A Clinician’s Business Mindset Can Transform Hospital Supply Chains

A lot of supply chain leaders can talk strategy. Far fewer can trace it back to what happens when a patient is on the table and a team cannot afford a single shortcut. That’s why this conversation with Joseph Carr, Vice President and Supply Chain Leader at Akron Children’s Hospital, lands differently. Joseph started his healthcare career as a registered nurse in the operating room, then carried that clinical urgency into healthcare supply chain, strategic sourcing, and hospital operations leadership.

We walk through the career moves that shaped his toolkit: an MBA and finance background, early work helping build a clinically integrated supply chain model at Mayo Clinic, exposure to Lean and DMAIC problem-solving, and the reality of performance-managed systems where metrics drive accountability. Along the way, we get concrete lessons on change management using ADKAR, why data access changes everything, and how missteps like a poorly handled glove conversion reveal the real cost of ignoring clinician voice.

Then we bring it home to pediatric healthcare. Joseph explains what makes children’s hospitals unique, from pediatric-specific procedures to the full patient and family experience, and why children’s hospitals can get squeezed on pricing due to GPO tier structures and smaller spend buckets. At Akron Children’s, he shares how a supportive culture and clinical collaboration helped launch the Commit for Kids sourcing strategy, expand category reviews at scale, invest in technology and ERP modernization, and use Lean projects to lock in best practices before bigger system shifts.

If you care about healthcare supply chain transformation, pediatric hospital operations, and building a strategic supply chain that clinicians actually trust, listen through to the end. Subscribe, share this with a colleague, and leave a review with one question you want us to tackle next.

Transcript

Welcome And Guest Setup

SPEAKER_01 0:03

Hello and welcome to the latest episode of Taking the Supply Chain Pulse. I'm Megan with Sainonge Company, and thanks for tuning in. Today we're excited to welcome Joseph Carr, the Vice President and Supply Chain Leader at Akron Children's Hospital in Akron, Ohio. Joseph brings a truly unique perspective to healthcare supply chain, having begun his career as a registered nurse and working across virtually every hospital setting along the way. This conversation explored leadership, perspective, and real-world lessons from the front lines of healthcare supply chain. Now here's your host, Fred Kranz.

SPEAKER_02 0:37

Joseph, uh welcome to the uh podcast. Thank you.

SPEAKER_00 0:42

Thanks for having me, Fred.

SPEAKER_02 0:44

And you moved to uh Sonny Akron from uh the the cold depths of Orlando, Florida, is that right?

SPEAKER_00 0:52

That's right. I'm still flying out. Um and but you know the beauty of uh living in the Midwest is if you don't like the weather, don't worry, it will change. Uh so that's been uh my experience. But yeah, we love it. Um and the change of seasons, it it's great. It's great.

SPEAKER_02 1:10

Well, I moved to Northeast Ohio in 1983 from Miami, and uh when I first got up uh in Northeast Ohio at Timkin Mercy Medical Center in Canton, which is now part of the clinic, um, I saw this article in the Beacon Journal that said that Akron gets more rainy days and fewer days of sunlight than Seattle does. So that's oh wow. That's that's what you've got. That's what you've got to look forward to. I I don't want to be the one to break it to you, but uh but that that's the way it is.

SPEAKER_00 1:43

So so anyway, we're gonna have you here.

SPEAKER_02 1:48

Tell us a little bit about your background, about uh how you got started in healthcare. Where you know, just give us a little background about yourself.

