Solving challenges that arise throughout the end-to-end healthcare supply chain is no easy task, and the complexity of the issues may be the most apparent when it comes to backorders.
Michelle Clouse, Concordance Healthcare Solutions Customer Experience VP, uses a 9-lane swimming pool analogy to educate her team on the movement of a product through the supply chain and to create awareness about the impact a backorder can create: “If I’m in the middle lane – in distribution – that’s what I’m focused on. I may notice what’s going on in the lane on either side of me and maybe occasionally I see what’s going on in the lane beside that.” She pointed out that she has little line of sight to what’s going on in the far left lane, i.e. point of manufacture, or the far right lane – point of use. “All the lanes need to work together,” she said. “We need to understand how each lane affects the other in order to truly make a positive impact in the process.”
The University of Tennessee Medical Center (UTMC) and Concordance detailed a powerful example of how a simple backordered item can rock the distribution channel and a healthcare system at HIDA’s 2019 Supply Chain Visibility Conference. Anticipating disruptions, the trading partners had proactively co-created a platform to bring thought leaders together, understand and prioritize improvement areas, and to collaborate at multiple points along the way.
“We started uncovering the very deep impact that even one backorder had on UTMC,” Clouse said. Their team “needs to know if it’s really an exact match and if not, what are the differences?” For example, when pre-filled saline flushes were unavailable, a technically reasonable substitute was identified as a syringe accompanied by a vial of saline that clinicians could prepare manually. This simple substitution had a cascading effect on UTMC’s workflow.
Domino-Effect Back Order Challenges for UTMC:
- Inventory original items throughout the health system to determine when they’d run out
- Review pricing and contract eligibility of alternate item
- Set up new item number for alternate and mark bins throughout hospital
- Create training protocol for the new process. Most millennial nurses had only been trained on the pre-filled syringe protocol at their health system.
- Track and record who had been trained, needed retraining, and review schedules in case a nurse had been absent during the initial training.
Both Clouse and UTMC Supply Chain VP Ron Collins agreed that simple-solution backordered items may spark issues that aren’t even anticipated – like clinician training. Clouse said her team learned that they needed better – and faster – communications pathways with UTMC. “We need as a distributor to provide the best information we possibly can so the provider can make informed decisions – and do it quicker,” she said.