By Steve Tracey📧, Kusumal Ruamsook📧, Norman Frankel, and James J. Mangini
CSCR White paper, August 2024
Healthcare providers require a broad array of personal protective equipment (PPE) supplies to perform diagnosis and treatment. After gloves, medical gowns are the second most commonly used PPE items in healthcare settings. Over the last several years, preferences among healthcare providers worldwide have gradually shifted from reusable medical gowns to disposable ones designed to be discarded after a single use. The single use nature means that this critical supply needs to be constantly replenished. The COVID-19 pandemic has brought PPE supply chain vulnerabilities into spotlight and served as a resounding reminder that new ways of sourcing are required. Reusability can provide an impactful source of leverage in sourcing strategies aimed to enable resilience in times of crisis, as well as provide cost efficient and environmentally sustainable advantages. Nevertheless, transitioning from disposable to reusable medical gowns is by no means a simple matter of switching products purchased. After each use, reusable gowns require proper laundering to clean and remove microbicide from the potentially contaminated items before putting them back in an inventory for reuse. Not all healthcare providers have these reprocessing operations established. In this paper, we present a decision framework that takes an end-to-end supply management perspective to provide a structural thinking lens for healthcare providers embarking on the road to reinvent medical gowns sourcing strategies through reusability.
View full paper here.
Suggested citation
Tracey, Steve, Kusumal Ruamsook, Norman Frankel, and James J. Mangini. 2024. “Reinventing Medical Gowns Sourcing Strategies through Reusability.” White paper, Center for Supply Chain Research® (CSCR®), The Pennsylvania State University.
Related CSCR White Papers:
Read “Reusable Medical Device Supply Chains in a Pandemic Setting: A Case of N95 Respirators” here.
Read “Healthcare Supply Distribution and Inventory Systems” here.
Efficient and safe gowning procedures are an essential components of productive medical device manufacturing practices within a supply chain, but without standardized process for gowning existing and best practices being unique to respective firms, businesses will expose themselves to an abundance of risks if they do not focus on this topic. Specifically, a weak gowning procedure leaves firms susceptible to quality issues during production, safety concerns for employees, high unit costs of equipment, and many more serious consequences. Another issue arises through the fact that there is no common best practice for gowning in the medical device manufacturing industry, so one company’s success with gowning procedures cannot be directly transferred to another due to unique needs for each business. This thesis will analyze how a leading player in the medical device manufacturing industry, Company A, manages their gowning procedures across their global sites as well as recommend how they can improve this specific area within their supply chain to benefit the firm as a whole. Six leaders from Company A were interviewed with a standard set of questions which were made to gain insight into Company A’s current issues with gowning and areas for potential improvement. These interview results, along with data collected of gowning procedures at every global site were combined to provide employee driven recommendations. The results were compared with the limited academic research in this space and deliverables were made for company A based on these results, explaining ways they can improve their supply chain through change. The final recommendations for Company A focus on improved communication and the formation of a harmonized gowning procedure. The key takeaway from this project and thesis is finding ways to improve gowning procedures specifically for Company A, which will lead to many benefits for their overall supply chain.
Supply distribution operations are a significant aspect of healthcare services both from the patient care quality and financial perspectives. Unlike commercial products, stockouts of critical medical supplies could result in a life-threatening situation for patients and compromised safety for medical staffs. Traditionally given a low priority, effective supply distribution and inventory management is increasingly moving into the center stage of healthcare systems due to potential improvements in terms of cost savings, patients’ satisfaction, and effectiveness of healthcare employee work flow. Shortages of critical personal protective equipment (PPE) amid the COVID-19 pandemic, the spate of mergers and acquisitions across the healthcare industry, and the high inflation rate further stimulate this shift in mindset. This paper aims to develop conceptual strategic frameworks of healthcare supply distribution network that depict variations of multi-echelon inventory and distribution network structure, echelon inventory positioning, and distribution flow models. The frameworks provide an essential basis for a healthcare system in its evaluation for decisions on system design, and strategic distribution and inventory planning for both normal operations and crisis preparedness circumstances.
In the event of a pandemic, there is the potential for an overwhelming influx of patients along with an increase in expanded uses for protection beyond the infected patient, resulting in a sharply increased demand for medical care resources. In this “surge use” circumstance, demand for certain medical devices could rise beyond healthcare providers’ ability to expand their supplies to match increases in demand, leading to critical supply shortages. Transmitted by respiratory droplets or airborne particles, the COVID-19 decease particularly heightens the importance of respiratory protection devices. Reuse of PPE is an effective measure to reduce pressure on supply capacity during surge use events. This measure, however, is in contrast to the current propensity towards uses of disposable devices for respiratory protection. In particular, surgical N95s are intended as a single-use device. In this paper, process flow of medical device reprocessing for reuse, respiratory supply chains, and key players are discussed.
Inventory governance is an area of supply chain where companies follow “best practices”, but without a definition of what these general guidelines are, some businesses open themselves up to unnecessary risk when they do not focus on this topic. Specifically, a weak structure in this area can lead to miscommunications, knowledge gaps, and lost sales, among other detrimental side effects. Another issue arises with “perfect” guidelines looking different for every company, so one company’s successes with inventory governance cannot be directly transferred to another. This thesis examines how a top healthcare and pharmaceutical supplier, Company A, manages their inventory processes as well as recommends how they can improve this area to benefit their supply chain overall. Fifteen employees from Company A were interviewed with a standard set of questions crafted to gain insight into the company’s current inventory governance procedures. The tribal data collected was analyzed to provide employee-driven process recommendations. The commonalities found were compared to limited academic research in this space; deliverables were compiled for Company A based on these results, detailing ways they can advance their business with a few changes. Final suggestions on how Company A can improve their inventory governance center around strengthened communication, increased visibility, and education. The main takeaway from this case study and thesis is finding ways to improve inventory governance specifically for Company A, which will improve their overall supply chain operations.
In March of 2020, the world was forever changed when the World Health Organization (WHO) declared a global pandemic due to the emergence of a disease called COVID-19. During a time of global pandemic, society attempted to slow the spread of disease before vaccinations were developed through techniques such as social distancing and the use of Personal Protective Equipment (PPE). As a result, the demand for PPE surged to historical records, and supply was not able to meet demand. This resulted in worldwide shortages for all different types of PPE, and even healthcare providers struggled to obtain the necessary PPE to protect themselves while treating COVID-19 patients. Therefore, the intent of this research is to provide a list of best practices and recommendations for contingency planning after COVID-19, specifically for the PPE industry. Current literature was reviewed and analyzed, and best practices were garnered from the literature. Three industry executives were also interviewed about their thoughts and experiences with PPE during the COVID-19 pandemic. Their opinions and recommendations were compared and contrasted with the best practices from literature, and ultimately a list of holistic best practices was developed and recommended for contingency planning. Best practices for contingency planning include enhancing the Strategic National Stockpile infrastructure, bringing more PPE manufacturing onshore in the U.S., improving end-to-end PPE inventory monitoring, filtering out misinformation on social media platforms, establishing clear guidelines on the reuse of PPE, and developing innovative ways for consumers to dispose of masks in order to mitigate environmental damage.
