and conduct the business reviews, assess suppliers on the front end so the vetting gather whatever data we can and learn as much as we possibly can, deposit that and share it with our sourcing team and then also conduct business reviews to share what we found and vet it directly with the potential business partners.
Speaker 3:Right? So as we're meeting with these suppliers, we're sharing. Here's how you look to us, here's how your product shows up, here's the efficiencies, here's some waste that we see, what's your perspective and let's talk about that, and that'll get you into discussions that give you some insight into some waste that we see what's your perspective and let's talk about that, and that'll get you into discussions that give you some insight into some of that business decision making. Right, if they're willing to sit down and talk about the fact that a product is always late, might be on their end, might be on our end, might be both right, the way I'm expressing my demand and the way that they're showing up. There's a correlation there. So we've got something to work on, and if they want to roll up their sleeves, we can talk supply chain to supply chain and solve the problem. That's a partner I want to continue doing business with. If not, then likely not right.
Speaker 1:Right, yep. Well, that takes care of the product availability part. Now let's talk about the different types of people you need to have in your system today, compared to what I needed when I started in healthcare supply chain 50 years ago, and where you're getting those from, how difficult it's to get them and what you're doing about it.
Speaker 3:Yeah, this is one that gets a little personal. This is where I'll spend some time in retirement, because I'm really proud of the fact that our supply chain team at Trinity Health, we enjoy formal relationships with 13 different universities, and those relationships vary. We have teams of students helping us solve problems in a project fashion. We have interns, we precept management fellows. Every year we do guest lectures at our alma maters and other universities. We judge case competitions.
Speaker 3:So there's a number of different ways that we engage with university, but the goal well, actually the original goal was to make sure that students at university that were getting their degree in supply chain recognized that there's a whole industry here that could use their talent right Healthcare acquisition strategy, because I found that those young professionals that are so hard to keep engaged love going back and being the expert at their alma mater and doing a guest lecture, and so enabling them to participate directly with university and participate in our engagement with those different universities and with students has been terribly rewarding for them, and I think we've probably kept some of our top talent, because they also have an opportunity to help these universities and help these students out.
Speaker 3:So it's just been a really interesting strategy and one that you know I brought to the Michigan chapter of ARM. I've got other chapters of ARM looking at doing similar things, similar student engagement, university engagement. We're running our second healthcare case competition in the state of Michigan here in the next month actually, and I've got other chapters that are interested in doing that. Mike Schiller and I have had conversation about doing it at National. So a vision I have, as I put energy into this in retirement, is we'll have chapters doing case competitions with universities in their market. The winners from those state competitions go to regionals and the winners from the regionals end up presenting at national arm and there'll be three or four universities and that really raises kind of the status and awareness around health care supply chain as a destination for technically skilled supply chain individuals.
Speaker 1:Yeah, that's a great approach. You know we do that. We have a similar thing in the Bellwether League.
Speaker 2:And that wraps up the first part of this week's episode. We hope you join us next time to conclude our discussion and, as always, don't forget to subscribe and connect with us. Online. You can find all of our episodes. If you have a topic you'd like to discuss or want to be a guest on the show, you can reach out to Fred directly at F-C-R-A-N-S at S-T-O-N-G-E dot com. Thanks for tuning in.
