Monday, April 24, 2017

A Day Without SPD


Back in mid-February, immigrants around the nation stayed home from work and school to protest President Trump’s vacillating and volatile immigration “policy” (deportations, blah, blah, blah, big wall, blah, blah, blah, close the borders, blah, blah, blah) and “to demonstrate how important they are to America’s economy,” according to an Associated Press report. Further, “many businesses closed in solidarity, in a nationwide protest called A Day Without Immigrants.”

One wonders what immediate and long-standing impact the protest made — whether employees and students somehow were penalized for going AWOL without “calling in sick.”

Certainly, uniformed police officers can contract “blue flu,” laborers can “strike,” professional athletes can pout and whine for more compensation to help them endure their multimillion-dollar-a-year poverty-level contract that fails to befit their lifestyles.

Yet this civil protest, which made a point (at least garnering some publicity) and maybe nicked the economy, ignited thoughts of a healthcare group important to a hospital’s economy and a patient’s health.

Yes, as IAHCSMM holds its 59th Annual Conference & Expo in Nashville during the second week in May, we’re talking about the unsung, seemingly under-appreciated sterile processing and distribution soldiers in SPD.

Imagine “A Day Without SPD.” No, we at Healthcare Purchasing News, which has been with IAHCSMM consistently for 40 of those 59 years, are not advocating that dedicated SPD staffers simply walk out in “mock” rebellion to the lack of appreciation by the C-suite on down through clinical, financial and operational fellow executives and staffers.

But, what if, by some dispensing of reality and suspension of belief, (alternate universe storylines dominated the sci-fi genre long before alternative facts became an acceptable concept in media and politics), SPD simply vanished? People, equipment, function, footprint.

What would a hospital do?

You might say that single-use product manufacturers gleefully would welcome and salivate over the prospect of a gilded financial age for them. Imagine the windfall profits … at least at first … until the hospitals, motivated by stingy payers that control the market, had to figure out how to deal with the budgetary fallout.

Someone would have to clean, decontaminate, high-level disinfect and sterilize instruments and equipment used in medical/surgical procedures. Yes, admit it. Many facilities would reuse SUDs at least once or twice to relieve the fiscal pressure.

But would those products be reprocessed well enough? As well as what SPD could have done?

Would doctors and surgeons and nurses be willing to risk it? Would the hospital CEO, CFO, CMO and CNO? What about the insurance companies?

Imagine the resulting infectious outbreaks from improperly reprocessed products. Imagine the ensuing lawsuits for negligent care.

Imagine the hospital CEO’s wife or husband having to go into life-ensuring emergency surgery on that particular day. Imagine the insurance company CEO’s wife or husband.

Much can be ballyhooed about SPD’s importance to healthcare operations and high-quality patient care.

But this exercise in conceptual thought isn’t meant to be critical, pandering or patronizing to anyone. It’s meant to be a sincere wake-up call.

SPD needs and deserves respect. Those who perform and practice within that field have earned it — no matter their educational level. Pluck a blue-blooded Wharton-trained MBA graduate from the C-suite and place him in SPD for a day, pitting him against a well-trained sterile processing tech with a high-school diploma to reprocess endoscopic instruments to be used next on a member of a prominent wealthy donor family of the hospital. If that family were given the choice, whose reprocessed products will they want used on their relative? Whose do you think?

For IAHCSMM members, it should be about the three-legged stool. The legs stand for quality, safety and respect (for colleagues, patients and the profession).

Quality is instrumental. You achieve it through SPD certification, validated IFU implementation (and preferably standardization), and fluid collaboration with Surgical Services/Infection Prevention. This formula represents one of the true pathways to healthcare reform. And it starts in SPD.

Rick Dana Barlow

Monday, April 3, 2017



Refugee Camps, TURKEY


Animal Services & Welfare Community Development 

Dental Clinic 
Dental Services & Care 
Disability & Low Income Services Educational Programs 
Emergency Response 
Homeless Support Services 
Maternal Health & Infant Care
Medical Clinics & Hospitals 
Medical Missions

Countries served 11 15
Orders shipped 701 117
Charity partners 44 65
Product sent ($M) 1.0 5.4


To improve the delivery of healthcare worldwide by gathering, processing and distributing surplus medical and health supplies to charities at home and abroad.
The world’s response to this need has not been enough. In 2016, the United Nations estimated total required aid to meet emergency level and urgent needs of the most vulnerable Syrians at $4.5 billion; by March of this year, only $2.9 billion had been received. As Antonio Guterres, the UN High Commissioner for Refugees, has said, "The Syria crisis has become the biggest humanitarian emergency of our era, yet the world is failing to meet the needs of refugees and the countries hosting them.”

