HealthcareNursing

Supply Chain Continuous Improvement in a Pandemic Context

Ms. Inas Al Khatib

UCGConference Proceedings:


Presented in 11th American Healthcare, Nursing and Patient Safety Conference from November 15-18, 2022 in San Francisco, USA- Best Western Plus Grosvenor Airport Hotel

Speaker Name: Ms. Inas Al Khatib
Affiliation: APM Chartered Project Professional (ChPP)
Category: Speaker Presentation & Chair Person
Speaker Profile: https://health.universeconferences.com/inas-al-khatib/

Unified Citation Journals, 1(4) 1-15; https://doi.org/10.52402/Nursing206
ISSN 2754-0944

Biography:

With over 15 years of professional experience as an APM Chartered Project Professional (ChPP) leading instrumental projects within the health care and industrial manufacturing industries. A certified Master Black Belt Lean Six Sigma, CPHQ, Prince 2, PMO Certified Practitioner. A keen learner, and researcher on CO2 emission reduction, publisher in engineering journals; currently pursuing her PhD in Industrial Engineering.

Inas is a holder of Bachelor of Business Administration in Information Systems from the University of Lincoln, Bachelors of Aviation Sciences from the Engineering College of Abu Dhabi University, MBA from the University of Manchester and MSc in Quality and Safety in Health care Management from the Royal College of Surgeons in Ireland.

She has directed a multi-disciplinary and diverse portfolio of life science contract manufacturing and distribution, home medication delivery, dry warehouse and cold room activations, digital platform activations, logistics of inauguration events, space build, activation and decommissioning, health care entity/asset integration, Warehousing ERP system and EMR system deployments, ISO/Magnet/JCI/local regulatory accreditations. Awarded the HIMSS Davies IT Award and has a proven track record of identifying and resolving complex issues, helping reduce costs and minimize waste while increasing profitability, traceability and effectiveness. Closely working with commercial, governmental and regulatory entities to streamline and digitally transform operations.

Booz Allen Hamilton, Cleveland Clinic Abu Dhabi, G42, Musanada etc. are amongst the employers Inas had the pleasure of being part of their community. Transformation, IT, Supply Chain and Logistics, Continuous Improvement, Strategy, Operations, and Manufacturing Engineering Management are her fortes. While volunteering in humanitarian missions and NGO program operations remains her passion.

Abstract:

Introduction:  At the initial stage of any pandemic securing drivers will be a challenge as many fall ill and swiftly securing replacements is typically a challenge for logistical operators. Last mile delivery companies are recommended to (1) form a business continuity consortium which allows them to tap into a contingency driver pool for emergency coverage (2) secure a pass that ensures smooth crossing of borders during lockdowns. In an attempt to strengthen the last mile delivery system in healthcare during crisis, implementing these concepts would require close collaboration with the respective registration and regulatory authorities of the markets they operate in; while another approach would be to depend on crowd logistics whereby delivery operations are carried out by using passengers’ excess capacity on journeys that are already taking place, resulting in economic, social and environmental benefits [1].

During lockdowns, medication home delivery drivers would typically require to present documentation confirming their association to certain healthcare facilities increasing the risk of service delays and medication damage. Contrary to driving licenses issued on an individual level, the emergency pass registration of drivers would need to be on an organizational level and recognized when presented. Moreover, it is crucial for the driver registration process to be digitalized, rapid and user-friendly in languages commonly used by drivers. Ideally this pass privilege could even be linked to the mandatory identification cards of those drivers.

The containment of the COVID-19 pandemic was significantly affected by the unbalanced distribution of emergency supplies, low coordinated transport efficiency, high costs and lack of emergency logistics information [2]; having an authorized governmental logistical arm for emergency use to support private logistical organizations sustain their commercial contracts in cases of lockdowns, would keep this category of operators financially afloat.

Despite commercial websites help businesses create their brand awareness [3] yet they are not enough to clearly identify for healthcare facilities whether a particular logistical operator has the licensed IoT temperature-controlled truck fleet and required manpower capability needed to handle operation in a state of emergency. Having free access to a database that hosts MTU lists and ensures it is kept updated, without the need for a requestor to go through a lengthy process to extract such information is vital. The reason why healthcare operators seek this information is to urgently commission logistical operators for medication delivery and other forms of consumable transportation.  Should a market require trucks to be licensed, the Medication Transportation Unit (MTU) registration standards and process must be fast-tracked during pandemics. This would dictate that the used application portals should allow for multiple truck registrations under one submitted application whether as part of a new or renewal registration process.