SPEAKER_00 1:56

Sure. Um so I, you know, growing up in Florida, you know, my dad worked in Space Center and those type of places, and um I was very blessed to have a good upbringing. And uh I um I started to work in business and finance um and uh worked my way through my undergrad, got my MBA at uh our alma mater University of Miami, um, and uh worked in different sectors, and then um I I really wanted to get into healthcare, so I made a career change and went to nursing school. Um, that's only knowing Tylenol going into nursing school, you know. Um, but you know, I was a good student, good read, and uh came out of that accelerated program, was very blessed. Uh Mayo Clinic gave me an opportunity to work in their uh OR. And so I uh went from there for a couple years working in their operating room uh as a nurse. And uh I think somewhere along the lines I asked a silly question such as what's the price of that? And the next thing I know, uh they wanted to build a clinically integrated supply chain, and I was a good guinea pig for it. Um, and that was uh, you know, 18 years ago. And uh just great tutelage, great mentorship. Um, and then from there, um I uh had that opportunity to grow even further um and worked at uh Ascension, the resource group. Uh learned uh a good amount about strategic sourcing and the implementation process and uh strategic um uh partnerships and uh was able to uh I did that while I was in St. Louis. Um and then that was our first taste of the Midwest, I suppose. Um and then from there I uh I did take a step back in my career. My father passed, so I got back to Florida to help out with the family uh and uh worked at Advent Health uh simultaneously, which I'm super grateful to that team. Um learned purchase services and a lot of different contracting areas that I had it really refined. And um from there I was given the opportunity to get back into the fast lane and I uh was able to go down to South Florida and work at uh HCA under the Health Trust umbrella. Uh we were in charge of 14 hospitals during COVID in Miami. Uh that was uh a uh an adventure. Uh shout out to my colleague Joe Brittner, uh, who we tag teamed uh that uh during the uh pandemic. And uh in fact, uh I was uh you know recruited and subsequently he was as well. We both went into a DOO program at uh HCA, um, where I was a vice president of operations and learned how to run a hospital um and extensive knowledge, extensive boot camp to be able to do that. And next thing I know, I I I really enjoyed supply chain and the focus, and so I was given an opportunity to um have a tutelage in the uh the executive uh team at Orlando Health under Suzanne Thompson Quintero. Uh, learned a significant amount about how to build a strategic supply chain. And next thing you know, Akron Children's is knocking on the door, and um I it was time I was prepared uh by a great mentor at Mayo Clinic with Mark St. George and Jim Francis all the way through, uh the teams that I had um already mentioned and many more uh to be able to take the helm. And uh it was their first VP of supply chain to be able to uh take a Blake canvas and build a strategic supply chain. So that's a little bit about my pathway, uh definitely uh unique and being a nurse and also but uh it wouldn't have come without all those mentors and um the desire to grow. Yeah, so let's let's uh delve a little deeper into that.

What Nursing Teaches Leaders

SPEAKER_02 5:58

Let's see what the various formal areas of training you received helped you with insight into becoming uh VP of supply chain now. So let's start out with how did uh being a nurse give you insight? What did you learn? What did you learn from being a caregiver?

SPEAKER_00 6:18

You know, as a caregiver, um you know, it it it's hard to teach anybody to be caring. Okay. I think that's one of the principles, it's like teaching a work ethic or teaching, you know, somebody to be moldable or hum or humble or teachable. And so caring is kind of something that really was something I I servant leadership, you'll see this emulated. So as a caregiver, you're always really focused on the patient and uh centric to what the overall mission is of the organization. And you know, you become very close as a team. Um, the OR was a great team environment, um, very close-knit teams. Um you uh in in the sense of you know um being very diligent about processes, um there's uh patients don't benefit from short runs. And as a result, the methodical ways that you do things um assure that you're going to properly take care of a patient, such as when you're going through the steps before you start a surgery, uh, that timeout steps, uh it really teaches you to be methodical about process steps and not shortcut things because ultimately, you know, there's downstream impacts, and in that instance, it's patient care. Um, so those are really strong things. You uh you I recall a lot of the team environment, a lot of the attention to detail, um, and always being um uh ready uh with a sense of urgency to be able to attend to a patient. So those are kind of that speed to market translated, you know, the the attentiveness to processes translates, of course, servant leadership translates, etc. So I hope that helps shed some light.

SPEAKER_02 8:27

Yeah, and uh Mayo Clinic uh where you started um was uh run and managed by the physicians, uh which is uh uh similar to the Cleveland Clinic and the Marshfield Clinic, and usually if the word clinic is in there, that's the uh governance structure that's out there. Um different for perhaps than say South Miami Hospital in Miami before it became part of Baptist Celtics and was just a standalone community hospital. Um but what when you were there, what what year did you start at the clinic?