We can choose to do more.

In 2017, Globus Relief teamed up with Islamic Relief USA and other refugee-focused charities to do its portion of the “more” that is needed. Globus Relief packed 28 forty-foot containers full with 3000 medical mattresses and 240 pallets of medical products. Shipped in January, these containers arrived in Turkey on March 24, 2017 and are being utilized in local hospitals and clinics serving refugees in that refugee-laden area. These items will enable these charities to continue to supply more than 250 hospitals and clinics and perform essential medical treatments, which currently number more than 1.8 million to date.

The need is tremendous. Let us do more.

Globus Relief is Your Humanitarian Non-Profit Inventory Solution. Please contact us if you have medical or dental equipment, instruments, and supplies or other resources available for donation.

Wednesday, March 22, 2017

Fake news for April fools


There’s a fine line between alternative facts and real ones. As we pass through April 1, read these headline blurbs and decide.
  1. Springing from the trendy “The Internet of Things,” one Supply Chain manager starts a basement cult centered on “The Purchasing of Things.” Suppliers around the country rejoice and fill the offering plate at each weekly worship service.
  2. Clever purchasing director discovers that the CFO’s golf clubs can effectively work the kinks out of contract price matching with the GPO database if he whacks his own MMIS hard enough with a nine iron.
  3. One hospital increases Supply Chain staff efficiency by making employees wear Foley catheters and leg bags in lieu of bathroom breaks. Savings generated from the workflow (and waste flow) improvements more than offset the costs of Foleys and bags purchased. Infection preventionists launch immediate protest.
  4. After a cost-conscious hospital bans purchasing of EpiPens, an industrious infection preventionist develops a new way to deliver epinephrine through Nerf blasters you can buy in the dollar bins at your local pharmacy outlet.
  5. Hospital value analysis manager is praised for improving clinical and purchasing process collaboration based on recommendations learned from the Dr. Oz television show.
  6. In a new twist on the “wearables” fad, one company develops a special skin-tight “A.I.” suit that allows staffers to work 24 hours a day. Sterile Processing leaders express concern that the suits must be certified to function properly during that overnight 3rd shift.
  7. In the latest effort to boost interest in supply data standards for healthcare products, GS1 Healthcare decides to incorporate the use of emojis in GTINs. Guess what the smiling turd represents?
  8. To improve communications with Supply Chain, critical care nurses are flocking to the “Materials Management Magic Wand.” This insanely popular product is nothing more than a multicolored squeaky clown hammer that comes with easy-to-read instructions: An arrow pointing to a silhouetted forehead with the words, “Aim here.”
  9. Sterile Processing tech finds a creative use for older model sterilization containers as effective storage bins for staff sack lunches and for flashing frozen dinners.
  10. New Louisiana university study finds that the best time for a New Orleans hospital to run low on supplies is between 3 a.m. on Fat Tuesday and 3 a.m. on Ash Wednesday.
  11. Feeling threatened by growing interest in two-bin Kanban systems, the makers of automated supply cabinets up the ante by equipping each of their models with a built-in Keurig machine.
  12. Automated Press Ganey sensors for immediate-access patient satisfaction scores represent the latest premium option for bar-code scanners, RFID scanners, and RTLS.
  13. Cronuts become the newest incentive of choice given to doctors by the savviest and most sophisticated of product sales representatives.
  14. Repless “advisory” team caught watching Netflix and Hulu on their iPads during virtual surgical “consultations.”
  15. A band of Luddite logisticians are developing Meaningful Use guidelines for clipboards, pens and sticky notes.
  16. To promote adoption and implementation of electronic health records, former band members of ELO reunite and go on a national tour as EMR. They re-release “Don’t Bring Me Down,” with an emphasis on paper-based patient records and payer reimbursement.
  17. Disappointed Supply Chain pros regret learning that 340B is not part of their compensation package. Nor are employee discounts for private-label products.
  18. To boost interest and participation in UDI implementation, the FDA borrows from the Lean Six Sigma philosophy and blends it with the martial arts colored-belt ranking system, granting gilded Black Belts to the heaviest users. In a seemingly unrelated development, retail outlets around the nation experience a run on black spray paint.
  19. When just-in-time distribution slips and stockouts prevent just-in-case hoarding, empathetic Supply Chain departments employ the just-in-bieber method, singing “Sorry,” a capella.
  20. What did Supply Chain pros give up for Lent? Top five sacrifices include stockouts, user-defined fields, Report Writer, patient charges and HPN. Wait, what? Sorry. Typo. They mean HPN’s SKU’d column.

