13 minute read
Intalere’s Steve Kiewiet: Transparency is key
To help answer questions on how the COVID-19 pandemic is affecting the U.S. healthcare supply chain, The Journal of Healthcare Contracting reached out to Steve Kiewiet, Chief Commercial Officer, Intalere. He offered the following comments. JHC: What are some best practices of leading IDNs, health systems and hospitals that have disaster and disruption plans in place? How are they trying to stay ahead of any potential issues? Steve Kiewiet: I think some systems do a great job in communicating with everyone in their system about the impacts when disruptions occur. They manage their inventory and utilization effectively and engage their clinical community in ways to maintain care while reducing the use of impacted products or finding alternative products for the delivery of care. Emergency operations and crisis management are executed well by many systems. The shortfall is we don’t work together to make this best practices, common practice for everyone in the industry. JHC: How do we as an industry prevent shortages that may occur due to hoarding and panic buying? Kiewiet: Transparency is the key. We must, as an industry, commit to enabling and participating in end-to-end supply chain visibility and transparency. We should be able to track and trace every product necessary for the delivery of care from raw materials to the use in delivery of care. Inventory levels should be transparent to every link in the chain. Each stakeholder should be held accountable to use that transparency to ensure the complete supply chain is optimized versus the optimization of one link over another. Transparency can help prevent overstock and understock issues. It can ensure all necessary products for care are in the right place at the right time for the right patient. We need to take all of the “lessons learned” from every previous supply disruption and implement the change necessary for every link in the chain. JHC: Are you seeing lessons learned from previous disasters being implemented? If so, how have we gotten better at handling situations like this? Kiewiet: I think individual systems have gotten better and individual manufacturers have gotten better. I don’t believe the industry has improved at all. Every disruption becomes a case study in the same lessons learned from the last disruption. Yet, as an industry we don’t take those learnings beyond the local or individual stakeholder level. We don’t come together as an industry and make the changes necessary to remove the risks and bring end-to-end resiliency to the supply chain. Healthcare isn’t consumer goods; we can’t keep living in reaction mode and playing the role of hero firefighter. We need to be fanatic about fire prevention. It would be great if I never had to watch another presentation, read a case study or attend a seminar on the lessons learned from the latest disruption. Steve Kiewiet Transparency can help prevent overstock and understock issues. It can ensure all necessary products for care are in the right place at the right time for the right patient.
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Dear Healthcare Colleagues,
During this unprecedented, challenging time of the COVID-19 pandemic, it is more important than ever to honor and support the healthcare workers that are making a difference every day. It is the first responders, doctors and nurses, and all of those behind the scenes in hospitals, including cleaning and maintenance staff, who deserve our utmost thanks and appreciation for their unrelenting strength and resilience.
With the number of COVID-19 cases continuing to rise, the focus on infection prevention and enhanced safety within hospitals is crucial. As my colleague, Caitlin Stowe, clinical research manager at PDI Healthcare, explains in this informative piece, there are key company-wide best practices to follow to ensure hospitals are properly protected. This includes establishing comprehensive cleaning and disinfecting protocols, utilizing proper equipment and products, and maintaining adequate supplies.
As we have all witnessed, the most critical and valuable ingredient in infection prevention is the human element. Hospitals and healthcare facilities need to support their entire healthcare team. This crisis is not going away quickly, and we need to sustain these frontline heroes. Make sure they are physically and mentally healthy, and above all, keep them protected and safe.
Now is the time for hospitals and healthcare facilities to focus on a layered approach to infection prevention, including hand hygiene and personal protection equipment, as well as implementing rigorous surface and equipment disinfecting processes. Managing the supply chain and having honest discussions with distribution partners is also a key element to ensure adequate supply of critical products, such as masks, cleaning supplies and life-saving equipment, during this time of heightened demand.
We are all in this together. With a focus on best practices for infection prevention to protect patients and our healthcare professionals, we can safeguard our communities. Our thoughts and gratitude remain with all of those on the frontlines as we all forge ahead.
