By mid-January 2020, as the world learned that a mysterious virus was starting to overwhelm Wuhan, China, NYU Langone Health’s leadership recognized that the threat was double-barreled. Eventually, the virus might well arrive in New York City, and if it did, sufficient quantities of the personal protective equipment, or PPE, needed to shield patients and frontline workers, might not. With 70 percent of the world’s PPE manufactured in Wuhan, critical shortages resulting from disruptions or delays could prove just as dangerous as the virus itself.
The challenge of managing an inventory of PPE falls to Supply Chain Management, whose staff of more than 400 has been called upon to source, procure, distribute, and replenish ever-more-scarce items at an ever-faster rate. Jacquelyn Marcus, vice president for Supply Chain Management, who joined NYU Langone in 2019, came with extensive experience in consumer-packaged goods, where diversification of sources minimizes service disruptions. She soon learned, however, that for decades hospitals have used a very different model. Rather than stockpiling supplies, they tend to order merchandise through a single distributor for just-in-time deliveries and immediate use.
Coronavirus disease (COVID-19) has turned that model upside down virtually overnight, creating an insatiable global demand for clinical body armor such as N95 respirators, face shields, and isolation gowns. Ordinarily, Supply Chain purchases 99.8 percent of its PPE through 1 medical distributor. But the pandemic has imposed tight restrictions on hospitals based on their historical usage of supplies. With its allocation from the distributor down to 9.25 percent last spring, Supply Chain had to locate other sources. Fast. “There was no roadmap for this,” says Marcus.
Recognizing as early as January that supply disruptions would jeopardize patient and staff safety, Daniel J. Widawsky, executive vice president and vice dean, chief financial officer, had one key question for Mark Pollard, vice president for hospital operations: “What are the top 12 things that will be in highest demand?” Clinical leaders identified such essentials as exam gloves, intravenous (IV) fluids, catheters, and disinfectant wipes. “Without wipes, for instance, clinical spaces can’t function,” notes Marcus. “We looked at about 120 different items, and we made some proactive purchases that put us in a much better position.”
As case counts surged last spring, Marcus and her team had to find suppliers that met not only U.S. Food and Drug Administration (FDA) requirements, but also NYU Langone’s quality specifications, as substandard and counterfeit PPE began to flood the market. “We pulled products from every corner of the Earth,” says Widawsky. “We were always one step ahead, always looking around the corner. It came down to agility, execution, and muscle.” By choosing vendors strategically and spreading out orders, Marcus explains, Supply Chain “didn’t have to put all of its eggs in one basket.” Before products were distributed, they were inspected by Infection Prevention and Control and Environmental Health and Safety. “We weren’t going to compromise safety,” says Marcus.
Many of the lessons learned are guiding Supply Chain’s management team as they reshape their long-term strategy. “We’ve worked really hard to find factories outside of China,” says Marcus, “so our landscape now includes multiple sources.” Partnering with Real Estate Development and Facilities, Supply Chain has tripled its warehouse capacity to 150,000 square feet, enabling 3 to 6 months of critical supplies to be stockpiled. If need be, PPE can be transported to our hospitals the same day it’s needed. All told, Supply Chain received more than 1,500 leads for products, but only 34 made the cut. “We had no fraudulent supplies and zero quality or safety issues,” says Marcus, “which is something we’re all really proud of.”