Rick Dana Barlow

Wednesday, February 22, 2017



With the AORN Congress starting on April Fool’s Day, and Healthcare Purchasing News celebrating its 40th anniversary, it seemed only fitting to share some bumper snickers and T-shirt “pundamentals” to recognize and revere the noble and paramount profession of nursing.

Some of these 40 may be public knowledge; others are modified or simply contrived, but satirized for your protection. Enjoy the laugh and be proud of what you do and how you contribute to high-quality healthcare delivery.

  1. OR Nurse: Because “Miracle Worker” isn’t an official job title.
  2. RNs always give 100% … unless they’re donating blood.
  3. Floor nurses know that supply hoarding is a cache business.
  4. Nurses never have enough time to be so busy.
  5. Nurses always call the shots.
  6. Nursing is all fun and games … until the doctor tries to assist.
  7. Nurse Management: Keep calm … and use a sticky note.
  8. The nurse is the first person you see after saying, “Watch this!”
  9. No matter how serious, orthopedic nurses never ignore the humerus.
  10. I.V. nurses know how to pump you up.
  11. Nursing IT secret: When the surgeon loses his mind, know that his backup must be somewhere.
  12. RN power: Cute enough to stop your heart; skilled enough to restart it.
  13. Nurses wear scrubs. They don’t need capes.
  14. Anyone who thinks “the customer is always right” never worked in critical care nursing.
  15. Some surgical suite problems are caused by a loose nut gripping the surgical robot controls.
  16. Nurses know that surgeons screaming at them just need to be rebooted.
  17. Nurse engineering: If something’s not broken, mark the other side so the doctor gets it right.
  18. Be nice to nurses. They keep doctors from killing you.
  19. You can talk to the doctor in charge, or the nurse who knows what’s really going on.
  20. Nurses have the best jobs. They get to stab people with sharp, shiny objects!
  21. Nurse Managers aren’t control freaks, but they can show you the right way to do something.
  22. Nurse power: Walk softly but carry a large-bore 18-gauge needle.
  23. Some doctors swear by their supply chains. Some nurses swear at their supply chains.
  24. Infection preventionists know that bacteria may be the only culture some people have.
  25. Nursing veterans love the smell of anesthesia in the morning.
  26. According to nursing chemistry for sterility, alcohol is a solution.
  27. Nursing journal editors know the semicolon is not a medical condition.
  28. Nurses know that some days, it’s not even worth chewing through the red tape.
  29. Nurses know that even the best healthcare system in the world needs to be good enough for patients.
  30. Good nurses realize some doctors specialize in counter-intelligence as they can recognize stupidity.
  31. Smart nurses see UDI in an EHR world.
  32. Product Evaluation Committee Meetings: The ultimate whine and geez party.
  33. Nursing is the new black.
  34. Nursing signature of success: Be yourself. Everyone else is taken.
  35. Be the kind of circulating nurse that when you enter the sterile field, Dr. Satan says, “Oh crap, she’s here!”
  36. As a nurse I may not be perfect, but I’m so close it scares me!
  37. G.I. nurses know, when you neglect to irrigate, the patient moves to litigate.
  38. Nurses don’t give up. They know Moses was once a basket case.
  39. N.U.R.S.E.: Never Underestimate Registered Surgical Excellence.
  40. Nurses: Fixin’ cuts; stickin’ butts.

Rick Dana Barlow

Wednesday, February 1, 2017





       Animal Services & Welfare
       Assisted & Independent Living Services
       Boy Scout/Eagle Scout Projects
       Clinics – Dental, Medical, Mobile, Vision, Veteran
       Community Health Center
       Community Development Programs
       Community Preparedness
       Dental and Health Facilities
       Dental Services & Care
       Disability & Low Income Services
       Disaster Relief
       Educational Clinics & Programs – Dental, Nursing
       Emergency Preparedness & Response
       Fire Departments
       Food Banks & Hygiene Kits
       Health & Care Fairs
       Health Education Programs
       Homeless Support Services
       Hospitals – General, Children’s
       Hospital/Clinic Facility Upgrades
       Maternity Care & Programs
       Medical & Dental Vocations Training
       Medical Services & Care – General, Emergency, Geriatric, Pediatric, Pharmaceutical, Respiratory
       Missions – Dental, Medical, Pediatric, Vision
       Neuro Rehabilitation Center
       Refugee Care
       Schools – Dental Hygiene, Nursing
       School Nurse Supplies
       Special Education Programs
       Surgical Missions - Facial Reconstruction, Ophthalmic, Orthopedic, Pediatric, Urological
       Sustainability Programs
       Veteran Programs
       Youth Programs

