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
From Value Analysis to Sterile Processing: How Better Beats Bigger in Healthcare Supply Chain
We explore how smarter value analysis, better space planning, and disciplined sterile processing turn hidden complexity into safer, simpler care. Crystal shares cases where consolidating supply rooms, mapping risks with FMEA, and aligning teams produced measurable gains.
• nonclinical path that leads to healthcare supply chain expertise
• value analysis maturity beyond price toward clinical integration
• standardizing sourcing, SKUs, and stocking logic across hospitals
• space planning that prevents “closet creep” and fragmented PARs
• sterile processing risk mapping using FMEA tied to standards
• bridging OR, SPD, and service lines to end silos
• pairing ops experience with industrial engineering for ROI
• moving beyond low‑hanging fruit to flow, labor, and waste reduction
Subscribe and connect with us online where you can find all of our episodes
If you have a topic you would like to discuss or want to be a guest on the show, you can reach out to Fred directly at fcrans@stonge.com
Hello and welcome to another episode of Taking the Supply Chain Pulse. This week, Fred is connecting with Crystal Rodriguez from St. Ange. Crystal started in 2022 as a healthcare project manager. And here's your host, Fred Kranz.
SPEAKER_02:Today we're going to be talking to Crystal Rodriguez, who has uh got a very interesting and very diverse background that I want to talk about that I think is really gives her an advantage over uh many other people uh because of how she's seen the healthcare supply chain from different different places uh within the hospitals. Crystal, welcome.
SPEAKER_01:Hi, Fred. Thanks for having me.
SPEAKER_02:Um I you know, I'm blanking. What could you tell me what your title is? I forgot to write it down.
SPEAKER_01:Yep, I'm a project manager in healthcare at St. Anj.
SPEAKER_02:Okay. And tell the people a little bit about your background because you have a very diverse background. And I think I want to get into that and and uh talk about how your background has helped you do your job now. So tell us about your background if you would.
SPEAKER_01:Yeah, so um, you know, when I was little growing up, I always wanted to be a nurse. Um, and every year my family would take a trip to a local amusement park, and we would pass this level one trauma center that I would always say, I and I had no, like I was like four or five years old, I had no real idea, but I would always say, someday I'm gonna work there and I'm gonna help people. Um as I got into high school and wanted to pursue this career in nursing or healthcare, I realized I really couldn't handle bodily fluids. Um so I pivoted, thought maybe physical therapy would be um an opportunity for me to pursue, and I fainted on my first patient seeing before I even saw the incision. So I knew I needed to rethink my strategy in regards to how I was going to participate in healthcare. Um, my dad was an accountant, so he encouraged me to pursue that path. So I started college as an accounting major, um, but quickly realized you know that wasn't really the path for me. I switched over to a degree or uh a pathway for business and art. Um, I also considered interior design for a moment. Um all of those kind of helped build my path to where I am today. And so I don't think if I wouldn't have gone that path, I wouldn't be where I am. But all of that was meant to happen to get me to where I am today at St. Ange. So out of college, I landed a role as an assistant store operations manager at Staples, um, worked in retail operations for a couple of years, um, but wasn't feeling totally fulfilled. Um, still had that desire to be in healthcare. So got my foot in the door at a local, at that health system that we used to pass, that level one trauma center, um, quickly advanced to a couple different roles there, started out as a surgery scheduler, um, transitioned to an OR support coordinator, and then a value analysis facilitator, and then a supply chain healthcare project manager. And it was really through those last two roles, um, the value analysis facilitator and the supply chain project manager for that health system, that I really found my true calling and what I wanted to do for like the rest of my life. So that's how I ended up here at St. Ange. So did you grow up in Hershey? Um, so I grew up in Hanover, Pennsylvania, which is central Pennsylvania, went to college at Lebanon Valley College, um, stuck around there because I met my now husband. Um, and yeah, so I I live in Lebanon today. But always been part of central Pennsylvania.
