Episode 6: Shortages and Recalls Part 2

Supply shortages and product recalls continue to challenge healthcare organizations, making proactive value analysis more important than ever. In this episode, we continue the conversation from Episode 5 and discuss teams can prepare for disruptions, evaluate alternative products, minimize clinical and financial risk, and strengthen collaboration across departments to maintain quality patient care during times of uncertainty.

Mentioned in this episode:

Episode 5: https://www.buzzsprout.com/2566869/episodes/19453708

FEMA: https://training.fema.gov/nims/

FDA: https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts

FDA Alerts: https://public.govdelivery.com/accounts/USFDA/subscriber/new

Want to learn more about Blue.Point? Contact us today for a free product demo! More information at www.bluepointscs.com or email info@bluepointscs.com.

Data Slayer Podcast

Through this podcast, our subject matter experts will cover in-depth conversations on healthcare data, clinical research, industry trends, real-world stories, and more. 

Blue.Point provides health systems with a specialized data analysis platform designed to optimize clinical product utilization. Our technology identifies savings opportunities and delivers non-bias insights on product best practices, standardization, and utilization-driven impact across hospital systems.

Interested in learning more? Visit www.bluepointscs.com

Transcript

SPEAKER_02 0:04

Hello and welcome to the Data Slayer Podcast, where insight meets impact, brought to you by the team at Blue Point Supply Chain Solutions. I'm your host, Jennifer Dodi, and joining me from Blue Point are Anne-Marie Orlando, the Vice President of Clinical Services, Keegan Smith, the Senior Manager, Analytics and Product Development, and Sarah Hobbs, the Clinical Program Director. Welcome everybody. Hi. Thank you for joining me today. Today we are going to continue our discussion on shortages and recalls, focusing this time on how to navigate them successfully and hopefully build resilience. We touched on this a bit in episode one. So if you haven't seen it, I will link it in the description of this episode. Otherwise, let's just dive in. So we mentioned this in episode one, and that's the importance of relationships, open communication, and expectations. So how do these factor into the equation? And Marielle, how have you start?

SPEAKER_03 0:59

Well, I think one of the things that I always think about is that you can't control everything that's going to happen. Yeah, I can't control what my distributor is going to do. I can't control what Mother Nature is going to throw at us or any other, you know, competing disasters that have occurred over the last uh, you know, what is it, 10 years or so. Uh, but what we can do is control how we are prepared to meet these challenges. I think that's the only thing that we can control. And so, you know, there's that's where there's a lot of prep that needs to go into um being prepared for that. Uh, think about everything at the hospital, right? Your uh, you know, do you have your backup power, right? Are you testing that regularly? But food, think about food. That's a big one that people often forget, right? Because you just think, well, I'm gonna get my food delivery. But if you are in a true disaster, right, food is going to be an issue. Water may become an issue. So there's just a multitude of layers. And then when you think about power, I mean, how many people you watch the pit? Uh and when they when they when they lost uh, you know, their all their screens and they shut down their connection to the EHR and they had to go old school in the paper, and and the the poor, you know, young kids, young docs were like, what? How do I do this? What and I think those of us who've been around healthcare for a while, we remember that paper documentation. Um, you know, but think about it from a supply perspective. If you were to lose your uh, you know, ability to order supplies through your you know electronic devices, do you know how to do a manual order? Would you even know what to order? Do you have the numbers? Do you have the phone numbers? I mean your account number, all those things you would you would need to know to make a phone call, say to your uh, you know, maybe your distributor would probably know. Uh you'd be able to work through them, but do you have the phone number to your, you know, you know, primary vendor of your NICU, uh, you know, respiratory uh, you know, circuits, right? And and you think, oh my gosh, like that's a specialty. I hardly ever call them. They're not gonna know me, but I need to know my account number. I need to know uh, you know, everything in order to get that the product catalog number uh to order. So um how do you do that? And do you know? So I think pre prepping is just so key to any disaster and being able to meet that shortage or recall or uh with some kind of resilience.

SPEAKER_00 4:01

Like you think about this, you really can't control the manufacturers, you can't control the delays, you can't control the weather, you can't control any of that. But what you can control is how well prepared you are. And so preparing for that by having lists or backup plans really uh can really make it a lot easier to manage. So um kind of going back, Jen, to what you were asking about the relationships and all the communications. Um I just think if you have those, if you have relationships that are good with vendors or uh manufacturers or anything else that you can rely on to call or they can help you in a in a pinch, right, then that really will help you. But really, it's more the open communication than anything, and just being being transparent, saying you need help when you do need help, and not just trying to do it all yourself. Um, but like I said, to me, preparing for those moments is really the uh key factor in all of it.