We look back on 2016 with gratitude and amazement – at the generosity of our donors, the dedication of our partners, and the diligence of our employees. Because of the efforts of these and many others, we were able to fulfill our mission to improve the delivery of healthcare worldwide. In particular, in 2016 Globus Relief:

       Partnered with over 220 charity partners worldwide
       Provided aid in 59 countries, from Afghanistan to Zimbabwe
       Shipped the equivalent of 64 containers to hundreds of destinations
       Filled more than 1,230 requests for medical & dental humanitarian aid
       Distributed over $30 million in supplies, instruments & equipment

Donations were employed to back a full array of humanitarian programs (see list at right), from suppling clinics in Kosovo, to treating war-weary refugees in Syria and Turkey, to medical missions across South America, to vision treatment in Ghana. Domestic and local programs also benefitted – nursing schools, veteran programs, maternity care, community clinics, charitable dental care, homeless support services. And the list continues. Truly we are engaged in a tremendous work.

As we now look forward to 2017, we are enlivened by the opportunities to expand this work even further – to help more people, in more places, more efficiently. To accomplish this, we hope in 2017 to: (1) increase the dating on donated supplies to comply with international shipping guidance constraints (minimum of 12 month dating), (2) identify and obtain funding sources to ffset inbound donation and product acquisition costs, (3) heighten internal efficiencies through process consolidation and the eventual move into a permanent, non-leased building and (4) enhance our current IT resources to decrease labor costs while elevating product accessibility and transparency.

We cannot say enough about what the support of you, our donors, partners and other stakeholders, has meant to the good Globus Relief provided in 2016 and will yet mean to accomplishing our aim of increasing that impact in the future. We look forward to collaborating with you in this great effort in 2017 and beyond.

Globus Relief is Your Humanitarian Non-Profit Inventory Solution. Please contact us if you have medical or dental equipment, instruments, and supplies or other resources available for donation.

Monday, January 23, 2017

Supply Fi


Many people recognize the honorable and indelible motto of the United States Marine Corps. as “semper fidelis” or the abbreviated “semper fi.” This Latin phrase, means “always faithful” or “always loyal.”

For four decades, Healthcare Purchasing News (including its previous names) has been always faithful and always loyal to covering, exploring, reporting on and writing about supply chain events and issues — including purchasing and materials management, sterile processing, surgical services and infection control — as important, as tantamount to healthcare organization success and patient care quality. We didn’t want you to surmise that the “Fi” in the headline somehow signified “fiction” as in sci-fi.

In fact, one of the overriding themes woven into HPN’s industry coverage involves the critical importance of supply chain to the clinical, financial and operational blueprint of day-to-day activities. Individual and organizational development hinges on it.

During the last decade, HPN implicitly and tacitly promoted the idea that Supply Chain belongs in the C-suite — either directly with a seat at the table or indirectly as the immediate go-to executive tapped by the CEO, CFO, COO, CMO and CNO (not necessarily in that order all of the time) to handle big picture issues with a firm grasp on all the snapshot issues feeding into them.

Deep down, that underlying philosophy continues and remains unchanged.

But for this decade, the next decade, HPN more overtly will reinforce the notion that for Supply Chain to justify its executive-level position and status it must fortify itself with data science and solid clinical connections. This means that whether right or wrong, Supply Chain needs to be armed with information and backed up by physician and surgeon “manpower” to influence, if not drive, decision-making authority.

Supply Chain will accomplish this through their inherent negotiating expertise, which involves a degree of persuasion, fueled by data. What’s that mean? Healthcare reform has placed clinically driven and motivated physicians and surgeons under fire for the last two decades. What these clinicians lack, by and large, is business intelligence as another dimension under consideration for thorough diagnoses.

This doesn’t mean the doctors must partner with the CIO and the IT department to succeed any more than a consumer will lean on his or her car dealership salesperson or mechanic to advise him or her how to drive. No disrespect intended for the IT folks but in simplest and most idealistic form, they make sure the communication and computer equipment works, integrated into the medical/surgical, imaging and laboratory infrastructure. Supply Chain, meanwhile, should be sourcing and acquiring that equipment, with clinician input and oversight, of course, but also delving into the data science elements of analysis and analytics (read about the difference between these concepts deeper inside this edition) to help clinicians make optimal decisions that impact the quality of care they deliver and how the patients who receive that care respond in kind.

