Navigating the IV Fluid Shortage: Strategies for Resilient Supply Chains

By: RPI Tech Connect   November 19, 2024

The IV fluid shortage is putting healthcare supply chains to the test, challenging hospitals to adapt while maintaining patient care. A recent survey released by Premier Inc. finds that 86% of U.S. healthcare providers are facing IV fluid shortages, with 54% warning inventories could run dry within 10 days.

In this episode of RPI Tech Connect, Principal Supply Chain Consultant Stephanie Marquez explores the causes of the shortage, its impact on healthcare operations, and how facilities are managing the crisis. Learn how Infor SCM tools like Inventory Intelligence enhance visibility and predictive ordering, along with proven strategies from RPI to help mitigate disruptions.

Tune in to discover actionable insights for resilient healthcare supply chains.

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Meet Your Host, Chris Arey

Chris Arey is an experienced B2B marketing professional with nearly a decade of working in content creation, copywriting, SEO, website architecture, corporate branding, and social media. Beginning his career as an analyst before making a lateral move into marketing, he combines analytical thinking with creative flair—two fundamental principles required in marketing.

With a Bachelor’s degree in English and certifications from the Digital Marketing Institute and HubSpot, Chris has spearheaded impactful content marketing initiatives, participated in corporate re-branding efforts, and collaborated with celebrity influencers. He has also worked with award-winning PR professionals to create unique, compelling campaigns that drove brand recognition and revenue growth for his previous employers.

Chris’ versatility is highlighted by his experience working across different industries, including HR, Tech, SaaS, and Consulting.

About RPI Tech Connect

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Transcript

Chris Arey
The critical IV fluid shortage has further hindered the healthcare industry. What caused the shortage and how can organizations prepare for these types of supply chain disruptions? Stick around as we discuss all of this and more.

This is RPI Tech Connect. Thanks for joining us. I’m your host Chris Arey. And today we’re diving into a challenge that’s putting healthcare supply chains to the test. The shortage of IV fluids. For hospitals and healthcare facilities, insufficient resources like this can disrupt care and put strain on clinical staff. It raises a critical question. How can healthcare organizations better prepare for and manage these types of supply shortages?

To help us unpack this topic, I’m joined by Stephanie Marquez, RPI’s principal supply chain consultant and a fan favorite around the Infor community. So Stephanie, thank you for joining me today.

Stephanie Marquez
Thank you, Chris. I appreciate you having me today.

Chris Arey
Yeah, it’s been about, I wanna say it’s been almost a year now since I’ve had you back on the program, but always a joy. All right, well, let’s jump right in then Stephanie. So could you give some context into what’s happening with this IV fluid shortage? Like where did it come from? What caused it? And yeah, what’s going on?

Stephanie Marquez
Yeah, so, you know, I just kind of want to preface this discussion. And just state that I’m not a clinical expert. But I do have some knowledge and perspective from my years working within healthcare with professionals across a variety of different systems around the country. You can also say that my exposure to healthcare is deeply rooted and started at home. My mom’s a retired nursing professional with her RN, BSN, and MSN and almost 40 years of healthcare experience, both with direct patient care and nursing management. So we discussed a lot of healthcare, especially

When I transitioned my career into supply chain healthcare. So you mentioned IV fluids and the shortage and the impact that that plays. And I think it’s really important to stress how incredibly critical of a role that plays in patient care. And they serve in many different primary roles within healthcare. So for example, to name a few, IV fluids are used for hydration, right? Medical delivery, nutrition. Again, that’s just to name a few. They also have an impact

On a number of specific patient populations. So we’re not just isolated to one grouping of people. It impacts surgical patients, elderly, long-time care patients, pediatric patients, and those with chronic illness. And it definitely is often the foundation of patient stabilization and recovery in hospital settings. So when we have something like IV shortages, there’s definitely a number of different consequences on that patient.

Delayed life-saving treatment, increased cost to bring in alternative supplies, which then increases the clinical staff’s workload, right? Because somebody has to help research and find those alternatives. So I think we could really just talk about that for a very long time.

Chris Arey
I have a silly question, I think I know the answer. I’m hoping you can clear it up for me. IV fluids, those help people stay hydrated, right? When they’re in the hospital bed or something. Okay, so yeah, not having access to that sounds like a pretty scary situation for healthcare providers. So I think these issues were recently exacerbated by the hurricane events. Is that right?

Stephanie Marquez
Yes. Yes. Yes.

Chris Arey
It’s a tough thing, it sounds like, be able to prepare for. Natural disasters are few and far between, and when they strike, you really never know how severe they’re going to be. But I’m curious, from your perspective, how are hospitals managing this shortage on the ground, and what kind of strategies can they deploy to make sure patients who need those fluids can still get

Stephanie Marquez
Yeah, I wish that I could say this is the first time that hospitals and health care facilities experienced this. Back in, I might get the year wrong, but Hurricane Maria impacted Puerto Rico in a catastrophic way many years ago. And that had a critical impact to IV fluids that were kind of brought to the states. So it’s not the first time that health care has experienced something like that.