SPEAKER_00 9:03

So I was where there when uh Dr. Rupp was CEO over at uh Mayo Clinic. So that would be oh man, I I need my wife for these year questions. Years are running by me, Fred. Um I don't I don't recall, over 15 years ago. Okay as well as there.

Clinically Integrated Supply Chain At Mayo

SPEAKER_02 9:22

Yeah, the reason I ask is I had started a project with Jim Francis when I was working with uh VHA performance consulting, so you can see how long ago that was. Uh when he was at Barnes Jewish, and he was he was among the uh earliest part of the formation of that IDN. Okay. And uh there were significant issues in establishing uh a working relationship there in the ORs. They had the Barnes OR, they had the Jewish OR, uh, they had all kinds of problems. And there was there was a we are the OR, we take care of our supplies ourselves, and we don't need any help. Now that 15 years ago, Jim Francis had been around for a long time, and I'm just wondering what was the relationship uh with between the OR and supply chain when you were with the May Clinic in Jacksonville.

SPEAKER_00 10:23

Well, exhibit A, I was the guinea pig to be able to um build those communication highways um because we had different languages, and fortunately, my business training helped me to develop the finance, you know, uh language and for the most part, but I didn't have any other language. I didn't have supply chain language when I joined supply chain after being a clinician there. So it was precursor to the clinically integrated models that we have now, um, which was fun because we were being revolutionary. We were doing things that um folks felt and saw, but really hadn't had any specific uh game plan. And so there are some visionaries and brilliant people that we worked with, not just on the um supply chain side and business side, but on the physician side, that um as you brought these thought leaders into a room, um what they built and developed has been um you know something that has lasted to today. Um and so it was it was elementary um it at the beginning, um, and a lot of uh language barriers, but when you have such a high acumen and you go through that change management process of ADCAR and start with awareness um and have the right information, which was the starting point, um that really opens everybody's eyes to be able to make educated decisions. So in everybody's defense, there was just a lack of uh information readily available to be able to teach. Um and so that was my experience. And uh, you know, other things give credit over to the teams. Mark St. George, I didn't mention Ted Pappas was great, um, and learning lean and how to do Dimaic projects to bring all these different voices into one room to be able to build something that uh would not be uh effective uh with one dimension, um, whether or not it was preference cards or you know, organizing the inventory, uh, et cetera. Um, so I think those were the building blocks uh to running a strategic supply chain that I learned very quickly. Um I mean it started with having a glove conversion without surgeon feedback. That doesn't go well, right? So that was uh one of the things that we were able to go through the proper process and uh, you know, uh have as a liaison uh somebody that could speak all those languages and get additional toolkits to be able to help. So again, uh it was just a great building block, great foundation.

SPEAKER_02 13:26

I I laugh at that glove, the glove uh conversion process because there that was surgeons' gloves, right? Not exam gloves. They were the surgeons.

SPEAKER_00 13:34

That's exactly right.

SPEAKER_02 13:36

Um but so when you were when you were working at uh Mayo in Jacksonville, had you already gotten your MBA? I had, yeah.

SPEAKER_00 13:46

I had my MBA before I went to nursing school, in fact.

SPEAKER_02 13:49

So you okay. Because because with me, it was the opposite. I had I had had seven years of of clinical work before uh before I had any management work, and then I had had another um thirteen years of management work before I got my MBA. So what you're what you're saying is you had already been infused with a business perspective from having obtained your MBA before you got started in supply chain. Correct. How did that serve you?

SPEAKER_00 14:23

Ooh, well, that taught me very quickly. I mean, I had worked in banking and finance, I was a manager before I came into healthcare and other industries, private equity, uh, areas that had advanced systems, um, really, you know, uh investing in technology. Um, and when I came into healthcare, um, if I'm not mistaken, a lot of organizations at that time were still doing paper charting, you know, and in the finance industry, everybody was reinvesting in a new uh system entirely overhaul every two, maybe three years at the most, to have a competitive advantage. Um, so it taught me how antiquated healthcare was from a technology standpoint of that area era, but look how fast it's come along, you know. Um still antiquated, of course, as compared to the outside of healthcare sectors. But um yeah, it it was pretty eye-opening uh the technology, and it just it was, you know, for me, it was really uh uh just uh uh again, a blank canvas of opportunities to bring value to an organization with a different perspective. So it it wasn't like I had all the solutions. I just could help, you know, um diagnose the issues through tools like lean, etc., and be able to come out with some solutions. So yeah, that's been the fun part about being in healthcare uh is that there are opportunities, uh, most likely anywhere you go in different areas, and if you have the right um toolkit and approach, uh you can bring value to an organization.