That’s why we’re amping up and ramping up our exploration of Supply Chain’s clinical and IT connections.

No, I’m not referring to Supply Chain issues in a clinical and IT world. I’m referring to clinical and IT issues in a Supply Chain world. Big difference. Don’t believe me or agree? Stick with us and you’ll see what we mean. By our 50th anniversary in 2027, we think Supply Chain will be right where it’s supposed to be perched.

Rick Dana Barlow

Thursday, December 22, 2016

Ten in 10 ahead


Last month, we highlighted 10 milestones from the last decade as Healthcare Purchasing News marked 40 years of service. This month we fast forward with 10 predictions about the next decade as HPN races toward its 50th year.
  • The group purchasing industry, which surfed a considerable consolidation wave during the last decade, hits some breakwaters in the coming decade, as the largest GPOs foresee greater valuation — in revenue, efficiencies and cost savings — by splintering into key specialties to foster and foment competition. With the market shifting to clinically motivated provider-driven shared services operations, these smaller specialty service organizations cater to data science, labor/workflow and supply/service demands.
  • Armed with legal protection, manufacturers will sign “immediate-use manufacturing” license agreements with providers that allow healthcare facilities to 3-D print a growing array of products on site. Clinicians will be able to produce a variety of implants on demand as a countermeasure to consignment and loaner programs. Bolstered by this progress, manufacturers cautiously expand the 3-D printscape to a variety of commodity items as a strategic solution to disaster-related shortages, and demand-driven backorders.
  • As reports of improperly reprocessed devices multiply, single-use device manufacturing enjoys growth extensions into higher-tech minimally invasive product categories, including single-use-only rigid and flexible endoscopes. Reprocessing SUDs for limited additional use generates heavy debate and discussion.
  • Because a majority of states will require SPD certification over the next decade, a nationwide accreditation and certification requirement surfaces, which is endorsed by a number of clinical and professional organizations. Further, the federal government will require certification of all reprocessing techniques for reusable products as part of granting marketing clearance for all new products and retroactively will phase in the same for previously cleared products over a five-year period.
  • Frustrated (and rightly so) by the slower pace of adoption and implementation of healthcare supply data standards for medical/surgical products versus pharmaceuticals, standards proponents make one last push. Noteworthy organizations succeeding with the federal Unique Device Identification requirements, along with links to electronic health records, push through the operational resistance just ahead of an anticipated CMS penalty for non-compliance. With universal data standards for healthcare products and services in place by the late 2020s, healthcare organizations undercover rafts of data inaccuracies and operational inefficiencies that will reshape education and training in the 2030s.
  • With automation, digital and electronic capabilities woven like fibrous tapestry throughout a number of the largest healthcare trade shows in the U.S., a horizontal integration movement emerges to create a confederated exhibition of clinical and medical science and technologies. This North American Healthcare OmniExhibition for diagnostic imaging, IT, med/surg, laboratory/pathology and oncology includes marketing and sales incentives to encourage cross-attendance and cross-exhibiting/sponsoring growth with an eye on patterning itself after Europe’s ginormous Medica show.
  • Supply Chain finally will be acknowledged and accepted as the largest expense category in a healthcare organization, encompassing both labor and non-labor costs, products and purchased services. Supply & Service Management enjoys departmental and professional title popularity for a while. Consequently, a data science-driven Supply & Service Management department (encompassing collection, analytics, visualization and virtualization) will propel its key executive leaders to C-suite importance, prominence and relevance.
  • Data science gains momentum in Infection Control and Prevention as clinical experts can become certified in surveillance techniques and clinical data analytics. This will motivate epigenetic modeling to reinforce patient and population health-based behavior modification, a controversial but more proactive and less reactive approach to infectious outbreaks.
  • Look for technology advances in air quality to reach new heights as breakthrough developments for filters, scrubbers and pulsed-light stationary and mobile devices emerge that are safe for human exposure even as they render bacteria, dust particles and other microorganisms inert and easy to remove via vacuum suction or blowers.
  • The plethora of personal and remote healthcare devices, including smart phone apps and wearables, hits a fever pitch as manufacturers take a cue from Hollywood’s sensor-bedecked motion/performance capture suits and release healthcare-specific models that can monitor vital signs, chronic conditions and physical therapy progress that can be uploaded to the EHR.

Rick Dana Barlow