SPEAKER_03 5:12

And I think not only external, you reminded me internally, right? So uh your key departments, um, you know, are you sharing your back order reports with them? How often are you running your back order reports and saying, hey, CAF lab, I've noticed that these five uh, you know, guide wires have been on back order for the last two months uh or you know, last month. Should I give you a report every Friday? How critical is it that I get these in? Or are you just gonna say, yeah, we've moved on from those products? You can actually delete them from my par. Um, you know, that there could be, you know, two answers to that conversation. So is it an urgent thing and uh and or is it something you don't have to worry about, but it's keeping that internal line of communication open open as well.

SPEAKER_01 6:02

Yeah, Anne Marie, you just hit what I was gonna say to a T. I was gonna say that it's equally important to make sure that the plan is known system-wide internally for when you do have something. So it's not just one department feeling like, oh my gosh, we've got this problem because it might stem further.

SPEAKER_03 6:24

So yeah, yeah, and they may not even notice they don't have it, quite frankly. I I mean, there are some areas in the hospital where it's not it's a critical item, and it's and those critical items are often not used often, but when they need it and they grab for it and it's an empty space, that's that's a very difficult conversation to have or to hear, right? That's that call that you get in the middle of the night, and there's uh, you know, oftentimes it's a very difficult thing to hear, you know. We don't have, you failed us, right? And and that's not in something any one of us want to hear, right? Because then you're failing that patient too.

SPEAKER_00 7:08

So yeah, so you don't need it until you need it, and then when you need it, who's taking care of it? Exactly.

SPEAKER_01 7:16

And it's like education too, right? Like if you have a plan and you let people know what to look for in order to prepare and not have a crisis mode, it helps so that you're not getting those calls in the middle of the night and educating, like, all right, here we go. Like, look for these signs, look for this. Like, let's prepare ourselves, let's have these open discussions across internal sectors and yeah.

SPEAKER_03 7:47

100%.

SPEAKER_02 7:48

Yeah, it sounds like you have to have kind of a set process in place to in order to deal with that and oh yeah, yeah, that how the communication can flow. Um and and internally, how does that look? Like what team members are involved?

SPEAKER_00 8:07

Or I think about that, it goes back to the communication. You really do need to pick who's at the table, right? Um, and so trying to pick who's at the table really comes from the experience of those that have gone through it in the past, right? And so then then those people come to the table and then they have an idea, and greater greater the group, right? Um so uh trying to figure out who that is really comes from like think about this COVID experience, right? We all talk about that, but we had some people that didn't know where to go with it, but then they were relying on the experts that knew. And so those experts would be supply chain, those experts would be um the nurses that are actually utilizing the product, and what you can do as a substitute if you don't have that product, like you have to have that clinical expertise as well. Um, so you bring together the supply chain, the um the leadership that can communicate, and then you bring together the nursing as well.

SPEAKER_02 9:18

Yeah, it sounds like there is a lot um banking on experience. So having those experienced team members that um have either gone through it or have um experience in the process.

SPEAKER_03 9:31

Okay, I think the first line when when you're keeping those lines of communication open when there is something that occurs is ensuring that you one, communicate that, but two, then come up with a plan of how can we conserve what we do have while I uh research that uh that potential substitution. Um because I think that's that's a key piece. I would just read something yesterday about the IV shortage, right? That we had a you know a few few years back, right? And a lot of people were affected and you know, cases were canceled. That affects patient care, patient outcome a lot of things. But one of the things in this article that I did not read was having that conservation discussion. What can we do as you know, our medical experts, our clinical knowledge? If I need to prehydrate a patient who's coming in for a procedure, you know, in the morning, and I don't have that bag of you know saline for them, what can I do to ensure they are prehydrating? Well, that maybe have them drink water up until a certain time, you know. Let's let's let's confer with anesthesia. When would be a great time for them to really be NPO? And how can we prehydrate and how we can uh you know use you know PO fluid in in lieu of that? And is that actually best practice? In a lot of cases, yeah, it actually was and actually had um just as you know clinically uh appropriate and the outcomes were just as great, uh, whichever way they they used, and it also saved money and it also was better for the patient, and it and it also helped conserve the IV fluids, and there was a lot of good things that actually came out of it, and many people continued on with some of those practices that uh they established at that time. So um, you know, always be willing to get those people at the table that Sarah was talking about and and have those conversations of conservation. Let's think about that. What can we do?

SPEAKER_00 12:00

So you quickly find out how much you waste when you need something so badly, and then how are you gonna conserve that? And you're like, oh man, this you know, we recently started recycling, and you quickly realize how quick are how much just trash that you were just throwing in the trash that you weren't really sorting through and saying, Well, this is plastics, and then all of a sudden you have all these plastics growing. So I mean it's kind of it goes back to that, like it just points you out, it points out what you do waste and how how you can conserve it based off of just the mindfulness and thoughtfulness of how you're utilizing the products.