SPEAKER_02:Great. Well, what's interesting, and I I I I don't think, you know, people don't understand the diversity and the complexity of the healthcare supply chain. And just to make things clear for folks, you had you had a background in value analysis. Value analysis is a very important part of supply chain that that gets overlooked because it actually uh imp it actually creates a process for choosing what products will be used in a hospital and controlling the number of uh storekeeping units or SKUs that are present. Okay. Very important. The second thing that you did was you uh worked in strategic sourcing. So now you've got you've got uh how how we're gonna decide what we're gonna buy, how we're gonna uh how we're gonna source that. And the third thing uh that your experience in the perioperative suite is uh experience in probably the most um supply intensive uh area in any healthcare organization. So that has that has given you all that. Plus, as I read in your uh your uh LinkedIn page, you're a PR manager at a winery, and I'm wondering how that helped.
SPEAKER_01:Yeah. So I actually I had an internship um in college at the it was well, most people know it around here as the Pennsylvania Renaissance Fair, but it's actually owned by the by the Mount Hope Estate and Winery. And so as a business major in college, looking for an internship, they were looking for a public relations manager, um, which seemed like a good fit for me. I was interested in art and theater and things like that. So um that's how I ended up there. And then I did such a good job for them. They offered me a full-time public relations manager role um fresh out of college from there. So that was actually my first professional job as public relations manager at the Mount Hope Estate and Winery.
SPEAKER_02:So you've had a a rich background. I mean, not even talking about your your uh uh experience at Staples where you were uh professional in uh copying and stuff like that, too. So I mean, yeah, you really you really have a well-rounded picture of things, okay? So now that you're here, um, you know, what types of assessments are you involved in?
SPEAKER_01:Yeah, so I think our team, I mean, we do a whole bunch of different assessment assessments. If we focus just on healthcare, um, I would say, you know, our goal here is really to look at those behind-the-scene departments that I consider the foundations to a lot of healthcare systems, and um look at how we can make those operations more efficient so the clinicians can focus on their um their license and what they do best, which is patient care. So, some of the assessments that we've done have been in sterile processing department, um, supply chain operations assessments. Um, we do some assessments to look at how space is being utilized, so not even just operations, but just how space is being utilized. We'll look at staffing models. Um, we'll also take a look at how technology is supporting the um enterprise as well, and if there's any opportunity for improvements there.
SPEAKER_02:Yeah, and um this is just an opinion because I don't think you can get any any facts uh to support support it. But how many times do you walk into places where you find things that have just grown over the years uh from whatever they've been doing just to make things work and that have never had any uh oversight or or actually insight into uh what they're doing to see if they could improve uh operations?
SPEAKER_01:Yeah, I would say every single place that I walk into, that's what we find, right? Because I think a lot of times um these support services departments within the hospitals, they're just so reactive um to maintaining everyday operations that they're they're not really taking time to step away, look at what they've collected or look at how they can make things better. Um, and it's just it's just there, right? It just grows over time. That's just what happens. That's just the nature of the healthcare support service beast.
SPEAKER_02:Yeah, I I think uh you and I talked a while ago, and you were talking about a um uh a supply chain uh assessment you were doing where you found 108 separate uh uh par level locations in one hospital. Is that correct?
SPEAKER_01:Oh, yeah, that is correct. So um that was for a health system that we were looking at in um I would say New Jersey. It was so the reason we got called in for that assessment was because they they had five hospitals that they were managing within the health system. They were acquiring two additional hospitals that would now be under their health system branding. And they were struggling with standardizing supply practices across locations. So we went into um each one of those facilities, including the two new ones that they would be taking over, um, looked at their supply operations and how things were being moved throughout the building, how they were being managed. And I would say it's pretty typical to see a supply room per inpatient care unit. At this particular hospital that we were at on this visit, there was like three or four supply rooms for one inpatient care unit. And the reason that had happened was because um the room was not initially uh space um conducive to what they needed it to be. And so they kept finding these holes to shove some more supplies in that their supply chain could manage. And this quickly turned into each inpatient unit had four or five different supply closets, um, some of them not even within the inpatient unit proper. Um, so they could just keep supplies stocked for that location. So that was definitely one of our recommendations from the assessment was for supply chain to be involved with some of the pre-planning that was happening when they were looking at building a new unit or um building a new hospital or a new tower, making sure supply chain was at the table and had some insight or decision making in regards to what supply space was needed. Um, so they didn't have four or five different supply stocking locations for each inpatient unit, and they could have one or two rooms that made their process more much more efficient.