Stay safe and healthy,
Sean Gallimore Senior Vice President and General Manager PDI Healthcare
Infection risks are everywhere. So are we.
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Keeping healthcare facilities infection free
Best practices and protocols from an infection preventionist
Introduction The response to the COVID-19 pandemic from medical caregivers has been heroic, said Caitlin Stowe, clinical affairs research manager at PDI Healthcare. “It’s highlighted the everyday work that nurses and physicians do. Everybody in the hospital plays a key role in the prevention of infections, and I think it just goes to show that healthcare workers are the heroes right now. We have to keep our caregivers as safe and healthy as possible so they can be on the front lines saving as many lives as possible.”
Share Moving Media, publisher of The Journal of Healthcare Contracting and Repertoire Magazine, asked Stowe for her insights into how best to keep those healthcare workers safe amid the risks associated with the coronavirus.
Stowe has been an infection preventionist since 2009. She started her career at a cancer center, and worked her way up through various care settings. Stowe was a system director for a couple of years before she made the jump to industry back in 2016. She has a master’s degree in public health and global communicable disease and a certificate in infection control. Stowe is currently working on her PhD in health science and she is certified in infection control, health care quality, public health and vascular access.
In the following article, Stowe highlighted the infection prevention products that will be key to healthcare facilities’ efforts, short-term challenges providers will need to navigate, and the long-term planning that will be needed to maintain an adequate supply.
Infection prevention products hardest hit There are a lot of hard decisions that healthcare facilities are having to make in regards to supplies, Stowe said. The biggest one is the use of personal protective equipment (PPE).
How much protective equipment does each provider have for its staff to adequately protect the healthcare workers and patients? “The supply chain has a really hard job right now working with their distributor partners and having open communication with their leadership in infection prevention to ensure that they are maintaining adequate supply levels.”
Another supply category that supply chain teams need to be concerned about is surface and equipment disinfectants. “Do healthcare facilities have an EPAregistered disinfectant on list N, which means that it has an emerging pathogens claim? This way we can feel comfortable in knowing the disinfectant is killing the coronavirus.” The coronavirus is an enveloped virus, on the lowest level of the hierarchy of pathogens, so it’s fairly easy to kill.
“Some of the latest research that I’ve been reading says it lasts in aerosol form for a couple of hours, and can last on a surface for two to three days. So it’s really important that not only are we making sure that we have enough protective equipment to help our team members and staff care for patients, but also making sure we have enough disinfectant to appropriately wipe down the surfaces, because we don’t want that to perpetuate the spread of this in the healthcare setting. We need to ensure that we’re also doing really good surface and equipment disinfection.”
Stowe said supply chain teams must work with their infection prevention team and their nursing leadership to estimate usage. “And with the situation so fluid it’s obviously subject to change,” she said. “But in a worst case scenario, what’s the par level or what’s the daily supply that you’re going to need in order to take care of your patients safely?”
Indeed, cleaning personnel play an important role when it comes to preventing any kind of infection. “The No. 1 way to prevent infection is hand hygiene,” she said. “The No. 2 way, in my opinion, is adequate surface and equipment disinfection, because 80% of infectious diseases are spread by touch.”
Once the needed supplies are identified, if healthcare facilities don’t have adequate supply levels, or supplies are back ordered, is there a contingency plan in place? “Providers need to work with their infection prevention leadership, their nursing leadership, and the C suite in general to ensure that there’s not going to be a delay or a gap in care because they don’t have the equipment and/or supplies needed to do their job safely.”
To help with this, the Centers for Disease Control & Prevention (CDC) has issued some guidelines for reuse of PPE, for alternative PPE to ensure that people are still being protected. (Visit www.cdc.gov/ coronavirus/2019-ncov/index.html)
Short-term challenges and long-term planning Staffing will be a major short-term challenge for providers, which makes keeping caregivers safe and their work environment infection free critical. “We have to make sure that we’re protecting our staff, because if they are exposed they have to self-quarantine – usually a minimum of 14 days if they have high risk exposure. The CDC has changed their guidance on
this a few times, but right now if you have a high risk exposure, meaning you were not wearing the right PPE when you were caring for a confirmed patient, you cannot work for 14 days minimum,” Stowe said.
