Managing The Medical Supply Chain
Believe it or not, supply chain activities account for approximately 50 percent of hospital budgets when you factor in the cost of the goods, procurement, storage, engineering, pharmacy, food service and nurses' time spent on supply chain activities. It's no wonder then that supply chain management should be a top priority for hospital CEOs, but unbelievably many don’t consider the supply chain from a strategic perspective.
The economic downturn has had a positive effect in this respect, giving supply chain management a renewed prominence, boosting it in many hospitals from the basement to the executive suite and organisations that have placed strategic focus on the discipline are reaping significant savings. But there are still a lot of changes that can be made to streamline hospital supply chains and it's necessary considering that by 2020, medical supplies will surpass labour as the biggest expense for hospitals and health systems.
Where To Start
- Standardise commodities
- Maximise use of contracts with group purchasing organisations
- Manage inventory
- Use relationships with vendors to the fullest extent
By addressing the tasks above, hospitals and health systems will immediately recognise significant savings. However, the biggest opportunity lies in resource utilisation and reducing variation in care. As Ed Smith, Executive Director of Supply Chain Management, University of Mississippi explains, “You cannot sacrifice quality for cost. For that reason we don’t base our decisions solely on cost. In some cases, the higher cost item is associated with better outcomes. If we can reduce length of stay, eliminate infections and speed recovery time, we are impacting the bottom line in a big way.”
With this in mind it is also essential that physicians are involved in the decision making process to both enhance their understanding and to receive valuable input on care delivery processes.
Key Steps To Effective Supply Chain Management
“Whoever can deliver care at the highest quality and the lowest cost will be the winner,” says Richard Gundling, Vice President of The Healthcare Financial Management Association. These key steps will help CEOs manage strategic supply chain and garner the best return on investment.
1. BUILD RELATIONSHIPS
As a supply chain officer it is important to understand that you don’t know everything. Building relationships with colleagues, both clinical and non-clinical throughout the organisation and listening to their feedback will help make the supply chain more efficient and workable long term.
2. ALIGN WITH PHYSICIANS
Organisations need to engage physicians proactively in supply chain management. By placing them in leadership positions on value-analysis committees can help achieve significant buy-in from medical staff. They also have the technical know-how and can thus be involved in contract negotiations, formulary development and technology assessment.
3. PRACTICE EVIDENCE-BASED MEDICINE
Eliminating variations in care through the adoption of evidence-based medicine not only improves outcomes, but also reduces expenses. Reducing readmissions and preventing infections, among other things, optimizes reimbursement and places less pressure on the supply chain.
4. FOCUS ON CLINICAL INTEGRATION
The supply chain should be integrated with the care delivery process. A high-performing supply chain delivers the right product, at the right time, in the right quantity, at the right cost, resulting in improved outcomes and greater efficiency.
5. AUTOMATE THE SUPPLY CHAIN
The need for automation in the supply chain is clear. Lack of automation can lead to overstock and overspending on supplies. Materials management information systems provide real-time information on pricing, product availability, contract compliance and usage. Automation also enhances supply chain accuracy and expedites the billing process.
6. ADOPT STANDARDS
The adoption of supply chain standards such as GS1 can enhance efficiency, patient safety and regulatory compliance.
7. ENHANCE VALUE ANALYSIS
The value analysis process helps hospitals determine whether they are getting the right product at the right prices. Value analysis teams provide nurses, physicians and others a say in product utilization and performance.
8. THINK LEAN
Process improvement methodologies, such as Lean and Six Sigma, can identify inefficiencies within the supply chain and streamline processes.
COVID-19 "causing mass trauma among world’s nurses"
Healthcare providers are facing ongoing nursing shortages, and hospitals are reporting high rates of staff turnover and burnout as a result of the COVID-19 pandemic. In June a report found that levels of burnout among staff in England had reached "emergency" levels.
Registered nurses Molly Rindt and Erika Haywood are nurse mentors on US recruitment platform Incredible Health. In this joint Q&A they tell Healthcare Global about their own experiences of burnout and what can be done to tackle it.
