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You Can't Transform, Until You're Informed: A 'ListenFirst' Approach To Supply Chain Transformation

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October 11, 2018 by Scott Caldwell

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Article published on Becker's Hospital Review-Leadership and Management Channel

Caregivers and healthcare providers deliver compassionate, quality healthcare to patients in need, while also focusing on improving the overall health of individuals and communities. In recent years, the healthcare industry has evolved to include more policies pertaining to EHRs, meaningful use and performance goals. These additional administrative responsibilities have added a significant burden to our caregivers. With no corresponding increase in resources, coupled with the continued demand for medical services, our caregivers have far less time to spend with patients.

Reflecting on the compounding effects of additional administrative requirements for caregivers, a shortage of resources and a growing demand for healthcare, non-clinical staff must continually ask "What can we do to help?" and "How can we lift the burden placed on caregivers, so they can spend more time with patients?"

To understand how we could help, we visited one of our facilities to complete a "Dock to Doc Tour" – a walking tour with hospital leaders that tracks the life cycle of supplies in a hospital. This collaborative tour with C-suite executives follows a pathway that starts at the receiving dock and ends in the operating room with the doctor. We elected to visit a site of care that had attempted to proactively address the aforementioned issues. This site of care had highlighted their warehouse model, claiming the utilization of an onsite warehouse provided efficiencies that delivered high-levels of caregiver satisfaction. As such, this seemed like a natural place to gain ideas and insights on developing a national supply chain organization focused on serving the caregiver and the end-user.

However, once we arrived at the warehouse, we gained a different perspective. Although the onsite warehouse allowed for the expanded storage of product, we noticed nearly 75 percent of the space was used for non-supply related functions, including: records storage, copy and print services and housing obsolete capital equipment. This ineffective use of space made us question if the warehouse model really resulted in higher caregiver satisfaction.

As our Dock to Doc tour progressed into the hospital, we walked directly into a shift change where we observed nurses transitioning and giving reports, patients frantically pressing their call buttons, and other hospital staff maneuvering around the floor to serve lunch or clean patient rooms. In the middle of this hectic work environment sat a nurse's station filled with supplies. Curious, we asked a nurse why supplies were kept at the nurse's station. The nurse said it was because supply closets were full, and the warehouse had a lack of space, which forced the nurses to create a secondary location to store excess products.

As the tour continued, we listened to the frustrations of caregivers as they rushed to balance patient needs and locate the supplies needed to provide care. While walking to the basement of the hospital, we learned the warehouse model was further complicated by caregivers having to manage their supply needs through two separate ordering practices. Our observations brought us to the conclusion that although the warehouse was well intended, it in itself, did not result in caregiver satisfaction.

Before the Dock to Doc tour, we hoped the warehouse model this facility created would reduce or silence the typical "noise" found in the healthcare supply chain. In our minds, a caregiver-centric model should reduce stock-outs, remove duplicative supply storage areas, deliver hospitality, and drive caregiver satisfaction. With those goals as our primary drivers we asked ourselves: "Why can't a supply chain model deliver products at a low cost while still allowing caregivers to do what they do best?" and "How could we create and implement solutions to shift day-to-day caregiver time away from the supply chain and back to patient care?"

We determined a great end-user experience started with the caregiver in mind and not the supply chain. This meant our logistics and operations experts had to set aside their core capabilities to instead approach a complex situation with basic listening skills. We coined this as our "ListenFirst" practice, which we eventually trademarked and turned into a daily exercise and integral part of our Operations through our URL,www.ListenFirst.com. By embracing our ListenFirst practice we sought to identify caregivers' preferences and challenges while uncovering the root of their frustrations. Through this process we built trust and earned the privilege to manage the inventory in each of our care locations. By managing all inventory areas, we gained a greater understanding of the supply and demand in each of the facilities we were supporting. Only then, after practicing ListenFirst, were we able to fully understand the core reasons behind caregiver dissatisfaction.  

Once the core caregiver frustrations were determined, and trust was gained, we applied our operational and logistical skills. Our operations team found that solely using a warehouse does not create a streamlined, efficient, or hospitality-oriented supply chain. In fact, we closed the warehouse in the original Dock to Doc tour and eventually closed all warehouses across our Participants. The closures generated $11.2 million in operational cost savings, reduced cash committed to inventory by $116 million and improved fill rates from 93 percent to 98 percent over a five-year period. These factors assured our caregivers they would have the supplies they need, when they needed them.

Due to its documented success, we chose to continue using the ListenFirst practice across all Participants, delivering more than $1 billion in annual cost reductions and maintaining streamlined connections from supply chain storage to the heart of patient care. Through the ListenFirst practice we created a coordinated and efficient virtual operations and logistics solution that runs silently in the background and maximizes the time our caregivers have available for what they do best: caring for their patients.

Overall, the demand on healthcare caregivers is growing; however, the time given to our caregivers is not. Our call to action started with a belief that caregivers should not have to worry about supplies as they serve their patients. The items caregivers need should be available when needed. The items caregivers need should work. The items caregivers need should assist in providing quality, low-cost healthcare. Adoption of a ListenFirst supply chain practice helped us achieve those goals, allowing healthcare organizations to maximize caregiver time and add to a patient-centered system. A transformational supply chain is managed with the caregiver in mind, so they can focus on those they serve.