Supply Chain Creativity During COVID-19

Editor’s Note: Dennis Maher, vice president, Supply Chain & Support Services, and Bob Scheuer, director of Materials Management at UW Health.

Just as we typically don’t think about how groceries get to our grocery store, we probably don’t wonder how medical supplies get to our hospital room or doctor’s office. But for those of us who work in hospital supply chain management, we know a lot of negotiating, storage and coordination goes into this at the best of times.

As the world confronts COVID-19, issues regarding medical supply chains have been thrust into the spotlight. When a previously nonexistent health threat spreads across the globe in a matter of weeks, demand for essential medical equipment suddenly outstrips supply. Fraudulent vendors become a higher risk. Established vendor partnerships are strained. In fact, this virus originated near a major personal protective equipment (PPE) manufacturing area in China. This greatly reduced supply at a time when the world needed it most.

While most of UW Health has thus far not encountered a surge of COVID-19 patients, we have still faced unprecedented challenges since the onset of the pandemic. To overcome these current and potential shortages, serious creativity and collaboration need to be front and center.

With so much still unknown, a best-case scenario might be a new normal of carefully caring for COVID-19 patients in steady conjuncture with the many other patients who need our support. This creates a significant and prolonged increased need for PPE, posing tremendous challenges as the supply chain is under immense stress.

Using Public and Private Partnerships

As an academic medical center where our physicians are also faculty of the University of Wisconsin School of Medicine and Public Health, UW Health often works methodically. Now that time is of the essence, the health system and university have been collaborating closely and swiftly, and UW Health is benefiting greatly from its close partnership and proximity to the institution’s educators and students.

This partnership helped us quickly source and manufacture several pieces of essential PPE, including protective face shields for medical staff. Just weeks after COVID-19 first began spreading across the United States, UW-Madison College of Engineering Professor Lennon Rodgers and his team developed a prototype face shield that quickly moved into mass production at a low price. With the help of Delve, a local design firm, two local assembly facilities – Midwest Prototyping and UW-Madison’s own Digital Publishing & Printing facility – began churning out thousands of face shields. Today, several thousand shields have been produced and shipped to other hospitals around the country.

Making Unusable PPE Usable

In mid-March, UW Health received 1,250 hoods from the strategic national stockpile. These were meant to be used with our PAPRs, the respiratory protection systems that protect healthcare professionals when bodily fluids can be aerosolized, such as during intubation. Powered by a blower strapped around the wearer’s waist and connected by a hose to a hood covering the head, PAPRs offer the highest form of protection to a medical professional’s head, face and respiratory system during high-risk procedures.

Unfortunately, the hoods we received from the national stockpile were not usable because they could not connect to the hoses attached to our PAPR blowers.

UW-Madison’s Engineering team again came to the rescue, designing a small plastic connector that solved the problem. Using 3D printing technology, Midwest Prototyping produced the connectors that restored functionality to the face hoods. Midwest also extended the hoods, so they not only covered the wearer’s face, but the entire head and neck as well.

Keeping Hand Sanitizer Flowing

As COVID-19 rapidly spread, the supply of hand sanitizer dwindled everywhere. We knew we would be hard-pressed to safely care for patients without it, so again we relied on the ingenuity and expertise of partners, this time at the UW-Madison School of Pharmacy’s Zeeh Pharmaceutical Experiment, which typically focuses on supporting drug development.

Combining ethanol, isopropanol, hydrogen peroxide, and glycerin – some of which was donated by UW-Madison’s Chemistry Department – the School of Pharmacy began producing hand sanitizer, turning out 100 liters per day.

Reuse and Recycle

Sometimes supply chain challenges are not about getting or making more, but making existing supplies go further. We began sterilizing used N-95 respirators to reuse if we experienced a significant surge of patients. We have not yet needed to use them, but preparing for the worst is vital.

UW Health goes through thousands of surgical, isolation and patient gowns each week. Sourcing new, disposable gowns would be nearly impossible in the current climate. Fortunately, we are part of a laundry cooperative that not only launders all linens but sterilizes surgical and isolation gowns. Partnerships like this put a health system in a better position to control the supply chain than if it were a contracted client to a third-party laundry vendor or disposable gown supplier.

Supply chain management during a worldwide health pandemic has tested every healthcare organization in unimaginable ways. This experience, however, has reinforced how keeping patients and staff safe can remain the highest priority by tapping both the resourcefulness of our own supply chains and the creative talent of partners in our own backyards.

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