Once supply in teams have an adequate supply for the organization’s day-to-day needs, Stowe said the focus should turn to proper maintenance of that supply. “Not a stockpile of that supply, because that’s not going to do anybody any good, but building up a day or two extra worth of their supplies to ensure that there’s not going to be a break,” she said.
Also, there is the human element to think about. Supply chain teams should check in with their staff. Is their staff mentally and physically doing okay? “Everybody’s stressed,” Stowe said. “Ensuring that you’re supporting your team members through this long-term marathon is important. It’s not a sprint. This is a pandemic that’s going to go on at least for the next few months at a high level. And I’ve seen forecasts from the CDC where if we don’t do the social distancing and
all those other public health measures we’re trying to implement now, it may go through 2021.”
Protocols to follow Stowe recommended the following protocols as they relate to infection prevention for healthcare facilities:
Visitor restrictions. The visitor restrictions that a lot of facilities have been implementing are necessary, Stowe said. To that end, hospitals and health systems can check that policies and procedures related to the appropriate use of PPE are in place, that they are being educated to and communicated, and that there are spot checks to ensure
that their staff are doing the right thing. “Everybody must know when they need to wear a mask, when they need to wear a N95, and when equipment and surfaces need to be cleaned.”
Cleaning. Every multi-care patient use equipment should be cleaned in between each patient, Stowe said. The equipment should also be cleaned at regular intervals. “How often is a patient room getting cleaned, or the high touch surfaces getting wiped down on a regular basis?” Doing those enhanced cleaning procedures will definitely help reduce the bioburden of this virus in the environment.
A supply chain team checklist First and foremost, Stowe recommended that supply chain teams maintain an open dialogue and good relationship with their organization’s infection prevention team. “The infection prevention team has the most up-to-date guidance from the CDC, the WHO, their local health departments and they really are the subject matter experts that can help the supply chain prioritize what they need,” she said.
Stowe said open lines of communication – and “frank” discussions – will be needed with their industry and distributor partners. “Have really frank discussions with your distributor partners and say ‘This is what we need. Do you think you’ll be able to fulfill it? If not, help me find somewhere that can give me the supplies that I need.’”
Providers and suppliers alike are working day and night to ensure that we have adequate supply for the facilities so that the supply chain isn’t disrupted. “However, it works both ways,” Stowe said. “Facilities should not be hoarding supplies, or building stockpiles because that doesn’t benefit anybody. One reason is because the expiration dates of disinfectants are fairly short. So if you stockpile hundreds and hundreds of cases and then you don’t use them, that’s just product that’s going to expire.” Stowe likens the situation to a Seesaw, “a little give and take on what’s the appropriate amount to use and extra to keep in stock. But also we don’t want to hoard because other providers will need these supplies. We don’t want them to expire before you can use them.”
What we can learn from the COVID-19 response? As a public health professional, Stowe said the COVID-19 pandemic highlights the need for more public health funding. “We’ve been cutting funding to public health services for years so from a public health standpoint, we’re so strapped for resources that maybe they weren’t as effective as they could have been in the initial stages because we really just, we didn’t have the staff or the resources.”
Stowe said like a lot of infection prevention suppliers, PDI Healthcare is working hand in hand with its infection preventionists and hospital supply chain departments. “We’d never want care to be delayed or not given because of a failure or a lack of supplies when it comes to PDI, and like I said, surface disinfection of equipment and areas are some of the most important things you can do after hand hygiene. We are working hand in hand with our partners to ensure that we’re addressing all their questions and concerns and making sure that they feel as comfortable as they can with the current situation.”
