Industry Leaders Claim The Medical Supply Chain Short Fallings Are Reaching An “Unprecedented” Level
Even three years after the start of the pandemic, hospitals are still struggling to reconcile their demand with the shortcomings of the current supply chain.
While many supply chain managers at hospitals across the country are scraping enough resources together to provide care to patients (albeit through alternative resources or trade offs with other hospitals), they do admit that not only did it take some ingenuity to get it done, but that it is not a sustainable practice.
We all know the problematic areas from early on in the pandemic, like trying to acquire enough N95 masks, gloves, disposable masks, disposable gowns, eye protection and so on. Today, however, the problems have spread much further throughout the rest of the industry and now certain drugs, devices, and essential PPE supplies are starting to suffer from the latest shortfall as well.
According to a 2021 State of Healthcare Performance Improvement survey report by consulting firm Kaufman Hall, 99% of the 73 hospital and health system leaders from across the country who responded to the survey reported challenges in supply procurement, including shortages of key items and significant price increases.
Shortages of a number of drugs and medical devices and supplies have been reported by the U.S. Food and Drug Administration. Availability of raw materials, transportation and labor shortages are among the factors cited as contributing to the problem.
Current drug shortages include amoxicillin and Adderall, and supply shortages have been reported in recent months on everything from syringes, to tracheostomy tubes, to AEDs.
Shortages of specialized “double dose” blood bags used to separate certain blood donations into separate plasma and red cell components have led to some blood collection organizations in the nation to sound the alarm.
Jason Keeling, executive director of the Allegheny Highlands Chapter of the American Red Cross that includes West Virginia and Maryland, said the shortage has not yet affected the area.
“The Red Cross does not currently anticipate an impact to our ability to supply blood products to our hospital partners. Out of an abundance of caution, the Red Cross will continue to closely monitor supplies until the situation fully abates,” Keeling said.
Medical supply chain issues are not a new phenomenon. Sporadic supply chain issues occurred prior to the pandemic. For example, many medical devices produced in Puerto Rico saw shortages following the devastating hurricane that hit the island in 2017, according to West Virginia Hospital Association President and CEO Jim Kaufman.
The current issues started with shortages of personal protective equipment, or PPE, in the early days of the pandemic, but then broadened in scope.
“2020 was a rough year, but we really saw 2021 be a harder year than 2020. 2020 was very specific from a supply chain shortage. It was PPE. … Going into 2021, that’s when we saw the challenges and the shortages from labor shortages overseas impact a vast amount of different product categories, so it was no longer that very specific (PPE) conversation. It was really across the board, and we’re still seeing that today,” said Bryan LaBuda, WVU Medicine director of enterprise materials management.
“I’ve been doing this about 25 years. ... I would say this is unprecedented. Obviously, there’s always back orders and things like this, but in my career I’ve never seen the volume and the variety of back orders. That’s 100% due to the pandemic, which turned into labor shortages, as well.”
Hospital systems have had to jump through additional hoops to overcome these challenges. The state’s two largest health systems both reported being able to meet the needs of their clinical teams in serving patients..
Resource sharing among hospitals ramped up during the pandemic and has continued, according to Kaufman.
“One hospital may be short of a certain syringe or certain tool that another hospital can ship over. This is where they work together, sharing resources,” he said.
At WVU Medicine, supply goals have been met “by leveraging WVU Medicine’s buying power with strategic vendor partnerships that have a focus on domestic manufacturing,” LaBuda said.
The health system also created Allied Health Solutions approximately three years ago to facilitate group purchasing and negotiate purchasing for the health system and partners. The health system also is building a distribution center in Morgantown that will allow WVU Medicine to feed supplies from all WVU Medicine hospitals from Morgantown. Currently the system pulls supplies from multiple locations, including Baltimore, Columbus, Ohio, and Greensburg, Pennsylvania, LaBuda said.
The merger of Mon Health and Charleston Area Medical Center systems in Vandalia Health has added depth to the organization that has allowed for improved resource sharing, according to PJ Henry, Mon Health System director of supply chain management.
The merger has allowed for increased collaboration, economies of scale and consolidation of efforts, all of which have helped hospitals in the system weather the storm, he said.
When a supplier places an item on a lengthy backorder, the system’s staff work to find different vendors who can provide similar products right away, he said.
“First and foremost, we put patient care as our primary focus, and we’ve always been able to do that,” he said.
Charleston Area Medical Center was also able to avoid outages of supplies and drugs that would affect inpatient care, according to spokesperson Dale Witte.
“When reports first surfaced about an increase in respiratory patients in other parts of the country, our pharmacy suspected shortages may occur and stocked up on supplies. So we haven’t experienced any medication shortages for our inpatients.
“We have seen some availability issues with amoxicillin and Augmentin, especially the oral suspensions in outpatient clinics and offices.”
National efforts are focused on diversification of production and sources of raw materials to ensure that an issue in a particular location does not disrupt the entire supply chain.
Locally, organizations agree that increased domestic production will help insulate U.S. facilities from bottlenecks caused by transportation or other issues overseas.
Both Mon Health and WVU Medicine have expanded their network to focus more on U.S. manufacturers.
“Certainly we don’t have to move all manufacturing back to the United States, but to some extent we have to have domestic resources that we can pull product and drugs and equipment from in the future just to protect us from any sort of supply chain breakdown,” Henry said.