At Scripps Health, clinicians play an essential role in supply chain decision making.
Engaging clinicians is pivotal in healthcare supply chain such as value analysis and standardization initiatives, the top supply chain executive at Scripps Health says.
Cecile Hozouri, MBA, has been corporate vice president of supply chain at Scripps since 2010. She joined the San Diego-based health system as a supply chain manager in 2003.
HealthLeaders recently talked with Hozouri about a range of issues, including the keys to supply chain success, conducting value analysis for products, and enlisting clinicians in supply chain decision making. The following transcript of that conversation has been edited for clarity and brevity.
HealthLeaders: What are the primary elements of supply chain success?
Cecile Hozouri: First and foremost, you need an effective supply chain team. I have a very engaged team that helps solidify and support the supply chain across the organization and helps get changes done.
Another piece is a collaborative approach with clinicians. We are constantly connected with someone from the medical staff, the nursing teams, advanced practice nurses, or even our chief operating executives to have conversations about something we are thinking about doing.
At its best, supply chain is a vehicle for change. The Scripps executive team supports us in seeking change. All of our top executives are very supportive of moving forward with change. This is where the collaborative relationship with our clinicians is crucial. The only way we are going to achieve success with a change is if clinicians are doing it with us.
HL: What are the primary challenges of serving as corporate vice president of supply chain at Scripps?
Hozouri: For the past three years with the coronavirus pandemic, we have had significant challenges in the supply chain. That includes everything from raw materials, to specialty products, to the simplest plastic products such as syringes and basins. We have been able to tackle the most critical supply shortages by working directly with our nurses and clinicians who utilize these products and determine the best options for substitutions while their primary manufacturers are unable to produce the original products. It has been a challenging three years, and it continues to be challenging.
While we have managed those challenges with the supply disruptions and backorders, we are also combatting supply cost increases. We have had multiple conversations with our vendor partners to strategize what we can do together to offset those increases.
HL: How do you rise to the challenge of increased costs?
Hozouri: I have a very effective strategic sourcing team and contractual team that supports this piece. We have an integrated supply chain with our clinicians, which helps us manage costs. When it comes to cost increases, we are bringing those vendors to the table. When it comes to a physician-specific product, we make the physicians aware of what the cost increases look like, and they help us with that. They may choose another product.
HL: Do you work with a group purchasing organization?
Hozouri: We utilize a group purchasing organization called HealthTrust. They provide a wide variety of supply and service standardization opportunities for us. They have a full portfolio of commodity, service, and specialty product contracts that have been negotiated at great rates.
Cecile Hozouri, MBA, corporate vice president of supply chain, Scripps Health. Photo courtesy of Scripps Health.
HL: How do you conduct value analysis?
Hozouri: We have a clinical value analysis governance structure that is chaired by our physician leaders at Scripps. And within our own supply chain department, we have a clinical team that is made up of nurses with backgrounds in surgery, cardiac care, critical care, and med-surg. Our nurse team works closely with our service line leaders and connects with our nursing departments to review supply utilization data specific to their areas of expertise. Those reviews are centered on quality metrics and supply variation across our health system.
Our supply chain team also supports the clinical service lines in new product and technology requests, and they review how new requests may support our patient experience. Our collaboration with the clinical service lines is designed to choose the best products for the best patient outcomes at the best price possible.
HL: How is supply chain management organized at Scripps?
Hozouri: We have a very connected supply chain at Scripps. We have a corporate office function that has our contracting, procurement, and value analysis team. Then we have operations and logistics teams that work directly with our hospitals and clinics. Logistics supports all product and equipment needs for our standard processes such as ordering, receiving, and inventory management.
HL: How do you include clinicians in supply chain decision making?
Hozouri: Involving our clinicians is critical to our supply chain processes. On a daily basis, our logistics team or our nurses in value analysis work very closely with our service line physicians and nurses to address product disruptions. The physicians and the nurses review our recommended product substitutions if the manufacturers are unable to produce their usual products. We need their feedback to make sure that the substitutions can support patient care.
Clinicians also support us on cost-reduction initiatives, and clinicians review standardization efforts with our supply chain teams. For example, our emergency department clinicians came forward and asked about disposable devices that are used once and thrown away. We looked into that opportunity, and they were right—we were spending a lot of money on disposable products and there was a lot of waste. With their help and collaboration, we achieved more than $1 million in savings.
HL: How do you engage clinicians when there are supply disruptions?
Hozouri: We usually have physician leaders within the service lines that we connect with. We also have a physician executive at each one of our hospitals that provide other point persons for us to go to. Overall, when we are dealing with a supply disruption, we reach out to the physicians and nurses in that service line and talk with them about the backorders and the items we need to substitute. We pick up the phone. We send emails. We share product information. We send out substitute products that they can touch and feel to make sure things are OK to substitute.
HL: How do you convince clinicians to standardize supplies?
Hozouri: When we do standardization projects, we work with clinicians as a group. For example, when we come forward with standardization ideas in surgery, we bring those ideas to the surgeons as a group and see whether they are willing to take a look at changes. Getting the physicians to the table has not been a challenge for our supply chain team. We have been working very well together, and providing the necessary data to make decisions has been an effective way to get clinicians to the table.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
At its best, supply chain is a vehicle for change, the corporate vice president of supply chain at Scripps Health says.
When supply costs are increasing, work with vendors and clinicians to control costs.
In supply standardization efforts, approach clinicians as a group to get their support for change.