Keywords:  Pandemic, Continuous Improvement, Change,

Home medication delivery service is highly recommended to continue as a consistent charged service available to patients throughout the year and not only during a pandemic or emergency. Therefore, the ability to offer such a service may need to be considered as part of the Inpatient and Outpatient facility accreditation and/or licensing process within the market of operation. This will entail healthcare operators building home medication delivery service into their Electronic Medical Records (EMR) systems and user application testing (UAT) which acts as a safeguard against any unfinished, inefficient or faulty end result reaching to rollout or deployment [4].

Intelligent Traffic Control Systems that employee intelligent cameras on the roads to identify the vehicle numbers and send this information to the central system [5] needs to be configured to recognize the private vehicles of caregivers (doctors, allied health, nurses, patient support employees) who are expected to physically head to their work in healthcare facilities (most in demand professions during critical times). Therefore, profession recognition within the vehicle registration process is important and having the capability to automatically override any imposed radar penalties for driving during emergency lockdowns is as essential through such a SMART system operating in any geographical location.

The need for a functional addressing system is increasingly becoming critical for the management of the rapid growing cities making this presence more essential for the prompt home medication delivery in a pandemic. A unified street addressing system is critical and needs to be an integral part of urban planning and new plot building permit processes. The lack of efficient and standardized addressing system in such cities hinder urban planning as it impedes the delivery of urban services [6].

Drones have displayed incredible promise in various aspects of clinical care [7]; commercial drone usage has become increasingly needed especially for medical delivery to remote areas. Delivery to a customer would require the drone to fly through the whole community occupying secondary space. Even if the customer gives consent for the drone to deliver the product, the question of other people’s consent in the community remains. Therefore, a law regarding this is required, which is possible only through the respective market’s aviation authorities. Drone related negligence, confidentiality, criminal offenses, insurance, trespass and nuisance needs to be considered when legislating this law allowing for mass usage of drones in healthcare to become a normal mode of transportation.

Mobile care (truck labs and clinics) and Virtual Care is essential in pandemics especially during lockdowns with mobile clinics representing an untapped resource for healthcare systems [8] such assessable care to be made available to communities especially in remote areas fulfills a continuous need and not only during pandemics. Increasing the capability of mobile health service delivery within the healthcare landscape and making it an integral part of it, has a positive impact on public health [9].

SCM Component | Warehousing

Business Continuity of cold and dry warehouses typically used to store pharmaceutical or medical supplies are left to the renting or owning healthcare facility to take care of which is not always a guarantee for setting the needed quality and facility management control mechanisms. Business Continuity and Risk Assessment techniques in Logistics [10] should be an integral component of SMART cold and dry warehousing permitting process governed by the market’s respective regulatory authority; with a pre-approved list of consultants made available through them, those can be reached out to by healthcare facilities and third-party logistics providers (3PL) to seek licensing readiness advisory services required in the respective market of operation.

During pandemics or emergency responses, formal logistics cells are rarely planned for in advance as part of a standard emergency response structure, therefore, coordinating a network of agencies which together would establish local logistical plans, allocate owners of specific items/resources, oversee the implementation of the plan and coordinate the activation of the plan in the event of an emergency forming the formal logistic support cell [11]. Throughout this exercise, emergency physical stock piles (large stock of goods or materials that have been purchased and held in storage by the healthcare facilities in storage for when needed) would need to be revisited especially for food supplies, medications and medical supplies e.g., syringes and PPEs. This includes the raw material stocks within local manufacturing facilities. A detailed feasibility study to establishing manufacturing facilities within dedicated life pharma and/or healthcare clusters to secure a continuous supply of crucial medical supplies during emergencies and crisis that may entail multiple waves of lockdowns.

SCM Component | Sourcing and Procurement

Business Continuity (BC) is recommended to be enforced on all service and supplies contracts procurement negotiates on behalf of their healthcare facilities therefore, the scope of work should clearly outline the BC requirements. To only have Business Continuity clauses in contracts is not sufficient enough as the vendor’s proposal submissions should clearly detail the emergency manpower coverage and business continuity workflows for their client (healthcare facility). Moreover, having a dedicated Business Continuity representative from the vendor’s side associated with a clear model of interaction is a pre-requisite to win a contract throughout the contract negotiation and management processes.

