But in the aftermath of Hurricane Maria, which had shuttered a prolific producer of IV bags, there weren’t any.
Korte had never seen such supply chain fragility. With no fluids on hand and no contingency plan, there was nothing left to do but say the words she never wanted to utter.
“I don’t have what you need.”
The patient survived. The team’s reputation barely did. Though saddled with circumstances beyond their control, the perception was that they had failed at inventory management. And reputation, as hospitals know, is everything.
How, Korte thought, can we make sure this never happens again?
The question weighs heavy on stakeholders across the care continuum that have weathered storms ranging from Katrina to Harvey to Maria to Helene — and it’s also one that guides Vizient’s approach to supply assurance. With natural disasters, global pandemics, international conflicts, domestic worker strikes and just about everything in between throwing a wrench into the value chain, implementing strategies to ensure providers have what they need to deliver uninterrupted care is beyond critical.
As recent events have shown, there’s no such thing as perfect. But every emergency is a learning opportunity — a chance to harness more collaborative, proactive preparation and timely, consistent communication with stakeholders.
Of course, doing so requires understanding the larger organizational effects of supply shortages, along with the tactics to address them. Here’s what to consider.
The downstream implications
8.4 million.
That’s the number of additional labor hours spent managing drug and supply shortages, which comes with a $360 million price tag.
Now consider that this number was reported in a Vizient survey circa 2019 — before the pandemic sent the supply chain into even greater chaos.
“Every shortage requires identifying alternatives, implementing shortage mitigation strategies, creating protocols and prioritizing patients,” said Mittal Sutaria, Vizient SVP, contract and program services, pharmacy. “In 2019, drug shortages were hovering in the 250s. During the first quarter of 2024, we saw an all-time high of 323 drug shortages annually. So, the cost of labor in managing drug shortages had also probably increased exponentially at this point.”
Certainly, providers feel the effects of supply shortages on a workforce that’s already stretched beyond its limits. Add to that the pressure to improve quality, and the complexities created by supply chain constraints are undeniable. Drug shortages especially undermine the quality of patient outcomes through delays in inpatient medication treatment, outpatient infusions and medical procedures.
“It's a race for time,” said Elaine Prince, vice president of operations support for Encompass Health, a 165-hospital system focused on post-acute inpatient rehabilitation. “Our whole goal is to prevent supply shortages from negatively affecting our clinicians and at the end of the day, our patients.”
But factors beyond natural disasters make this goal increasingly difficult. FDA and government inspections have increased since COVID, particularly in overseas plants that manufacture active pharmaceutical ingredients (APIs), which can result in delayed production of final medications. And while data and transparency have improved since 2019, there’s still room for more visibility.
“It’s about building on layers of resiliency and redundancy so that when these unanticipated disruptions occur, you’ll have the resources and access you need on hand,” Sutaria said.
The strategies
So, how do you prepare for anticipated shortages as well as the unexpected?
Proactively identify critical items: Determine the items your hospital most needs to provide patient care and then decide what the alternative will be if those products are on shortage. “We mapped out all of our critical products, and not including medications, that’s about 700 products,” Prince said. “We identified substitutes for all of them. It’s not enough to know that a disruption will occur — you must have a plan in place before it happens.”
And remember, Prince said, don’t just focus on IV fluids or other products that have seen shortages over the past five years. You must consider all supplies that are essential to consistent care — and pull the right team together to do so. “We worked with all clinical leaders, whether that be nursing or respiratory therapy, to identify those critical supplies. That enabled us to give different prioritization to items that are back-of-house versus those that are front-of-house.”
Ensure transparent communication: Once it’s clear that a disruption is imminent, look for resources that clearly outline what’s happening, along with the potential impact and solutions. Then, further communicate that information within your organization. “Management of critical drug shortages is a daily event for all of us,” said Ann Byre, assistant vice president, pharmacy and lab services at Allina Health, a 12-hospital system based in Minneapolis. “During the tornado that hit Pfizer’s Rocky Mount facility in 2023, Vizient partnered with the manufacturer to provide unparalleled insight through a market disruption brief within the first 48 hours. Through that, we were able to determine and communicate what products were impacted. That brief helped reduce panic.”
Commit to the right suppliers: Especially when it comes to changes in allocation resulting from supply disruptions, the most sustainable strategy is to build partnerships with key suppliers. “We’ve been really successful with some suppliers in increasing allocation based on commitment,” Prince said. “If we’re looking to move a category over, that’s part of our initial discussion. In opening new hospitals, we’ve committed to certain suppliers to ensure we have allocation percentages that match our future needs.”
Work assurance into contracts: Embed supply assurance commitments and service-level agreements into supplier contracts that extend beyond just price and clinical factors. “When we present to our executive management team, our brief includes supply assurance strategies,” Prince said. “There’s no better time than when you're leveraging a new agreement to make sure that everybody is focused on what your priorities are.”
- Look for programs that reduce workload: All of these strategies are
great — but they can be hard to do alone. Identify programs that consolidate supply assurance
activities and make them easy to plug into. For example, Vizient Reserve brings together
providers and suppliers to drive dedicated inventory that is stored stateside in supplier
warehouses so it can be accessed when needed. The program has helped ensure access to essential
medications, such as chemotherapy drugs, that were otherwise in short supply through normal
distribution channels. In addition to medications, Reserve also includes various critical
supplies categories as well.
“All drug shortages are not created equal,” Byre said. “In the oncology space, for instance, you never want to have to make decisions on who gets these critical medications and who doesn't. And I'm happy to say we’ve never had to because we have access to those mission-critical drugs through Reserve.”
‘There is a solution’
Korte can still picture that trauma surgeon, down to the cup of coffee he nursed that did little to quell the exhaustion of an all-night operation. But now she envisions a new ending to the story, one where there was never any question that all the necessary supplies were available.
“I often think, ‘What if we’d had these programs and strategies back then?’ — that would have been so significant,” she said. “That experience and the role I have now has lit a fire in me to let providers know there is a solution. There is something that can save you time, save you energy, save you panic.”
Building resiliency, Korte said, “is truly a mission.”
Learn more about Vizient’s supply assurance programs and resources.