orm_june-2024 - 26

OR BUSINESS
Supply chain stress fractures demand rock-solid continuity planning
BY MARISA TORRIERI
ore than 4 years after personal
protective equipment
production and inventories
crashed amid the global COVID-19
pandemic, the " new normal " in healthcare
supply chains seems to be " uncertainty. "
Although hospital margins
are improving and patient volumes
are trending upward,
" stress fractures continue
to remain in
place, " says Michael
Schiller, CMRP, executive
director of the Association
for Health Care
Resource & Materials
Management (AHRMM)
of the American Hospital
Association (AHA).
Michael
Schiller,
CMRP
In a presentation at the OR Business
Management Conference this past
February, Schiller outlined supply chain
challenges that continue to plague the
OR, ranging from staff shortages to geopolitical
trade disruptions to the scarcity
of materials once taken for granted.
Effective contingency planning requires
not only understanding the scope of
these " stress fractures, " but also leveraging
wisdom gleaned from the recent
past to inform continuity planning and
minimize the operational impact of future
disruptions. Compounding the challenge
are ancillary concerns that will
become more prominent in the future:
human trafficking, or forced labor, and
environmental sustainability.
Kinks in the global supply chain
Schiller cited the following as significant
risks to healthcare supply chains and
OR operations:
* Geopolitical tensions. Although geopolitical
issues have always posed
a risk to the movement of supplies
across oceans, multiple threats
have escalated simultaneously.
Houthi rebels disrupting shipping in
the Red Sea is just one example.
Redirecting transit through the Cape
of Good Hope can delay deliveries
26
OR Manager | June 2024
M
by as long as 47 days, Schiller says.
Some companies are considering
shipping to west coast ports-typically
a 17-day transit-but using
rail, over the road (ie, OTR) or air to
move product from there adds cost.
* Class I recalls. Reserved for products
that could cause death or serious
injury, the most serious category
of US Food and Drug Administration
(FDA) recalls can have a widespread
impact on quality and outcomes.
Schiller cites the example of sterile
water and saline products from
The Nurse Assist, LLC, which are
included in a variety of procedural
and care kits. The good news is regulators
in the US and abroad have
stepped up oversight, he says. For
example, the FDA recently expanded
sanctions to prevent plastic syringes
from Chinese manufacturer Jiangsu
Shenli Medical Production Co Ltd
from entering the US.
* Drug shortages. The American Society
of Health-System Pharmacists
(ASHP) reported 323 active
shortages during the first quarter
of 2024, surpassing 2014's previous
record of 320. The shortages
include cancer chemotherapy drugs
and emergency medications stored
in hospital crash carts and procedural
areas.
Fair labor
Minimizing human trafficking is one of
AHRMM's key priorities in 2024, Schiller
says. To that end, the organization
recently published an extensive guide
on identifying forced labor in healthcare
supply chains.
Healthcare organizations must work
with their manufacturing, distributor,
and group purchasing organization
(GPO) partners to evaluate risk and implement
policies for responding to reports.
Whether to sequester or donate
tainted products is likely to be a caseby-case
determination.
" If we do not have an alternate
product that we can use, we're going
to have to use the affected product, "
Schiller says. " But in all of this, we've
got to take into consideration the court
of public opinion, and the knowledge
that we're using product that is coming
from a manufacturer accused of engaging
in human trafficking. "
Environmental sustainability
Venture capital firms and other investors
are looking more closely at what
organizations are doing to boost sustainability,
Schiller says. He highlights
the potential for ORs to embrace a " circular "
economy-one centered on eliminating
waste and pollution by recirculating
products and materials and reinvesting
saved resources into environmental
initiatives and sustainable practices.
Initial targets are likely to be gowns,
slippers, drapes, and other potentially
reusable supplies. " When you think of
sustainability-how it impacts the surgical
arena, the procedural settings, and
supporting areas-there's opportunity
in this space, " he says.
Meanwhile, progress continues on
efforts to decarbonize the healthcare
sector. As an example, Schiller cites
the National Academy of Medicine's
Grand Challenge on Climate Change,
Human Health, and Equity. Launched
in 2020, this initiative aims to raise
awareness of promising efforts, establish
road maps toward effective strategies,
accelerate research, and otherwise
mitigate the impact of climate
change on human health. AHRMM is a
member of the supply chain committee.
Although the US Securities and Exchange
Commission (SEC) has yet to
issue formal regulations, healthcare organizations
and large companies face
growing pressure to measure their carbon
footprints, Schiller says. " We're seeing
a movement with larger suppliers out
there, more so on the retail side, where
they're driving sustainability accountability
with their manufacturing partners or
with their suppliers, " he says. " They're
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