SPEAKER_02:Yeah, and and uh you know you set this up by saying that this was a system that was acquiring uh more hospitals and that was growing, and it chose this time, it chose this time to do an assessment. And my my um feeling would be probably that had it not been growing, had there not been a strict operating operational reason for doing it, the stuff probably would have continued to go on without oversight. And and as long as nobody was complaining, and as long as no one was running out of stuff, um everyone would think they were doing a good job. Is that fair?
SPEAKER_01:That's fair. Um, some of it also came up with so the largest facility um for that particular health system, they were building a new patient tower, and we were fortunate enough to be involved with that and had some ideas in regards to what the supply room should be like. Um, the person that we were working with was a facilities and construction planner, um, but she was thankful that we were a part of that discussion because she acknowledged that the health system had not had that perspective when they were building a new facility. And she was the one that got us in touch with the supply chain team. Um, and when we started talking, they're like, Yeah, like we've been trying for a couple of years to get things standardized and and and be more efficient, but like our space is just not appropriately planned. And we're like, well, why don't we come in and take a look and see what we could do here? Um, so we did that assessment for each one of those facilities, and we were able to provide some um, I I would say not anything like astounding in regards to what's going on at each individual location, but we were able to provide some information about the gaps that we recognize to best practice that we see in other more efficient supply chains and offer some recommendations that you know they could make now without any sort of construction that needed to happen. And we also use that information to feedback to their central distribution center that might turn into an additional project for us to help them plan for that distribution center and how to how that impacts their current operations at each one of these individual hospitals as they continue to grow and bring more hospitals into their health system.
SPEAKER_02:Yeah, and um, you know, um I've been uh I write articles regularly, and one of the things I did was I I reached out to our folks saying, give me some ideas for an article. And one of our folks, Chris Yoder, had uh had come back with this uh question to explore is bigger really better? Um you know, with the growth of uh IDNs, uh do the bigger systems save money? And uh my answer in the article I wrote, which I haven't published yet, is no, better is better. Okay, doing things the right way is the most important thing, no matter what size you are. And and um I think that uh historically we have placed such a big emphasis on price, number one, for product. Number two, um when you're doing your work and you're talking about either the need to um optimize existing space or the need to uh uh optimize new space before it's built. The biggest key that you can have to doing that is an effective value analysis program that puts everything uh everything that's going to be coming into the organization through a process. How many times do you find that uh you're going into places on an assessment and you see that they don't have a strong or uh uh strongly supported or strongly functioning value analysis operation?
unknown:Yeah.
SPEAKER_01:Yeah, I would say when I first started at CNAunge, it was every single built, like every single facility that we went into. I do think that there's a level of maturity when you talk about the value analysis and where the health system is. Um, you know, I think people are trying to become more clinically integrated and be more mature when it comes to that value analysis um mentality. I think there's a lot that fall right in the middle right now. So they're not quite where they need to be as a totally mature value analysis um operation, where I would say they have strong um controls regarding the process of how new items get brought into the facility. Um, and then I would say there's a lot that are still on the very front end of that value analysis maturity where they're only focusing on price, um, maybe some standardization and efforts. So there's a good mix today, I think, in regards to where they are on the value analysis maturity and where things need to go. Definitely come a long way. And I'd say, you know, the three years I've been at St. Ange, which I think is great, there's a lot more activity around being clinically integrated and developing that maturity as we've seen with COVID and requiring us to function a little bit differently in regards to how we thought about supply chain before.
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SPEAKER_02:Yeah, you know, uh, in my opinion, the biggest uh the biggest change that has taken place toward um uh supporting value analysis. I mean, value analysis for many places, they just ripped the name New Products or Product Standardization Committee off the door and put value analysis on it and never changed anything. Yeah. But um with the biggest change in recent years has been that more and more physicians are employed by the health healthcare organizations instead of working independently and leveraging them for what they want. Yeah, is that is that fair to say?
SPEAKER_01:Yeah, I would absolutely agree with that. And I think, you know, as the value analysis facilitators in the organization um start changing their mentality and stop focusing just on price and seeing it more of a clinical benefit to the clinicians and becoming more clinically integrated, we see that transition to being more collaborative with the clinical staff and and getting decisions that um you know are more efficient and more effective for patient care.