SPEAKER_02 16:17

Yeah, and you had a formal structure from your training at in the MBA program, which was really interesting.

SPEAKER_01 16:24

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For Profit Metrics And Accountability

SPEAKER_02 16:50

So let let's take the let's take those gloves. I'm back at these gloves. Uh like I don't have time to tell a story. No, no. I don't have time to tell a story about the time I got yelled at by a doctor when I told him that uh the gloves we had in Vietnam, we didn't know who made them. They just sent FSN and a bunch of numbers. And the doctor says, son, you're not in Vietnam. And that that's that but that was that was in uh not-for-profit private health care. You then went from Mayo to the ultimate in control by comparison when you're working in for-profit ACA uh um venue. How did that work? How did was it easier to get things done there than it was working uh in uh in Mayo? And I certainly it was easier than it would have been in the places you went afterwards.

SPEAKER_00 17:44

Different different um paces and different missions led to different types of core competencies. For instance, at Mayo Clinic, what uh reinvestment into you know advancing the science and research and um how that supply chain evolved over the years, real being a top-ranked supply chain, um it's not a comparable. Um at HCA being a not-for-profit, um, you know, they reinvest in building and uh growing, and uh, you know, a lot of that is tied to their mission and construction and any other areas. So um uh their financial acumen um with metrics upon metrics and really at-hand metrics to be able to manage performance is second to none. Um and as a result of having line of sight into that, the expectations are to manage to those metrics and goals and hold people accountable. So it's kind of like a different um barometer on a spectrum where you have uh a performance-managed uh model and very heavy on that, and the balance of human capital. Some organizations lean towards the human capital, others lean towards the performance, and some are between. Um and as a result, you know, there they're just second to none when it came to metrics upon metrics and having that at hand as a vice president of operations, or if there wasn't in supply chain, they would come up with a way to be able to extract the data. So that was one of the things that you had uh information more readily available, and that was cascaded. And it was more of a uh being for-profit, you're going to see this outside of healthcare as well, uh, top-down type of organizations with structures and you know, uh specific goals that are not grassroots goals. These are some are, but for the most part, you have a cascade of goals, and uh it's just a different way of uh at the end of the day, you're trying to manage to performance to bring value to the organization. So different core competencies, of course, but uh similar uh in fashion on how to get there, uh just a different approach. But at the end of the day, uh the patient was, you know, the customer.

Learning To Build Strategic Supply Chain

SPEAKER_02 20:18

Yep. And then you transitioned back into the not-for-profit uh burgeoning IDN market. Uh and um the the I think the last place you worked before you came to Akron Children's was at um at Orlando Health, and that's where Suzanne Cantero Thompson had been, and that was where my my dear friend Randy Hayes had been for uh for uh several years. Um so and and you mentioned uh to earlier that uh Suzanne had uh had uh done a lot uh to to build that uh IDN. What did you learn from your time there?

SPEAKER_00 20:58

Well, you know, you can go work at already built organizations. Um, you know, Mayo was uh at the beginning, but for the most part, they had solid foundation. Having worked at the resource group at Ascension, it would just launch its own itself as a GPO, so but very solid, you know, just decision making that I got there and others. But um in this instance, you know, Suzanne had uh built a top 25 hospital system uh from uh pretty much you know not having been a top 25 previous, you know, in her previous experience. So she knew how to do it. And building a strategic supply chain is just a different um muscle, different acumen. So um for her, I came in probably a year or two after she had got going, and um, it was amazing how she was able to take uh it from what Randy had done and building a very Very human-centric model with uh you know the uh performance that they had attained. And then uh next thing you know, Central Florida market is booming, um, absolutely blew up as relates to um fastest growing markets in the country. Uh so it required a pivot of that strategic plan, and Suzanne was the right person to be able to help build that. And as a result, Suzanne um, under her toolage, was able to help teach me how to build a strategic supply chain. And she immediately linked me with Gardner and that team. Uh, and kudos to them. They gave me a lot of blueprints on how to, you know, understand the comprehensiveness of what it entails to be a strategic supply chain. It's less about just dabbling in pricing and doing stocking shelves, right? And that was something I learned, the comprehensiveness of a strategic supply chain and being able to build it uh more thoroughly. Um, and that helped me as the foundation to be able to go into a blank canvas and customize and scale down and take the best practices, things that would and wouldn't work, um, and uh bring that to Akron children. So fundamental, absolutely uh great tutelage uh for my current role coming in. Yeah.

