Health Care Matters: Supply Chains In and Of the Health Sector

Supply chain integration as a strategy to strengthen pandemic responsiveness in Nova Scotia

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Nova Scotia. During the first wave of the pandemic, Nova Scotia faced the massive destabilization of its traditional supply channels and had to grapple with role clarity and communication in its emergency response structure. Nova Scotia was able to centralize its pandemic sourcing, procurement, and management efforts to its provincial health authority. Healthcare supply chain teams were able to rapidly modify their sourcing and procurement processes in order to compensate for the destabilization of their standard supply channels and assume responsibility for the province-wide management and distribution of pandemic supplies. The Nova Scotia case findings make clear both the value of a centralized and dedicated healthcare supply chain response-that integrates all provincial care delivery organizations-and the diversification of the healthcare supply chain.

Digitally enabled supply chain as a strategic asset for the COVID-19 response in Alberta

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Alberta. With a history of emergency preparedness, Alberta’s unique context, one that includes having an already established, centralized, and digital healthcare supply chain strategy, sets this case apart from the others in terms of pandemic responses. A key challenge navigated by Alberta was the inadequacies of traditional sourcing and procurement approaches to meet surges in product demand, which was overcome by the implementation of unique procurement strategies. Opportunities for Alberta included the integration of supply chain teams into senior leadership structures, which enabled access to data to inform public health decision-making. This case demonstrated how Alberta’s healthcare supply chain assets—its supply chain infrastructure, data, and leadership expertise, especially—contributed to resilient supply chain capacity across the province.

Supply chain capacity to respond to COVID-19 in Newfoundland and Labrador: An integrated leadership strategy

This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Newfoundland and Labrador (NL). Faced with the destabilization of its traditional supply chain, NL leveraged an existing centralized healthcare supply chain structure to organize its supply chain response to the pandemic. To overcome product shortages, health leaders collaborated with their local business community and industries to source and procure personal protective equipment and create domestic manufacturing capacity for critical supplies. The healthcare supply chain response in NL demonstrates the value of a highly integrated and centralized healthcare supply chain management strategy. It also makes clear the value of a diversified healthcare supply chain, one which draws on local manufacturing capacity to create a domestic source of critical supplies and overcome shortages from global suppliers.

Improving resilience of the healthcare supply chain in a pandemic: Evidence from Europe during the COVID-19 crisis

The severe scarcity of critical medical supplies caused by the COVID-19 pandemic led to considerable procurement challenges in the healthcare supply chain (HCSC). As ensuring the availability of such supplies during disruptions is critical, the debate on how to increase supply chain resilience in healthcare has gained new momentum. We present empirical evidence from a multi-tier case study spanning nine European medical supplies manufacturers and hospital groups. Based on the resource dependence theory, we investigated procurement-related strategies to improve medical supplies availability. We conducted semi-structured interviews with 39 procurement and supply chain management experts and derived seven propositions on buffering and bridging approaches for managing evolving resource dependencies and thereby strengthening supply chain resilience in a pandemic. Overall, we confirm the resource dependence theory's applicability for explaining companies' mitigation measures in a pandemic disruption. We find that bridging measures within the healthcare supply base, such as offering procurement support for suppliers or leveraging long-term buyer-supplier relationships, are more effective for securing medical supplies than buffering measures. Complementing bridging with buffering, such as extended upstream procurement or resource sharing among hospitals, can lead to superior risk mitigation as capacities of the present supplier base may not suffice. Furthermore, we extend the resource dependence theory by showing that the severity of disruptions caused by a pandemic triggers new forms of buffering external to the HCSC. Both traditional and new buffering measures establish novel flows of medical supplies in the HCSC that can enable higher supply security in a pandemic.

