Hospitals and Post-Acute Care: The Culture of Communication

As of this precise moment, on March 30th, 2020, the current world-wide count of confirmed coronavirus cases is at 735,041! That’s up by almost 200,000 cases since Friday, when I last checked the worldometer[1] website for an update.

These are indeed difficult times, but they are incredibly instructive as well. 

In this era of flattening the curve[2], we’re all forced to learn things that we had little or no awareness of just days earlier. The average person for example, probably knows more about ventilators and social distancing than they ever dreamed they’d need to know. 

The term capacity, used to describe the possibility that our healthcare systems could become overwhelmed by the virus, justifies the need for flattening the curve, while concerns about the general viability of supply chains outside of healthcare, helps us understand the broader impact of the virus on our economy. 

It might be a surprise to hear of any association of supply chain practices, principles and terminology within healthcare by the general public, prior to the coronavirus. There are many reasons, most of which relate to the idea that what works in many supply chains doesn’t automatically translate to the healthcare provider supply chain[3].

This article won’t address the nuts and bolts of supply chains for healthcare or otherwise, but I do want to draw attention to the supply chain management (SCM) culture, or way of thinking, when it comes to PAC-provider support for seniors as their health and housing needs evolve.

Because SCM concepts operate in the background, they remain unseen by most consumers. They can affect the efficiency with which providers operate by reducing costs, making healthcare much safer, and contributing to a more positive patient and provider experience!

A very simple, SCM-101 example that, as consumers, we can all appreciate: your pharmacist knows precisely when to provide your refills!

With your prescription and dosages provided by your physician, plus the refill policies of your insurance provider, (and with the aid of technology), the pharmacy is able to calculate exactly when to fill the prescription and send the notification to help you avoid running out of medication. 

As the patient, you’re happy because you experience less worry about running low on medication and you might even spend less time waiting in line for your next refill. This also helps pharmacies serve more customers, a reflection of their capacity.

The speed with which we’re being forced to deal with coronavirus is not only what makes these times so instructive, but it’s what makes us see this as a crisis in the first place. 

The experience seems almost like trying to understand how a hummingbird’s wings work without the benefit of a high-speed camera to slow the action enough to see its individual motions.

While general principles of supply chain management include improving speed and efficiency in the delivery of products and services, they align well with the fundamental healthcare goals of reducing costs, improving quality, and improving the experience of patients and providers[4]. 

A supply chain culture recognizes communication and collaboration as among its foundations to meet these goals.

Today, hospitals and post-acute care providers rely heavily on Preferred Provider Networks (PPNs), for greater collaboration. These are often focused on reducing hospital readmission rates, and the transition to value-based care. 

Participation in these networks is growing fast. According to the Post-Acute Care Collaborative in a recent survey, just over three fourths of surveyed hospitals in 2018, had a functioning network, almost double the percentage of those surveyed in the previous year [5].

PPNs aren’t limited to skilled nursing facilities any longer. The survey reflected greater participation from other provider types, beyond just SNFs. This sounds really great on the surface, but the issue of understanding the many options available to elderly patients and their families isn’t new.

We believe confusion over available care options will exist for a long time. We’ll expand on that in our next post, but the reasons can generally be summed up by a lack of standardization and the influences of housing and community on care delivery, as PAC providers develop new approaches to serve their elderly residents.

A final thought that was reflected in the survey: PPN meetings focus on data sharing, not process improvement. Of course, process improvement is yet another fundamental aspect of a supply chain management culture... 

[1]Worldometer. (2020, March 27). Worldometer Coronavirus. Retrieved from https://www.worldometers.info/about/

[2]LIVESCIENCE. (2020, March 16). Coronavirus: What is 'flattening the curve' and will it worl. Retrieved from livescience.com: https://www.livescience.com/coronavirus-flatten-the-curve.html

[3]Morris, J. (2019, April 29). Healthcare Supply Chain Has Its Own Needs, Challenges: An Insider’s View. Retrieved from spendmatters.com: https://spendmatters.com/2019/04/29/healthcare-supply-chain-has-its-own-needs-challenges-an-insiders-view/

[4]Thomas Bodenheimer, M. &. (2014, September 2). From Triple to Quadruple AIM: Care of the Patient Requires Care of the Provider.Retrieved from Annals of Family Medicine: https://www.annfammed.org/content/12/6/573.full

[5]Advisory Board. (2020). What is the Current State of Preferred Provider Networks? Post-Acute Care Collaborative. Retrieved from advisory.com/pacc