Children’s Hospitals Care Differences

SPEAKER_02 23:25

Yeah, the whole idea um when you say strategic versus uh transactional, uh I would say that still 80% of the supply chains in the country are largely transactional. Uh and they like to use the word strategic in a sentence, but uh it it take it takes and and this is why I want to get to Akron Children. Um I'm familiar with Northeast Ohio because, like I say, I was a supply chain leader at Timkin Mercy Medical Center in Canton, Metro Health in Cleveland, um Meridian Health System, which is now part of the clinic, so I'm very familiar up here. Mo when I came up from uh Miami in 1983, most of the hospitals were mom and pop standalone hospitals. Uh Akron was uh was Akron uh City, which became SUMA, uh uh Akron General, and Akron Children's was there, all standalone community hospitals with staffs that leveraged their way for everything they wanted. Uh and now uh the marketplace in Northeast Ohio is owned by the clinic and university hospitals, and you are a standalone sort of vestige out there. Uh two things I'd like you to talk about. Number one, what are the different care requirements and challenges of a children's hospital versus uh a general general service IDN? And number two, what are your particular challenges in supply chain?

Commit For Kids And The Five Pillars

A Mission To Elevate Pediatric Supply Chain

SPEAKER_00 24:55

So, you know, I'll use I'll personalize this. Our fourth child is special needs little guy. Uh he is nonverbal, non-mobile. And so children's hospitals or part of an adult system, they've that's our second home. It has been for some time now. He's uh 10 years old now. And so we've gotten to taste test and see the differences and levels of care. Um and I've worked, you know, at multiple hospital systems to see how oftentimes children's hospitals can be a smoothing air when it comes to uh financial investments, um, technology, et cetera. Um, because you know, service lines are the uh way that uh organizations bring in um money, uh their revenue streams. And so you'll see a lot more investments towards ortho, neuro, um, you know, CV, etc. And children's and pediatrics tends to be, you know, not their primary choice in uh adult and children's hospital systems. And children's hospital systems, um I was amazed at the caliber of care. So neurosurgeons go for more schooling to become a pediatric neurosurgeon. More, I mean, uh the levels of acumen to take care of children, specifically children and teenagers, um, is second to none. Um, if uh Luca, uh, who gets a GJ tube, uh, you're familiar with these are feeding tubes, changed out every quarter. And in an adult with a children's hospital system, um, oftentimes they won't invest in pediatric-specific labs and things like that in IR. So you would say these see these tubes take an hour plus to be able to change out. Um at a children's hospital, it takes five minutes. Standalone children's hospital, Luca comes in, you know, they're already nervous, caregivers are nervous. It's not the you know, the best place they want to be, you know, is they've already been through so much traumatic event. Children, especially those that have chronic conditions, and they come into a children's hospital and it's curetailed for them. The experience from coming in to walking through to seeing, you know, uh characters and seeing, you know, like a playground, and then even going into the IR and having all of these, you know, different types of images around you that is um you're used to, whether or not it's oceanic scene, et cetera. And then the next thing you know, the procedure is done, and you have no event that has been traumatic. Um, and so since Luca has gone to Akron Children's, he has absolutely had like if you say, hey, we're going to go to see so-and-so, or we're going to the hospital, no reaction before it was, you know, a lot of traumatic and you know, um, crying, etc. So, you know, that level of care is just second to none. That's my personal experience having been had a hospital second home uh to us as a caregivers. Um, supply chain now, I mean that's a that's all that is absolutely when you look at a supply chain, you're building a blank canvas. I'm very blessed to have a very already clinically integrated um teams, uh, whether through the physician collaboration, through nursing, through all the way up through the C-suite, um, the pH is ripe at Akron Children's. So I've been here a little over a year, and with that, we built out a strategic plan with our uh five pillars, and as a result of that, um, we've been able to operationalize a lot of strategies that would take others years to do. Um, for instance, we were able to launch a what we call Commit for Kids sourcing strategy. This Commit for Kids program is basically moving uh us dabbling in contracts at around 15% of manageable spend uh to now uh be leading strategic reviews of over 200 categories for around 90 percent of the organization spend in just a matter of a little over a year working here. Um, it's unfathomable for many to think of how to do that. They're still trying to do it, but it was the pH of Akron Children's. It and it also was the um way that we went through the change management process, very uh, you know, collectively to go and teach awareness, the ad car process, teach us where we're at. Um, and uh it was pretty appalling the pricing of the children's hospitals as compared to adult hospital systems, that oftentimes the children's hospital would fall under the umbrella of a big you know spin bucket, and tier levels are how oftentimes your GPO pricing is set up. So children's hospitals, you know, uh are suffering from that uh setup because their spend may not be as high as others. So it was kind of eye-opening to see how uh high the pricing was for children's hospitals. You think of like you go to a theme park, children going in get a discount, right? And things like that. And um that it surprised me the pricing at children's hospitals. So I think that's paramount to our success. And then there's all the other pillars that we're working on, such as doing at ERP. We invested in four new technologies. Um, ERP is going to be one of those uh to be able to you know go speed of market with a lot of line of sight into technology, uh a lot of metrics, etc. And of course, improving what we currently have. Um, and lean, I mean, we've done 10 lean projects in about 10 months. Um, so we've instilled lean into the team. They already had an operational excellence team established here, and we just tapped into that team and shout out to Nicole Feller and that crew. Uh, we have done so many lean projects to be able to uh and and it was a precursor to the ERP. Now we can um, you know, establish best practices. So hope that helps shed some light on Akron Children's the how special it is to be at a standalone children's hospital, and then of course how to incorporate change into the well let's see, that's all the questions I had.

