Commentary: When failure is really not an option

When they wheel you into the operating room (OR), the last thing on your mind is the state of the hospital's supply closet. If there's one thing we take for granted, it's that the surgical ward—the epitome of a high-stakes work environment—will have the proper instruments, medications, and supplies on hand for the scheduled procedure.

Unfortunately, you may need to worry about that.

A recent survey of medical professionals revealed that OR supply chains are nowhere near the paragon of excellence we expect them to be. The study, which was conducted by healthcare giant Cardinal Health, found that a full 40 percent of respondents have actually canceled a procedure and 69 percent have delayed a case because of a lack of supplies. Furthermore, 27 percent have seen or heard of a recalled or expired product being used on a patient, and 23 percent have seen or heard of a patient being harmed due to missing supplies.

The research, the third annual "Cardinal Health Hospital Supply Chain Survey," was conducted last fall among 305 surgical staff and hospital supply chain decision-makers via Sermo, a social media network for physicians. The respondents represented healthcare organizations of varying sizes, specialties, and practice areas.

In an era of extraordinary advances in logistics and supply chain operations, including inventory management, control, and visibility, a logistics professional might reasonably ask, "How can that be?" Well, for all the advances we've seen in this field over the past two decades, it's clear there is still a lot of room for improvement when it comes to health care.

A big part of the problem is that current inventory management systems are anything but, well, current. A full 83 percent of survey respondents reported their organizations still rely on manual counting in some part of their supply chain. Only 15 percent have automated systems, largely RFID (radio-frequency identification)-based. All this goes a long way toward explaining why more than half of surgeons and OR nurses characterized inventory management as "complicated" or a "necessary evil."

So it's probably no surprise that the study concludes that ORs need better (read: automated) supply chain management systems and analytics to support patient safety and reduce costs. "Fixing these challenges requires thinking beyond the shelf," said John Roy, vice president and general manager at Cardinal Health Inventory Management Solutions, in a press release. "We believe streamlining processes and gathering real-time data through automated inventory systems can transform inventory management from a 'necessary evil' to a powerful tool that supports better quality of care."

The survey results indicated that OR clinicians are on board with the idea of automation, which they believe would free up time for patient care and support better outcomes. But they also had definite opinions about the kind of system they wanted to see. To be precise, respondents strongly favored the idea of a special OR-specific inventory management system, rather than one that's part of a hospital-wide inventory system. A whopping 92 percent of frontline clinicians said they saw a need for a separate inventory management system designed for the specific volume and nature of supplies in the OR.

Developing such a system might sound like a headache and a half, never mind the training and implementation. But that doesn't mean it's not doable. If we can build a system that ensures your local (or online) retailer doesn't run out of iPads the week before Christmas, we can most certainly make sure ORs are properly stocked when a patient is rolled in for surgery!