What does it mean to be suffering from burnout?
Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care.
While every profession has its stressors, the nursing industry has some of the highest burnout rates. The massive influence on patients’ lives, the long hours, and many other factors put nurses at risk of severe burnout. And with the rise of COVID-19, many healthcare professionals feel the strain more than ever.
Burnout in nurses affects everyone — individual nurses suffer, patients are impacted, and employers struggle with enormous turnover. This is why it’s crucial for healthcare systems and management to watch for signs of nurse burnout and take steps to provide a healthier workplace. Employers should be careful to watch for burnout symptoms in their healthcare staff — and not ignore them.
Symptoms include constant tiredness, constant anxiety related to work, emotional detachment and unexplained sickness.
How widespread is this problem?
Unfortunately, burnout affects approximately 38% of nurses per year and even the WHO recently labelled burnout as an official medical diagnosis. To put this statistic into perspective, nearly 4 out of 10 nurses will drive to work dreading their shift. Burnout is a reason nurses leave their positions.
Other top reasons for leaving included a stressful work environment, lack of good management or leadership, inadequate staffing, and finding better pay or benefits elsewhere.
Even before the pandemic, demanding workloads and aspects of the work environment such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organisational leadership were known to be associated with burnout in nurses.
Have either of you experienced burnout?
Rindt: I have experienced burnout as an RN. I was constantly fatigued, never felt like I was off work, and would frequently dream I was still at work taking care of patients. In my particular situation, I needed to take a step back and restructure my work schedule to allow for more time off. After doing this, I was able to reduce burnout by deciding to work two shifts back-to-back and then have 2-3 days off.
Haywood: I definitely experienced constant anxiety related to work - so much so it would impact the days I wasn’t at work. At one point, I was even on medication to help combat the anxiety and stress I was facing on the job.
I had heart palpitations, chest pain, and wouldn’t be able to sleep before working the next day, which slowly started to impact other aspects of my life. I knew I couldn’t continue to live this way, it wasn’t sustainable. Because of this, I began to focus on my needs and prioritising self-care, especially during the beginning of the pandemic. Putting my needs first and not feeling guilty were necessary for me to overcome burnout.
What impact is COVID-19 having on nurses' wellbeing?
Some nurses have suffered devastating health consequences. Many nurses have dealt with excessive on-the-job stress, fears of becoming infected, and grief over seeing patients succumb to COVID-19 while isolated from their families.
New evidence gathered by the International Council of Nurses (ICN) suggests COVID-19 is causing mass trauma among the world’s nurses. The number of confirmed nurse deaths now exceeds 2,200, and with high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse and protests by anti-vaccinators.
However, other small silver linings that came from the pandemic include increased professional autonomy, leadership opportunities and career growth potential.
How much of the cause of burnout is due to the hospitals or healthcare providers, and what can they do to address it?
Nurse fatigue poses serious problems for healthcare organisations, and a recent survey from Kronos found 63% of nurses say their job has caused burnout. The survey also found that more than 4 out of 5 nurses think hospitals today are losing good staff because other employers offer a better work/life balance.
Nurse burnout not only contributes to staff turnover, but it can impact the facility’s quality of care, patient satisfaction, and even medical outcomes.
Strategies to address burnout include training improving nurse-to-patient ratios, include nurses in policy discussions, and prioritise fostering a healthy work culture in hospitals.
What does your role mentoring nurses on the Incredible Health platform involve?
Rindt: My role can vary based on the needs of the nurses. The nurses love knowing they have someone in their corner who can give interview preparation advice or provide suggestions on how to improve their resume. Knowing that there is someone who is well-versed in the job process and can help set expectations on what to anticipate, really helps to remove a layer of uncertainty.
Haywood: When screening nurses, it is customised to what their individual RN or nurse practitioner needs, and at a time that is most convenient for them. Nurses are busy and often aren’t thought of first. Being able to provide support from the very beginning of their career advancement journey helps tremendously. We also provide resources such as resume templates and tips that can help nurses be successful and feel supported.