Behind The Scenes

Inside the “Brain” of a Healthcare System

Feb. 18, 2021

Season 5: Episode 2 UC Health has nearly two million provider visits with patients each year. Meet the team in charge of making sure the right supplies get to the right patient at the right time, even during a crisis.

7:00 a.m. Meet UC Health’s Supply Chain Team

All is quiet on UC Health’s main campus in Cincinnati, Ohio on this mid-November morning. The sun starts to rise as commuters head to work. In the basement of 3200 Burnet, UC Health’s operational headquarters, the day is already off to a fast start.

You may not see the friendly faces of UC Health’s supply chain team often when you are walking through the hallways of our facilities, but they play an integral role in supporting the lifesaving work our frontline workers do. Whether it’s face masks and face shields, IV bags, syringes or alcohol wipes, the UC Health Supply Chain team rises to the occasion each day, especially during a global pandemic.

When the novel coronavirus made its way into the U.S. early in 2020, hospital systems had to work tirelessly to increase their supply inventories to prepare for a possible influx of sick patients, while also making sure they had the proper materials to care for non-COVID patients and protect frontline workers from the deadly virus.

As the region’s academic adult health system, UC Health is equipped to treat the sickest patients, including those with COVID-19. Because of this, our clinicians and frontline staff must be prepared to care for any patient, no matter the diagnosis, at a moment’s notice.

Although the virus is new, UC Health Supply Chain’s mission remains the same. Whether it’s patients being transported via Air Care or Mobile Care to the Emergency Department, to neurological patients being treated at the University of Cincinnati Gardner Neuroscience Institute, to transplant recipients preparing for or recovering from their procedures, UC Health’s Supply Chain team needs to be available around-the-clock, ready to anticipate hospital needs and quickly fill any orders they receive.

COVID-19 challenges hospital supply chains around the country, but our team refuses to allow that to prevent them from successfully doing their jobs. They know a crisis, including a pandemic, can happen anytime. When doctors discovered the first regional cases of COVID-19 in March 2020, the Supply Chain team remained calm, continued their work and collaborated with their vendors to make sure our operations remained seamless.

Rob Wiehe, chief administrative officer at UC Medical Center and UC Health senior vice president and chief supply chain & logistics officer, oversees the massive supply chain efforts for the entire health system, which includes four inpatient campuses and 67 outpatient locations.

In summer 2020, Wiehe appeared before the U.S. Senate Finance Committee to provide testimony on the impact of COVID-19 on hospital supply chain systems. He also provided insight into how health systems across southwest Ohio collaborated with public and private partners to establish best practices for supply chain management, including establishing Ohio’s Virtual Stockpile of personal protective equipment (PPE). In 2020, UC Health spent approximately $400 million on goods and services.

At Rob’s right hand every day is Harold Dillow, assistant vice president of supply chain at UC Health. No matter the circumstances with the pandemic, including possible strained resources, the goal remains the same: Make sure every facility has the materials they need so our clinicians can deliver world-class patient care.

“Our focus is always on our internal customers because we know they directly affect patient care. We strive to have the right product, at the right place, at the right time, with zero defects. We do not waver from this mentality, even during a once-in-a-century pandemic. If anything, we view this as a challenge to prove our resiliency to the organization and demonstrate that we have their backs – no matter the circumstances.” Harold Dillow Assistant Vice President of Supply Chain

In order to ensure Supply Chain operations run smoothly, the day begins bright and early, well before daybreak. Team members arrive promptly, ready to complete the day’s tasks. Shipments from Medline, UC Health’s main supply vendor and one of the country’s largest healthcare manufacturers, arrive as early as 3 a.m. Medline’s delivery is the largest of the day, but shipments continue to the back dock of 3200 Burnet from 7 a.m. all the way up to 5 p.m.

7:30 a.m. Taking Inventory: A Strong Start in the Warehouse

As shipment trucks roll in, team members prepare to unload the supplies rapidly into the massive nearby storage warehouse. They grab their dollies and pallet jacks, and swiftly collect boxes of precious medical supplies off the back of the truck.

Scott Moubray, materials manager at 3200 Burnet, oversees the arrival process of supplies and ensures they are properly stored in the warehouse. He knows that he has to adjust his inventory at any moment if an emergency arises.

“The first thing that happens each morning is that the trucks come to the receiving dock, we unload, the receiving team verifies the order is correct and then that team puts it in stock in our warehouse.” Scott Moubray Materials Manager

The 16,500-square-foot warehouse features dozens of narrow rows of bins that house all of the supplies needed to ensure UC Health’s day-to-day clinical operations run efficiently. Since the COVID-19 pandemic began, the UC Health Supply Chain team has quintupled its inventory in the event of a surge of new patients. Scott and his team may not know when a crisis like a pandemic will happen, but they know that it can happen. They have to think ahead, especially if resources may be at a premium across the region, state or even the country. They may need to prioritize specific items that are in higher demand.

“Overall, we have 1,966 SKUs (unique supply items). Most of that currently is PPE,” Scott explains. PPE is arguably the most important material our Supply Chain team purchases during COVID-19. It’s been a critical item for hospitals around the U.S.

Given the volume and variety of patients who receive care at UC Health, orders flow in to the warehouse quickly throughout the day from the health system’s hospitals and outpatient facilities. Supply Chain staff have to be nimble and work fast to fill orders and ship them out quickly – time is of the essence.

When those orders come in, Scott’s team assembles a pallet (a small platform bed) with those specific items, wraps it and ships it to wherever it’s needed.

