Salt Lake City, UT -- (ReleaseWire) -- 05/27/2021 --Although used to functioning behind the scenes, the COVID-19 pandemic shoved Intermountain Healthcare's internal Supply Chain Organization (SCO) into the spotlight.
"My daughter used to say that I bought Band-Aids for a living," said John Wright, vice president of supply chain and support services at Intermountain Healthcare, with a chuckle.
Now his daughter – and the nation – has a better understanding, and appreciation, of the importance of supply chains, especially in healthcare.
Through strong vendor partnerships, flexibility in sourcing supplies from around the globe, and even some good old-fashioned creativity, Intermountain's supply chain team met the Herculean task of making sure that the healthcare system had enough supplies and medical materials to protect their caregivers and patients through the pandemic, while also donating critical supplies to other vulnerable communities and organizations in need.
PPE Goes Short
The Intermountain SCO is responsible for supplying 24 hospitals, 215 clinics, and a host of medical offices throughout Utah, Idaho, and Nevada. The team noticed supply chain disruptions months before COVID-19 cases ramped up in Utah.
"We started recognizing early that there were going to be some issues in January of 2020," said Trent Gee, director of supply chain solutions at Intermountain.
It started with delays in regular shipments of personal protective equipment (PPE). That's because most materials used to make medical grade masks and gowns come from Wuhan, China, which went on lockdown on January 23, 2020.
"We knew something was up, and we started to have serious conversations with our suppliers around product availability," Gee said.
Intermountain was about as prepared as a healthcare system could be, said Wright, because they had long had pandemic plans in place, and fine-tuned them in response to the 2013 West African Ebola outbreak.
"We've been meeting for years with infection prevention, the industrial hygiene team, and employee wellness to put together a list of pandemic supplies," said Wright.
The Intermountain SCO team also reassessed the vulnerability of their supply chain after Hurricane Maria hit Puerto Rico in 2018. That made IV bags, which are manufactured on the island, hard to get. Relying too much on suppliers all based in the same location or region meant that one event could make that item almost impossible to find.
The Intermountain pandemic committee met quarterly to update inventory levels and identify any changes that needed to be made. Instead of carrying 30 to 45 days' worth of those materials, Intermountain had more than a 60-day supply.
In January, the Intermountain SCO team started increasing that to 90. Wright said they did that by working closely with their PPE distribution partners and going directly to suppliers.
Wider sourcing, without getting scammed
But still, as the world vied for the same limited number of medical supplies, Intermountain needed more options, and not just for masks. Isolation gowns, shoe, and head coverings were difficult to source.
That meant looking at different vendors – and making sure those vendors weren't scammers.
"Every exporter and broker decided to get into this business then," said Gee. He was getting hundreds of emails a day, and vetting vendors who reached out directly to Intermountain's leaders, and even board of trustee members.
Intermountain declined to work with anyone who demanded payment up front.
The Intermountain SCO team also wouldn't process purchase orders until they were able to test items to make sure they were the real thing. They reported any instances of price gouging, which was rampant, to the FBI. Where N95 masks normally cost $.84 per mask, Gee saw prices as high as $7.65 per mask.
The Intermountain SCO team typically planned based on what the healthcare system used in the last 30 days. They switched to seven days, then to forecasting every day.
"Things were changing daily. We had to create a forward-looking demand tool that tied directly to our analytics team, which was forecasting patient volumes and the type of patients, all tied to an algorithm that was based on anticipated use by those types of patients," said Wright.
They created an electronic pandemic dashboard, accessible by physicians, other caregivers, and team leaders, so they could be reassured that Intermountain was not going to run out of supplies.
Intermountain also joined the Utah Medical Supplies Work Group, so that healthcare systems, along with local health departments and emergency responders, were aligned and wouldn't be competing against each other for the same limited number of supplies.
"We took the atypical approach of partnering with other entities so that if we were running out of something, we could trade supplies to make sure they didn't run out of something else," said Allison Corry, assistant vice president of procurement at Intermountain. "It's very different when you start hopping on calls and collaborating with people who are normally a competitor. But it was an obvious decision because it was the right thing to do for our patients and the community."
Getting creative about creating supplies
Because their regular PPE selections were so hard to find, the Intermountain supply chain team started looking at items that they don't normally use.
"A glove is not a glove is not a glove," said Corry. The team worked with the infection control nurses and physicians to see what could work and what they felt comfortable with, asking "what are the six and seven masks that could be used for each situation," she said.
They ended up making 20 PPE product substitutions. But it wasn't easy. Gowns were in such short supply that at one point, Corry said they started talking to nearby Brigham Young University about buying their rain ponchos normally used for football games. Fortunately, the team didn't need to go that far.
That's largely due to ProjectProtect, a collaborative community-based effort to manufacture PPE.
Intermountain made reusable gowns for patients undergoing routine, non-COVID related medical care. They then turned to the healthcare system's internal sign shop into a face shield making operation.
After sourcing medical grade materials, they partnered with The Church of Jesus Christ of Latter-Day Saints, the University of Utah, and community members who helped in sewing that fabric into masks for caregivers.
All told, the ProjectProtect initiative helped make about 110,000 face shields, five million medical grade masks and 55,000 reusable isolation gowns.
Between March 1 of 2020 and March 1 of 2021, Intermountain used more than 147 million pieces of PPE and sanitation items. That's up considerably from nearly 122 million items used during the same time the year before.
The Intermountain SCO team increased warehouse space by 38% and added two offsite warehouses. That's on top of the 327,000 square foot warehouse Intermountain already had in operation since 2012, shortly after the H1N1 pandemic when leaders realized they needed more supplies on hand.
They were also able to donate more than 12,000 isolation gowns to the Navajo Nation, goggles to the Salt Lake VA Medical Center, and cloth face masks to the Ogden City Police.
To insure a robust supply chain in the future, Intermountain created 11 new partnerships with PPE suppliers in the last year. Similar relationships were the key to keeping Intermountain supplied during the pandemic and avoiding major price spikes.
"We're better at doing our own validation and sourcing than we were before," said Wright. "We have better access to data now and a link between our clinical and business analytics teams. We're using a lot of that information still about what our supply demands are going to be in the future."
He said that the system has also strengthened those supplier relationships that have long been in place. Wright also acknowledges not everything went perfectly in the past year, and the he and his team learned from the pandemic experience.
"This was a mutually-experienced event that affected all of us – and I think we all learned from this in a way that has benefitted us for the future," said Wright, adding that "everybody knows what healthcare supply chain is now more so than ever before."
He pauses and then adds, "who knew that healthcare supply chain was going to be the 'it' department of 2020?"
They do now.
About Intermountain Healthcare
Intermountain Healthcare Supply Chain Organization (SCO) supports Intermountain Healthcare, a nonprofit system of 25 hospitals, 225 clinics, a Medical Group with 2,600 employed physicians and advanced practice clinicians, a health insurance company called SelectHealth, and other health services in Utah, Idaho, and Nevada. Intermountain is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes and sustainable costs.