And there isn’t really a perfect solution, but I think that there are a lot of different things that can be done, like you said, just to kind of help strategize. Forecasting demand and optimizing on inventory. So when we say things like that, what we mean is using data analytics, right, to help us get a better understanding of if there are seasonal times where we might have an increase in demand. Certainly inventory visibility. Those patient care direct clinical folks, they need to be able to know what they have, right? And then those that are responsible for replenishing the inventory need to know what’s on the stock, know, what’s in stock for them? What can they pull from to provide to the clinicians? Setting safety stock levels is something that we’ve seen an increase of specifically around, you know, COVID and PPE equipment, things like that. We’ve seen healthcare kind of transition into setting these types of levels. Yeah.

Chris Arey
Can I stop you? The safety, safety stock level is that like emergency like, like only resort to when you have nothing else available type thing?

Stephanie Marquez
Yeah, it can be or can just be kind of like if you have one specific type of item that has again those increased inventory demands You might raise your replenishment stock. So let’s say for example your organization says, We’re gonna always make sure we have 10 of these on the shelf Maybe they bump that up a little bit and they say okay.

We always want 15 on the shelf You don’t want to go crazy with it because you don’t want to carry the financial burden of having all of that inventory stock not being used So that’s why there’s a lot of different things that you kind of have to leverage the data and the information as well as experience to be able to kind of formulate what your solution might be.

Chris Arey
Okay.

Stephanie Marquez
There’s definitely other things, you know, we talk about technology and how can we leverage technology and supply management. Definitely getting the organizations onto an auto replenishment system. So when you lean into your application to help you track those inventory levels, having some sort of auto replenishment within the system says, okay, I know I need to issue a purchase order and get that product in the door without someone necessarily having to intervene.

Chris Arey
Mmm.

Stephanie Marquez
Think ahead of time too, if you are able to formulate alternative sourcing, kind of have like a backup plan, you know, and lean into vendor relationships, your vendor management, just to have multiple suppliers that can be able to provide those critical care items in the face of primary vendor disruption.

Chris Arey
So back to that auto replenishment systems thing you mentioned there, is there tools out there that have that kind of functionality or what does that process look like?

Stephanie Marquez
and yeah, absolutely. think, you know, we we support in for and cloud suite and we even have some clients that are on it for Lawson and there are those settings within the application that allows us to enable that functionality. So that’s not anything that’s custom or you know, that’s just delivered inventory management type functionality. But how you arrive at that is really through a process of discussion with your inventory management folks and even sometimes those clinicians to help determine what that auto replenishment or safety stock might look like.

Chris Arey
Very cool. So I feel like a process like that kind of like eliminates having to go and manually check what’s available in each one of these rooms, because you have visibility into what’s available where, and when you reach that threshold, it’s going to automatically send them a cue like, we need more of this. Is that right?

Stephanie Marquez
Exactly. And a way to kind of do that is we find that organizations that don’t have regular cycle counting process generally tend to have less visibility into what their inventory looks like.

So one of our kind of go-to recommendations is implementing a regular cycle count. Folks at organizations, I mean it takes work, it takes collaboration, but having a process like that put into place where you’re allowing the system to track that and you’re doing inventory counts regularly help to make sure you don’t find yourself in these types of predict comments.

Chris Arey
Nice, that sounds like it’s related to my next question here, which is actually about best practices for handling low inventory of items like IV fluid. So what kind of approaches would you recommend for managing shortages like this and lessening the blow?

Stephanie Marquez
Mm-hmm.

Yeah, definitely. So there’s a bunch of different things.

First off, I’d like to say certainly developing conservation protocols, right? So how are you collaborating? Every healthcare facility I’ve worked at and worked with in a consulting capacity has a value analysis team. That value analysis team is regularly collaborating with your clinicians and they help to develop, implement and prioritize those guidelines for those critical supplies such as IVs. So typically you can allocate based on urgency and patient need.

Chris Arey
Yes.

Stephanie Marquez
And in a time where we’re experiencing shortages, unfortunately, this often means delaying or modifying the usage for non-critical cases. having an understanding of kind of who takes priority within, you know, a healthcare setting is not a decision I would ever want to have to be responsible for making. Yeah. Yeah.

Chris Arey
I was going to say, that sounds really tough and you got to think that people within the healthcare organization are like, where do you even, I I’m sure they have criteria and a process for identifying what meets critical and what’s not, but like, just to be able to like, it just sounds dumb.

Stephanie Marquez
Yeah. Yes. Yes.

Like, yeah, exactly a decision tree of who we’re treating first or how we’re treating them. Establishment of a crisis response team, know, having different, essentially like focus groups or teams in place can certainly help. And this isn’t uncommon protocol, right? Where you have a dedicated task force of maybe multiple, multidisciplinary members that help to oversee those supply chain issues.

Most importantly, this team should be empowered to make those critical decisions. So you want the right level of folks participating in that task force. In some organization, it could potentially be the same team that’s developing those conservation protocols as it is those on that crisis response team. for example, you know, there might be task forces in a clinical setting for other critical care items like blood products. So that typically is in place in health care and

Chris Arey
Hahahaha.