SCM Component | Staffing

Perhaps the most obvious impact of COVID-19 pandemic on the labor force is the dramatic increase in employees working remotely [12]. Virtual Connectivity and remote work will no longer be confined to emergencies or pandemics, however, not every member of supply chain operational teams is readily equipped or set-up to immediately perform their usual activities which may cause operational delays and cost inefficiencies. Supply Chain functions are recommended to consider embedding remote work for non-frontline supply chain jobs, with virtual onboarding and orientation training incorporated as part of their virtual employee journey. Business Continuity training and certification of supply chain employees is key to their success supported by mental health insurance coverage for them to better cope with stress usually trigged by elevated levels of work demands during emergencies or pandemics.

References:

[1] H. B. Rai, S. Verlinde, J. Merckx and C. Macharis , “Crowd logistics: an opportunity for more sustainable urban freight transport?,” European Transport Research Review volume, vol. 9, no. 39, pp. 1-13, 22 July 2017.
[2] J. Wu and Y. Wang, “Distribution of the Emergency Supplies in the COVID-19 Pandemic: A Cloud Computing Based Approach,” Mathematical Problems in Engineering, vol. 2021, no. 1024-123X, 2021.
[3] F. Salehi, B. Abdollahbeigi, A. C. Langroudi and F. Salehi, “The Impact of Website Information Convenience On E-commerce Success Of Companies,” Procedia – Social and Behavioral Sciences, vol. 57, p. 381 – 387, 2012.
[4] Bennett, Coleman & Co. Ltd. , “Definition of ‘User Acceptance Testing’,” The Economic Times , 11 March 2021. [Online]. Available: https://economictimes.indiatimes.com/definition/user-acceptance-testing. [Accessed 12 March 2022].
[5] A. Ghufran, H. Adil, M. Abderrahim and H. Larbi, “Automated Real-Time Intelligent Traffic Control System for Smart Cities Using Wireless Sensor Networks,” Wireless Communications and Mobile Computing, vol. 2020, 2020.
[6] K. Abebrese, “Implementing street addressing system in an evolving urban center. A case study of the Kumasi metropolitan area in Ghana,” Iowa State University, Iowa, 2019.
[7] S. Balasubramanian, “Drones May Become ‘The Next Big Thing’ In Healthcare Delivery,” Forbes, 9 January 2022. [Online]. Available: https://www.forbes.com/sites/saibala/2022/01/09/drones-may-become-the-next-big-thing-in-healthcare-delivery/?sh=6f1130241e9b. [Accessed 12 March 2022].
[8] S. Attipoe-Dorcoo, R. Delgado, A. Gupta, J. Bennet, N. E. Oriol and S. H. Jain , “Mobile health clinic model in the COVID-19 pandemic: lessons learned and opportunities for policy changes and innovation,” International Journal for Equity in Health volume, vol. 19, no. 73, 2020.
[9] Bull World Health Organ, vol. 100, no. 2, p. 94–95, Feb 2022 .
[10] S. Valente, “Smart Warehousing: Applying Business Continuity and Risk Assessment Techniques in Logistics,” Linkedin, 7 August 2019. [Online]. Available: https://www.linkedin.com/pulse/smart-warehousing-applying-business-continuity-risk-serafina-valente/. [Accessed 3 March 2022].
[11] UK Cabinet Office , “Logistic Operations for Emergency Supplies – Guidance for Emergency Planners,” UK Cabinet Office , London, 2009.
[12] S. Lund , A. Madgavkar, J. Manyika , S. Smit , K. Ellingrud , M. Meaney and O. Robinson, “The future of work after COVID-19,” McKinsey Global Institute, London, 2021.

Upcoming Conferences;

  1. 12th International Nursing, Healthcare and Patient Safety Conference from July 25-27, 2023 in Dubai, UAE.
    More Details: https://nursing-healthcare.universeconferences.com/
  2. 13th American Healthcare & Hospital Management Summit from November 15-18, 2023 in Los Angeles, USA.
    More Details: https://health.universeconferences.com/

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