The team carefully monitors par levels for each item throughout the day. Par levels are the minimum amounts of inventory needed for specific supplies to ensure patient care is uninterrupted. Par levels can vary based on the item and the need for that item at any given time.

“We calculate our par levels by taking the average demand times the lead time, which is the amount of time it takes to order and get it here, times the safety factor, which is basically a buffer based off our experience of what we think would accommodate spikes in usage of that particular item,” Harold explains.

Team members take supplies into the warehouse and strategically organize them until inventory specialists submit requisitions, or written order requests. At UC Medical Center, UC Health’s largest hospital, inventory specialists roam each floor and monitor the supply closets. When a medical unit runs low on supplies, clinicians submit a requisition and Scott ensures that his team fills it promptly.

Typically, our main warehouse fills orders within 24 hours. Then the team loads the materials onto UC Health’s trucks and sends them wherever they are needed, whether it be UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care or any of UC Health’s outpatient sites.

This morning, the first loaded supply truck heads a block away to UC Medical Center.

9:00 a.m. Supply Management at the Ready – USTOR

Over at UC Medical Center, another UC Health Supply Chain group works 24/7 to keep the 724-bed hospital’s supplies stocked. As Greater Cincinnati’s only Level I adult trauma center, UC Medical Center is home to specialized programs such as trauma care, solid organ transplant and comprehensive stroke care that present special needs from a supply chain perspective.

In the event of any emergencies or urgent requests, supplies can be ordered from University Storeroom, also known as “USTOR”, located deep within the eight-floor hospital. USTOR augments the operations of the health system’s main warehouse and is designed as a sort of “rapid response” supplier.

USTOR receives its own shipments each day to keep their shelves packed with materials they need to briskly deliver to the upper floors of the hospital, whether it be the Emergency Department, Intensive Care Units or Labor & Delivery floor. Kimberly (Kim) Oden, supply chain manager, has been at UC Medical Center for 18 years and runs USTOR and its 1,233 SKUs.

“Everything here is bin located and has bar codes, making things easy to find,” Kim says. “We carry anything from bottles of alcohol, different types of gauzes and a vast variety of items, including life-or-death items.”

Over the past year, Kim has tripled the supplies she orders for USTOR in anticipation of any potential hospital surge of COVID-19 patients. Whenever supplies run low at USTOR, Kim contacts either her vendor or reaches out to Scott to see if he can fulfill her requests across the street.

“We have 30-90 days of supply stock on hand of various critical items, just making sure we have enough here and that the stock is in the right place at the right time,” Kim explains.

USTOR remains busy throughout the day, as staff, donning their face masks and UC Health badges, load, reload, wrap and organize supplies. Soon after, Stacey Means, one of our inventory specialists, comes down to load up a cart of the items she needs to take upstairs. Stacey packs her cart of supplies and makes her way down the underground tunnels of UC Medical Center to the nearest set of elevators. Her destination: 3 South, a unit where clinicians provide specialized neurological care.

9:30 a.m. Maintaining Supply Inventory at UC Medical Center

When Stacey arrives on 3 South, she wheels her cart into a supply storage unit located across from a patient room, replenishes the items that were getting low and uses a mobile device she carries with her to complete the order. The storage rooms are organized in a way where items can be easily identified and collected. Storage rooms are also within close proximity for nurses so they can come in and out without having to travel far from patient rooms. Items are kept in bins with color-coded labels, called Kanban cards, to identify each item. Near the door, a basket sits where nurses can leave the Kanban cards of items inventory specialists need to reorder.

“In each unit storage room, the nursing staff picks out of the left side and the right side is extra supply. When the left side is empty, the Kanban card will come off and go into the bin to be ordered.” Luigi Oliverio Assistant Director of Supply Chain

As Stacey finishes her orders, a nurse walks in, grabs a pack of tubing and heads into her patient’s room across the hallway. Nurses are grateful for our Supply Chain team, who helps make their jobs easier so they can focus all of their attention on their patients, many of which are in need of urgent care.

As the characteristically hectic day comes to a close, the UC Health Supply Chain team has successfully filled all of their orders for the afternoon and evening. The warehouse closes up and staff clock out at the end of their shifts, satisfied to know they accomplished their goals for the day. In less than 12 hours, they will come back in and do it all over again.

Kim knows how important her and her team’s work is to the overall purpose of UC Health to advance healing and reduce suffering in the community. As a UC Medical Center veteran, she understands that patients come here with different conditions and need varying levels of care. It does not matter the reason; her team needs to be ready.

“We never know what type of patient is coming to the hospital. Whether it’s a patient coming to the Emergency Department or arriving via Air Care, we have to be prepared. Our patients are first and foremost. They are not here because they want to be. They are here because they are very sick. And they deserve our 100% all the time.” Kimberly Oden Supply Chain Manager

While UC Health Supply Chain team members don’t interact directly with patients, they are just as essential to patient care as the frontline clinicians who do. Their expertise and professionalism ensures that every clinician has the tools they need to provide the world-class, subspecialty medical care for which UC Health is known.

Despite the obstacles of COVID-19, particularly the shortage of certain items, the UC Health Supply Chain team rises to the occasion to meet the needs of our patients and clinicians. Whenever the next crisis arises, they will be prepared once again to tackle it. For Harold, Scott, Kim and Luigi, the experience has been stressful to say the least, but has also been an incredible, rewarding learning opportunity. Each one of them and their associates are better because of it.

“This past year has stretched our processes to limits we could have never imagined,” Harold says. “I truly believe we are actually stronger now with the improvements we’ve made along the way.”