HAVING MY SAY by Fred W. Crans

Last of three parts

When it’s time to make – or break – a new plan

So begins one of the best-known songs in the long and iconic career of Paul Simon. “50 Ways to Leave Your Lover” is an in- struction manual for how to get out of a bad relationship. One of the 50 ways Simon advocates is to “Make a new plan, Stan,” which is something that many organiza- tions in healthcare found they needed to consider after the many disruptions and problems that surfaced during the last two years.


There is a graphic, courtesy of Resilinc, available at a-new-plan/ that shows a range of actual disruptions during the period of 2016- 2017.

Companies that rely extensively on peo- ple’s knowledge of suppliers and supply chains are slower to respond, fi nd it diffi - cult to adapt and take evasive action when supplier dynamics shift. As you may have read in the previous two parts of this three- part series, supply chains get disrupted every day due to many different reasons. In 2017, there were almost 300 supplier factory fi res in the Life Sciences industry. But supply chains can get disrupted from so many other events. On average, every two hours, something happens somewhere in the world that has implications for sup- ply chain practitioners today.

So it becomes imperative to “Make a new plan, Stan…” Making a new plan is not something that comes readily to healthcare, especially in its supply chain. When disasters strike, the industry’s history has been to respond, react and return to normal after the crisis passes. But the upheaval caused by the disasters of the last two years, including the devastating impact on manufacturing facilities that produced key supplies, has given healthcare professionals pause. Maybe it is time to “Make a new plan,


Here are some things that Supply Chain leaders learned last year that were hereto- fore either completely unknown or worse yet, not even considered:

Puerto Rico Matters: • Shortly after the hurricane, the American Red Cross was faced with a shortage of bags for collecting blood. Hospitals across the U.S.


he problem is all inside your head, she said to me. The answer is easy if you take it logically”…

• Organizations knew on whose trucks supplies came to the dock, but they didn’t know: o What company manufactured them o Where they were manufactured o Where the components that made up the products were manufactured

• Organizations did not have a ready list of alternative suppliers for key items

• Manufacturers often used single-source, single-manufacturing site sub-contractors for key components of their products. Manufacturing redundancies were often absent, putting entire product lines at the mercy of Nature.

• Worse yet, most organizations had nei- ther the capacity for nor the understand- ing of why and how predictive analytics could be brought to bear before disaster struck.

On March 14, 2018, I attended the 2018 Symposium on Health Sector Supply Chain, presented by the W.P. Carey School of Business at Arizona State University. The title of the Symposium was: “Puerto Rico Matters — Lessons for Managing Risk in the Health Sector Supply Chain.” Its intro- duction stated:

The Impact of Hurricane Maria on U.S. Health Care Delivery

The 2018 Symposium on Health Sector Supply Chain focuses on vulnerability in the health care supply chain. The Symposium idea has its origin in the host of problems facing the over 45 medical device and pharmaceutical companies impacted by Hurricane Maria in 2017. While many com- panies were “up and running” quickly, others experienced problems due to damage to their plants as well as continued problems related to access to power and employee access to work. Supplies, purchasers and distributors are challenged to design risk mitigation strategies to assure continuity of care. Policy makers are challenged to direct resources at the times of crisis – but of even greater importance, to craft policies that anticipate risk and mitigate risk.

have recorded periods of limited operations due to hurricane related shortages.

• “The bag shortage is the most signifi cant to be directly linked to the effects of the hurricane, but others are likely to follow.” New York Times (October 24, 2017)

• “Supply shortage tests hospitals”. The Wall Street Journal, January 8, 2018

Join with us to: • Explore perspectives from suppliers, providers, distributors and policymakers

• Consider consequences to patients • Understand the role of supply chain strategy to mitigate risk (Source: W.P. Carey School promotional leafl et).

Speakers at the symposium ranged from providers and key IDN executives to GPO representatives to professionals from both the healthcare and non-healthcare seg- ments. The message was clear: Disruption is omnipresent, and disruption can be mitigated by focused planning. The fi nal two questions I posed to the providers and suppliers I interviewed were: • How did the event(s) change the way you do business on a go-forward basis?

• What were your biggest takeaways from the experience?

Both suppliers and providers saw the need for better inventory planning. David Myers, Executive Vice President

and Chief Customer Offi cer at Concordance, cited the need for focusing on key items and increasing on-hand supply levels, and Nicholas Johnson, Materials Manager at the University of Vermont Medical Center said, “The supply interruptions caused by both Maria and the extended fl u season pro- vided the motivation for our supply chain to review what inventory policies to use for the different product categories. With the need to maintain continuity of supply while keeping an eye on cost containment, our supply chain reviewed how many days of supply was prudent based on the criticality of an item, the cost, the ease with which to introduce a substitute, etc.”

As for takeaways, once again, Johnson offered useful advice for the path forward, saying, “A supply chain’s best laid out plans

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