SPEAKER_02:Well, let's switch, let's switch areas of focus and go to my favorite area of focus, the place that I think is the biggest single operating uh improvement uh opportunity in any health system, and the one that I I can't imagine you could find one health system in the country that didn't need to have this function assessed and a plan built for it, and that is sterile processing. Let's talk about that. Tell me your experiences with sterile processing assessments, what you found, what kind of improvements you've been able to make, stuff like that.
SPEAKER_01:Yeah. So our assessments and sterile processing have really helped proactively identify some compliance and patient safety risk before they become regulatory issues or adverse events for a health system. I would say, for example, in a recent assessment we did for a health system in the Northeast, we conducted a comprehensive review of their sterile processing department. And in that review, we identified gaps in compliance and key standards and guidelines, as well as deviations from industry best practices. And then with each deficiency that we noted, we directly mapped that to an applicable regulatory standard and applied it in a failure mode effects analysis, also known as an FMEA matrix, to help the organization prioritize those risks based on severity, likelihood, and detectability. This really gave the leadership a clear and actionable roadmap for mitigating those high-risk vulnerabilities for that department.
SPEAKER_02:You know, um my my this is once again, I have to uh preface all these things. This is my opinion or my observation, is that uh until there's an event, nothing is ever done in sterile processing. And the sad thing is that sterile processing events can be catastrophic. Um and the other thing is, and this is where I would ask for your uh experience, is that almost always the people that are leading the sterile processing function have been trying to tell their bosses and their leadership about the problems they have and the things that need to be done for a long time without those things ever being addressed because you know resources are tight. Is that fair?
SPEAKER_01:That is fair. And I think a lot of times um the it's a team effort, right? A collaborative team effort. And those teams that are working with sterile processing, you have your clinical leads within the operating room, you have your service line leads, and then you have your sterile processing um staff. All three of those groups of individuals, and and your physicians, you know, are part of that as well, but all three of those groups need to work together in regards to the sterile processing or the reprocessing of instrumentation for patient care. And so a lot of times, what sterile processing staff see, or what the OR staff see, or what the service line staff sees, they don't necessarily know how to fix it because it's not their level of expertise. Um, so what we do as part of our assessment is we talk to each one of those groups, we understand the challenges that are being faced by each one of those individual groups, and then we help liaison and bridge those gaps between the departments to solution what needs to be fixed and what and prioritize what needs to be fixed first so you see it an impactful change to the process and improvement in patient care.
SPEAKER_02:Yeah, and um, you know, I have seen, I I know that uh I have heard stories, okay, and I don't want to get geography. I don't want to be I don't want to be um even close to being uh specific about geography. But I know that uh we have gone in and found places that were highly uh um you know highly uh um received and highly uh appreciated healthcare organizations that had real issues in their sterile processing and that and that us having been there has is sort of produced immediate uh corrective responses that probably save them uh from uh some really bad things. Is that fair to say?
SPEAKER_01:Oh yeah. Um we're working on an well, it's not really an assessment right now, but um as part of the project that we're working on for a hospital in the Midwest, um they're working on consolidating a couple of sterile processing departments that they have on campus to a single location. And we had the opportunity to go on site and visit each one of those. And some of the things that we were finding or noticing, you know, we would bring up and we would say, Well, why are you doing it like this? Or what's what's prompting this to be done this way? And what we were learning from some of the staff is, well, this is just the way we've always done it. So that's what we we don't really know anything different, right? And I think that's some of the value we bring because we get to see sterile processing departments all across the the nation, even internationally, and we get to share that information with some of these teams as we go in there and say, well, what if you did it this way? Or what if we, you know, looked at best practice for this particular process? What would that be? And how would that be different than the way you're doing it today? And, you know, um, particularly this one location that we were just in, we were able to provide them with um documentation from the manufacturer of their equipment saying, you know, the practice that you're doing was completely acceptable many years ago, but they've upgraded their equipment and you now no longer have to do that particular um practice that this health system was doing because the the equipment now accounts for that change in practice.
SPEAKER_02:Wow, they must be a they must be a pretty well-off system because my experience the uh sterile processing equipment didn't get upgraded until it died.