Assessment of Supply Chain Management Resilience within Saudi Medical Laboratories during Covid-19 Pandemic

Covid-19 pandemic has affected global supply chains disrupting local inventory management. Multiple studies have shed light on the scarcity of personal protective equipment. Still, not much data was seen on how this crisis resulted in the disruption of other health care sectors. This paper studies how this crisis affected supply chains and inventory management on the laboratory commodities during the Covid-19 pandemic within Saudi Arabia. A cross-sectional qualitative study targeting laboratory personals and suppliers in Saudi Arabia is conducted to evaluate laboratory material inventory management. Our sample includes twelve hospitals and ten suppliers. The study revealed that the supply chain functions resilience was moderate to mildly affected during the pandemic. The higher effect in the supply chain functions was in the lead time (58%), followed by purchasing (33%), then the inventory (25 %). The actual lab supply was significantly affected in 2 hospitals only, moderately affected in 7 hospitals (58%), and mildly affected in 2 hospitals. The unavailability of reagents was the highest result of the disruption (50%) besides the price change and lack of alternatives. Almost (86 %) of suppliers reported that their service was partially affected in most supply chain functions although they claimed having reasonable resilience measures/processes to sustain their operations. The highest risk mitigation process were the backup supply, recovery plan, and emergency/disaster agreements coverage. Most than half of the organizations reported that they have mature resilience measures. This leads us to conclude that both laboratory and supplier inventory and supply chain management had reasonable resilience processes in Saudi Arabia. Those measures were clear in minimizing the disruption effects caused by the pandemic and having a moderate impact on the laboratory operations.

A roadmap for applying qualitative comparative analysis in supply chain research

Purpose

The purpose of this paper is to introduce qualitative comparative analysis (QCA) to the field of supply chain management and provide a detailed roadmap that supply chain researchers can utilize when applying this methodology.

Design/methodology/approach

Data collection focused on the evaluation of product returns management practices as perceived by business customers who operate in a supplier–customer context. In order to analyze the data using the QCA approach, a multi-step analysis was developed.

Findings

The results indicate five solutions that lead to high levels of customer satisfaction. The existence of multiple sufficient configurations for customer satisfaction indicates equifinality because multiple alternative solutions can lead to the same outcome.

Research limitations/implications

The authors make a methodological contribution by applying the QCA method to the field of supply chain management and providing a detailed roadmap that supply chain researchers can utilize.

Practical implications

The authors provide managers five different and novel combinations of antecedents that lead to higher levels of customer satisfaction.

Originality/value

This study offers supply chain researchers a better understanding of when it is appropriate to use QCA and how to apply this methodology. From a theoretical perspective, past studies focused exclusively on the “net effects” of these antecedents, thus, did not capture the complexity of the relationships between these various antecedents and customer satisfaction. This is a noteworthy contribution as it highlights the complexity of the amalgam of relationships and factors that impact customer satisfaction within the context of reverse supply chain.

Service modularity in managing healthcare logistics

Purpose

The purpose of this paper is to examine how modularity is used for enabling value creation in managing healthcare logistics services.

Design/methodology/approach

Material logistics of four different kinds of hospitals is examined through a qualitative case study. The theoretical framework builds on the literature on healthcare logistics, service modularity and value creation.

Findings

The case hospitals have developed their material logistics independently from others when looking at the modularity of offerings, processes and organisations. Services, such as assortment management, shelving and developing an information platform, have been performed in-house partly by the care personnel, but steps towards modularised and standardised solutions are now being taken in the case hospitals, including ideas about outsourcing some of the services.

Research limitations/implications

This paper proposes seven modularity components for healthcare logistics management: segmentation, categorisation and unitisation of offerings, differentiation and decoupling of processes, and centralisation and specialisation of organisations. Thus, this study clarifies the three-dimensional concept of modularity as a cognitive frame for managing logistics services with heterogeneous customer needs in a rapidly changing healthcare environment.

Practical implications

Modularity offers a tool for developing logistics services inside the hospital and increases possibilities to consider also external logistics service providers.

Social implications

Managing healthcare logistics services through modularity has potential social implications in developing healthcare processes and changing the usage of health services. On a wider scale, modularity is helping healthcare systems reaching their goals in terms of service quality and cost.

Originality/value

This paper shows the context-specific antecedents of service modularity and the usage of modular thinking in managing healthcare logistics.