SPEAKER_02 12:41

Right. And again, it comes to experience. It sounds yeah, still comes down to that. Um, as well as how critical is the response time to when I mean it sounds again, it sounds like something that obviously the sooner you react, um, you know, the the better the outcome. But I feel like in this scenario, there might be times where you don't know when that tipping point is. You know, even going back to your example, the IV fluid shortage, yeah, Marie, how did that factor in the response time?

SPEAKER_03 13:17

Part of the preps and part of that discussion is going to also be understanding what are your the critical items in your facility, right? What are those items where if I didn't have that, you know, there's maybe not a lot of companies that are producing it. Maybe there's not a lot of options for the special population that I happen to serve. Like think about your NICU, you you know, little little babies, right? You can't just go to an adult hospital and say, Oh, can I borrow XYZ? It's not going to be the same. You you they're very specialized. And so, um, so you have to look at that. Uh, you know, there's a so definitely working with those departments to identify what in those departments if they didn't have, everything stops. Like there is no substitute, period. Um, so I think you have to start there. And then for those items that there are no uh, you know, if they didn't have that item, there's nothing they could do and they would have to stop. Is there uh other providers of that particular item that you're out of? You know, if it and is there a relationship instead of being uh, you know, committed to one? And I know this is you know controversial, you know, a lot of places want you to commit to one, you know, either manufacturer or whatever, but is there room, you know, build in room in that contract? So you can already have a relationship set up with a secondary supplier so that if you know things go awry with one, you have that secondary relationship already established and um you know, and understand what their capabilities are too. So can they scale up in the case of a shortage or a disaster? Um, you know, but I think what we found out during that uh time was people didn't have that secondary relationship established. And so uh it was very difficult to establish it in the middle of the disaster. And and that's no fault of anyone's, it just that's the nature of, you know, there wasn't a uh they weren't prepared to take on the amount of business that was available. So so think about things like that when you're going through your lists of you know, and identifying those critical items. How can you establish a potential secondary partner in that? And and build your list of subs. It's always you should always have that. It you know, because what happens is in another year, it may, you know, God forbid it happens again. But you know, in another year, I'm you know, maybe I'll be looking for another sub for the same thing. All right, it it's everything in supply chain, I feel, is cyclical at some point.

SPEAKER_02 16:18

So it sounds like you have to have a backup plan for your backup plan. I do yeah, yeah, and keep those updated.

SPEAKER_00 16:26

Yeah, well, and it's good too to have that backup plan, but to also kind of practice it. Like it's hard to throw out a you know, if you're having a fire drill, people tend to ignore those drills, right? Because, oh, or it's another drill. But when it's real, um, people don't know what to do. So um it's kind of one of those that like you need to continually keep it at the forefront of your mind where you're talking about it and you are actively addressing these um these potentials, the potential shortage. And like you can't send an email to the group and like as a mock as a mock shortage and say, hey, we're short on this, because then you would have massive freak out moments, right? And then it would be uh it would be bad. But you can also start educating and send out those, send out those communication points that say, hey, if this happens, this is what we do, just so that you're aware and to keep that education going, because you know, it's not just you don't you don't have just the clinicians that are doing it, ultimately it's the patients that are are affected are affected by all of it. And so how are we going to educate prior to and prepare prior to that to where when the shortage hit, the speed matters and we can get it done because we know what to do, when to do it, and how to do it.

SPEAKER_03 17:51

And you made me think about um, you know, if you can if for speed to uh you know solving the issue, you know, some people do warehouse certain items, right? And if you're lucky enough to have a space where you can, you know, have your own little stockpile, don't be afraid to work, or I shouldn't say don't be afraid, you have to take that stockpile and make it part of your general rotation, don't just put it in a corner and forget about it. It because what's going to happen is the product will outdate, the uh quality of the product will decrease, uh, it may not offer you know the same safe operation and safe results as you would expect. So, so if you are doing those, that kind of stockpiling, make sure it does get into general rotation. Um, it's really important. And then, you know, I do have to plug uh FEMA has uh several um free ICS courses. So instant command, so if there was a disaster, um, but they have tabletop exercises you can do. And think about your supplies, you know, if you were to run it in your value analysis supply chain department, you know, even if you just keep it to that department, you you know, do some tabletops, you know, practice does make perfect. It gives everyone kind of a preview of, okay, so if this happens, here are my first three steps. Here's the first, the, the three critical things I need to understand, you know, in this case. And you and the scenario may play out depending on what it is. If it's a you know, narrow surgical sponge, right? Recall, you know, it may be a little harder to map out, but plug in anything, any kind of shortage. Where am I gonna go? Who am I, how do I find my backup uh manufacturers or my maybe my secondary partners for that? Um in who are the physicians and surgeons or clinicians departments I need to engage with immediately in that in that area? How can I look that up? And so make sure people know um who they need to contact, you know, what are the top three priorities and practice it, you know, walk it through. It doesn't have to be a real one, it can just be um, you know, part of your meeting.