SPEAKER_02 31:41

What did I miss? What what uh soapbox would you like to stand on for about four or five minutes?

SPEAKER_00 31:48

Children's hospitals um I've worked in across the country. Um not for profit, largest, not for profit, largest for profit, um, number one ranked supply chain um and uh and others. Um and I can tell you that there is an opportunity to advance uh supply chain in the children's uh and teenagers areas. Um that to me is going to be my mission uh in my career here to be able to put children's hospitals on the map when it comes to being strategic supply chains. And there is such a great talent uh in with my colleagues uh that are under that CHA umbrella. And really uh what we're missing are tools and resources to be able to get there. And so uh, you know, uh for those strategic partners, we cherish you. Uh, we know you're making the investment into this for the right reasons and others. We invite you to the party to be revolutionary, not evolutionary, to change the way that we take care of our future, which is the children and teenagers whom we serve. That's our future, that's the posterity. So there's no better investment that I can think of uh at this season. So hope that helps. And I appreciate the time, Fred. Um, as always, my go you. Let's go, Miami. You got some uh here set up for the playoffs, but yeah, no, it I'm so blessed to work here, and I can't say enough. So thank you again.

SPEAKER_02 33:36

Yeah, and you have to be careful up here, Joe. Uh people here tend to talk about the all the time. Uh and uh and those of us from Coral Gables know that you can talk about the all you want, or really it's all about the you.

SPEAKER_00 33:54

The you, baby, the you.

SPEAKER_02 33:57

Thanks, Joe. We'll hope to talk to you again soon. Take care.

SPEAKER_00 34:01

See you, Brad.

Closing And How To Connect

SPEAKER_01 34:01

Stay soon. Well, that's all for today. Thanks so much for joining us. And don't forget to hit that subscribe button and connect with us online so you'll never miss an episode and can catch up on all the ones you might have missed. Got a topic you're fired up about, or maybe you want to be a guest on the show? Fred would love to hear from you. Just reach out at F C R A N S at S T O N G E.com. We'll see you next time.