Hospitals & Post-Acute Care: Supply Chain Management Thinking

Earlier this spring I commented on the “difficult” times we face, brought on by the onset of COVID-19 (1).

I was drawn to the fact that our public was being introduced to a new vocabulary through daily news releases and press conferences, as COVID-19 epicenters on the east coast searched for ventilators, and various forms of PPE.

Public officials were expressing concerns about the number of available beds to treat patients, and the potential for overwhelming the “capacity” of their health care systems (2).

The consistent use of supply chain management (SCM)(3) terms and references to hospital supply chains, were hard for me to miss as our nation began ramping up its capacity to address the rapidly spreading virus.

I believe SCM concepts and capabilities are key to solving many problems faced by healthcare, because they align well with existing healthcare industry imperatives such as Quadruple AIM(4) for reducing costs, improving quality, and improving the experience of patients and providers.

Continuity of care, another healthcare discipline that aligns with SCM principles, continues to be a significant issue for hospitals and post-acute care providers as patients (elderly or otherwise), transition to other forms of rehabilitative, residential, or long-term care. The proper flow of information enables collaboration across the care “continuum” among providers and staff, while ensuring patient safety.

I've called these times, “incredibly instructive“ as COVID-19 threatened to overwhelm our healthcare systems across the country. For many, it might be hard to equate a nationwide pandemic with the risks of an aging population, but it’s all about improving our capacity for care...

SCM is about maximizing “customer value”, by coordinating the collective efforts of each component in the most “efficient ways possible,” according to Robert Handfield, Ph.D, from the Supply Chain Cooperative at NC State University.

(We'll now substitute the terms consumer, or patient, for the term "customer".)

When applied to our patient transition example, Dr. Handfield's first principle of SCM says that each step of the patient’s care and treatment, represents the "cumulative efforts of multiple people and organizations."

His second SCM principle is based on the notion that "most organizations have only paid attention to what was happening within their four walls."

Let’s allow these to sink in. (I’ll come back to them in a future post, very soon, I promise...)

Now, imagine your patient is about to be admitted for acute care. You’re the assigned discharge planner, social worker, or case manager responsible for coordinating your patient’s care delivery and eventual transition.

You gather information. In your mind, or from a checklist, you review the steps necessary to coordinate treatments and care: insurance & eligibility, physician's orders, medications, care plans, perhaps even the individuals involved in your patient’s care, discharge plans, etc.

Is the patient being admitted for an elective procedure, (one that’s been scheduled)? Or perhaps a more serious condition that could mean the patient will likely need some form of long-term care once her hospital stay has been completed? Does she suffer from any chronic conditions that could complicate her care?

Now imagine the patient has completed her treatment and is about to be discharged into some form of post-acute care. What are your options? How urgent is the need for her post-acute transition? How involved is the patient’s family? What type of care? What if none of the options available to you are acceptable to your patient, or her family? What happens if you can’t find other alternatives that you trust?

Now, here’s an even trickier part: Ultimately, how will you determine if a post-acute care provider is a good fit for your patient? Is it even up to you?

Coming up next: Hospitals & Post-Acute Care Providers: Like a dance?

Founder's Note: For a while now, I've been studying the basic challenges of aligning those who need senior care services with those who provide them. I believe Supply Chain Management (SCM) principles, when combined with appropriate technologies, will help overcome the imbalance. 

?Resources:

Langkau, Len. 2020. "Founder's Blog, "Hospitals and Post-Acute Care: The Culture of Communication"." wiserwings.com.March 30. https://wiserwings.com/founders-blog/f/hospitals-and-post-acute-care-the-culture-of-communication.

Zhang, Sarah. 2020. "America's Hospitals Have Never Experienced Any Thing Like This: If they run out of space, where will all the sick people go?" The Atlantic. March 25th. https://www.theatlantic.com/science/archive/2020/03/coronavirus-hospitals-need-more-beds/608677/.

Robert Handfield, Ph.D. 2020. "What is Supply Chain Management(SCM)?" Supply Chain Resource Cooperative, NC State University. February 19. https://scm.ncsu.edu/scmarticles/article/what-is-supply-chain-management-scm.

Thomas Bodenheimer, MD & Christine Sinsky, MD. 2014. "From Triple to Quadruple AIM: Care of the Patient Requires Care of the Provider." Annals of Family Medicine. September 2. https://www.annfammed.org/content/12/6/573.full.