SPEAKER_02 20:22

That reminds me of those uh choose your own adventure books. Sounds like it's almost that. Like it would like the chapter would start with a scenario, either, you know, a hurricane or um a conflict breaks out in another country, and then this is the result. And you know, which which option are you going to choose and then kind of follow down that path and then maybe stop and say, hmm, that wasn't the right way. Let's go back and do it again. Exactly.

SPEAKER_00 20:49

Yeah at the end of the day, really, nobody ever looks back and says, Wow, we were way too prepared for that shortage, right? They're not trying to say that. So when you think about it, really, those uh all of the challenges that you've prepared for, um, it's just gotten through you, it's gotten you through it a lot smoother, and there's not the panic. And so that's where all of the clear communication and the best practice of practicing the shortage before it happens, to where then you can look back and say, hey, we did that, we did pretty good with that, but what can we learn from it now, right? Yeah, we were prepared, but there's something else like what if we aren't in this scenario? So just you you grow it, right?

SPEAKER_02 21:38

So yeah, having to have that critical thinking aspect, but also flexible in it.

SPEAKER_00 21:44

Yeah, so really kind of have try to have a playbook, right? Um have something that is identified where you know in your organization you can go to specifically in that playbook, and it try to try to keep

SPEAKER_03 22:00

it updated as much as possible but have those have those lists of phone numbers have those lists of people have have the people that are coming to the table have that information and to have it readily available for those that need it and if you've practiced enough then you they know where it is right um but have at least a couple of people that know where that playbook is to where you can go and grab it and say here's the list here's what we need to do in this situation I think that knowledge is power and so one thing I do subscribe to on an RSS feed is uh FDA recalls because it's um I don't have to think about it. So it just comes to my email and I it goes into a little bucket. Now I have to remember to go look at it but um I you know and I do need to do a better job of that but it it is nice because it automatically will come in and say uh you know we issue a level one recall on this a level three recall on that and you know gives you all the information that's related to it so um because sometimes um you know where those notifications go it may not be clear so you should also think about that process of how even if it's a recall situation where does uh that notification come in from so do you have a general recall mailbox you know I think that's that's important right so that there's a lot of visibility and several people have eyes on that um or is it just coming into say Keegan's mailbox and then maybe she's on vacation and it sits in her mailbox for a little bit right or you know sometimes there's a disconnect between your manufacturer and you and you may not get notified. So making sure that you know again if that recall is issued through uh you know the you know the FDA I think that that's a really good one to uh subscribe to I'll make sure to get a link to that in our episode description as well for anyone if you want to go and check that out.

SPEAKER_01 24:12

Um and also is there any way we can bring this back we are the data slayer so how does the data how can you I leverage data to help you in this preparation and education I think we kind of touch base with it right on our part one of this is just looking for those trends being able to say okay like in this natural disaster we saw this starting to fall down or oh we know this area is going to get hit with hurricanes what comes from this area you know like starting to really understand the environment and the outside factors that play into how you receive your products and um then looking at that data looking at those trends being prepared looking at the spend because I mean if spend is going up or something that could indicate like hey we're gonna start seeing you know supply go up even more and having it be hard to get that supply so just looking at that will help um I think data wise.

SPEAKER_02 25:29

I know there was a time we didn't need to know uh the origin of the plants uh of the manufacturing plants we didn't need to know uh where the raw materials were pulled from you know that was not a need to know basis it was like yep it just shows up at the dock and we're good and it's not like that anymore right so Keegan to your point it's you know if there was something that happened in this part of the world what products can I pull out of my ERP that are originate from there or what raw materials could potentially be affected and be able to get those um that list and it's it is all about the data so how you're setting up that your system and what type of uh information can you input into there so that uh you are able to then extract it absolutely all right any last thoughts before we conclude our shortages and recalls podcast well I can kind of go back to you know what we were talking about at the beginning is what you can't control to keep in mind just you can't control the storm um but make sure that your supply chain has the umbrella right so then you you are covered um don't be caught without that umbrella so prepare prepare prepare yeah very good advice you got it all right well that sounds like a wrap on today's episode um thank you all for participating and everyone out there listening and watching our podcast uh make sure you like and subscribe wherever you are enjoying this episode so that you'll be informed when our next episode airs uh and for more information you can visit our website at bluepoints.com or any of the links in our podcast or video description and remember best practice does not have to cost more when you slay your data with blue point until next time bye anyways we got a a blue theme going on today I know that's right oh breaking it up no that's okay it's probably better that someone's breaking I do have green under my tank talk is green so like you tie us all together yeah I'm not gonna make you uh never mind yeah keep it PG okay right