SPEAKER_01:Well, yes. So I will say that at the same health system in one of their um sterile processing departments, they had equipment that had Y2K stickers still on some of the equipment.
SPEAKER_02:So it's not not surprising.
SPEAKER_01:Yeah, so I will say that the equipment upgrades were not consistent across all the locations, but this the one that we were talking about, yes, the equipment was now pretty new for that location.
SPEAKER_02:And that's what I mean about better is better. So so bringing someone in, I mean, when you think about it, uh we have what do we have? Um we have about 40 40 or so people in our healthcare practice. Yeah, and and we have about eight to ten that have had really strong operational experience within the uh working within the hospitals and dealing with those issues personally that we that we address. And and uh so that gives us a huge advantage.
SPEAKER_01:Yeah, you know, I think that actually sets us apart from um some of our competitors, you know, because we do have individuals in our organization that do have that operational background. And then we also have um a really good team of industrial engineers um that went to school for you know process improvement, for analysis, um, which is just like to me, um, not being that data analytic person and um Excel wizard, you know, having a resource like that for me to be able to help me manage my projects and go through the data to support a lot of what we're seeing in regards to our observations and best practice gaps and things like that, it just makes us a really strong team. And I mean, I don't know why you wouldn't pick us to come to your hospital and do an assessment.
SPEAKER_02:Yeah, I don't uh well, I I don't know why you wouldn't, you know, pick someone because a lot of people just they never do it. But the thing that gets me about the uh industrial engineers is they like doing that stuff. They love doing it I mean, I mean, they're doing uh we uh uh I remember a meeting, uh weekly meeting we had uh about a year ago where they gave us uh all the same scenario and put us together in teams to figure out how to properly use the space and this, you know, and there were like 40 people just getting all excited about where this is gonna end. I'm going, wow, you know, I never I never had the I never had the uh training or or the expertise or would even have thought to uh think about the things that these guys bring with them every day to work. So it's pretty cool.
SPEAKER_01:Yeah, and you know, that's that I would say that in itself is worth the cost savings and return on investment for um these health systems that are looking to align um with their strategic goals. Um I feel like at this point, many health systems have already captured, you know, that low-hanging fruit in regards to cost savings and um simple, I'll call it simple supply chain standardization. And so what they need or what we need as a as a as a community, right, supporting our healthcare industry is we need those complex and strategic opportunities that we can find through data analysis to reduce waste, improve flow, optimize space, um, optimize labor in regards to processes to uncover those deeper cost drivers and prioritize sustainable high impact improvements that our industrial engineers are able to help us find through data analysis.
SPEAKER_02:Yeah, well, Crystal, I appreciate your being on board today with on the conversation. And uh I I think you've I think you shed a lot of light. And the reason that I was specifically wanting you uh to be involved in the conversation is you've done the work and and you've done the work yourself. Uh when you know, uh people try to um identify with a customer. Well, it's always best if you can identify the customer because you've been the customer too. You've you've been the professional that you're working with. And I think that's uh that brings an added level of insight that just the industrial engineers by themselves wouldn't have. And uh, and and certainly even you without the industrial engineers wouldn't have the ability to multiply um your your um abilities to make things come out with positive uh um solutions. You know, that's great.
SPEAKER_01:So yeah, you know, I I always go back to this, and I I feel like my drive to want to be a nurse or clinician when I was really young um has really helped me become the strong project manager that I am today because everything I do or everything I look at in regards to healthcare and wanting to make it better is so those nurses and those doctors can be able to work at their highest level of license and provide patient care. And what I do as a project manager in healthcare is I look to make sure that the processes that need to be done to support them are efficient and reliable and are critical to providing a smooth clinical environment so they can focus on that patient care. I love what I do, and I love being able to help patients by making sure that the clinicians and physicians have what they need when they need it to be able to perform patient care.
SPEAKER_02:You know, that comes that comes across in talking with you too, Crystal. So thanks for being on thanks for being on the podcast.
SPEAKER_00:Well, that's all for today. Thanks again for joining. And as always, don't forget to subscribe and connect with us online where you can find all of our episodes. If you have a topic you would 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. See you next time.