Stephanie Marquez
I know that just from consulting with some of the healthcare professionals that I’ve worked with. So leveraging a system that’s already in place that already has kind of laid the groundwork can help you kind of to mirror that for other items such as your IV fluids.

Another kind of one that we sometimes see is collaborating with other healthcare facilities. know, so establishing partnerships maybe with nearby hospitals or facilities because at the end of the day, right, patient care and the patient is the primary focus. And so while that may not be incredibly common or something that you see regularly, it’s definitely one that has been used in the past to kind of help mitigate or at least temporarily alleviate some of those shortage issues.

Chris Arey
Really happy to hear you mention that last one there about collaborating with other facilities. It’s something that a guest on a different podcast episode had mentioned. I think it was Bob St. Ledger from Info. We were talking about K through 12 and dealing with disaster recovery and how to respond to these things.

It seems to be a common theme among public sector and service organizations that the delivering better outcomes for your constituents is the goal and like it’s not a competition. And so if you have a network that, you know, maybe the area is not getting as much activity or, you know, patients incoming, like that’s a resource too to like, you know, get those IV fluids or whatever the shortage might be.

Stephanie Marquez
Exactly.

Yeah, exactly. And I know just for example, kind of where I am, I’m in upstate Western New York. We have two primary health care facilities and they have, you know, several large hospitals and a lot of smaller facilities that, that serve those, those rural areas in Western New York. And so those folks, they’re a little bit more isolated, right? So like leaning on those bigger, establishments to maybe help get them those products in time of need, I think is really, really important.

Chris Arey
That’s great. Thank you for sharing that advice there. Earlier on, you had mentioned something about policies. So how can you speak to maybe how these policy changes, like adjusting them can help like manage these shortages? Yeah.

Stephanie Marquez
Mm-hmm.

Yeah.

Yes, definitely. think certainly organizations that have a clear outlined policy is going to limit the guesswork. You said earlier, like it would be really difficult to have to make, you know, patient care decisions on the fly. And we want clinicians to focus on patient care. And if they have to make decisions that can be outlined ahead of time because you have a policy in place, that’s going to alleviate those administrative burdens in that moment, which should be used for focusing on the care of the patient.

From a supply chain management perspective, are, you we talked about different tools within Infor and within Cloud Suite, such as inventory intelligence. That being able to provide demand forecasting and predictive analysis gives supply chain professionals the visibility that they might need. So having that kind of factored into decision making and policy or, you know, just operational process, I think is really important. Inventory intelligence.

Intelligent specifically gives real-time visibility for the users in kind of like the centralized dashboard area. So you can kind of go to one place, get the information you need, make the decisions. There’s not necessarily this long drawn out analysis process or a manual counting that needs to happen. You get that information. That certainly helps us to support optimization, reducing kind of administrative time to research or analyze data.

So certainly key benefits of having something like inventory intelligence in conjunction with your clinical policies helps certainly to increase your inventory control, reducing the number of stock outs that you might have where you’re just out of it, which nobody wants to be in that type of situation, or an excess of surplus, right? Lowering organizational care costs, enhancing efficiencies, and certainly fostering informed decision-making. Which is what we want.

Chris Arey
You mentioned something there. Thank you for that, by the way. But the goal here is to make it so that clinical staff are not worrying about resource scarcity. Their goal, their primary objective is to deliver patient care and to make sure that they have the best experience they can given the circumstances for whatever the reason is that they’re in the hospital. So hearing about these things, these combination of things can really, it sounds like,

Stephanie Marquez
Mm-hmm.

Exactly.

Yep.

Chris Arey
Make their jobs easier because they’re not focused on these seemingly, I don’t want to say unimportant, but they’re the details of the job that they should not be focusing their attention

Stephanie Marquez
Yeah, absolutely.

Absolutely. I my I had a family member that had a really critical life and death health scare back in the early spring, late winter. And I think about in terms if her care team didn’t have the items that she needed, you know, we’re talking about IV shortages. She required a ton of IV fluids as part of her baseline care. And if that wasn’t there for her, the outcome could have been wildly

Chris Arey
Yeah.

Stephanie Marquez
Different. And so as someone who works in, you know, this side of supply chain and kind of sees that when you have a personal experience, you can relate to it. You just have so much more of an increased appreciation for those clinicians. I would have hated for one of her physicians, you know what I mean to, I need this. what? I don’t have it. Well, we don’t want people to be in that type of situation ever.

Chris Arey
Yeah.

Yeah, I’m sorry to hear about that situation with you, by the way. I believe she’s okay now?

Stephanie Marquez
She is okay, she’s doing amazing and had a phenomenal care team. And you know, so we love our healthcare professionals.

Chris Arey
Yes, thank you for sharing that. know, really is a matter, like a situation like this is literally a matter of life and death. And so anything that can be done to reduce the burden on the clinical staff for managing shortages is like, it’s paramount. And so thank you for sharing that with us here. For healthcare organizations that are maybe going through this right now.

Stephanie Marquez
Yes. Yes. Mm-hmm.

Chris Arey
Whether it’s with IV fluid shortage or something else, what advice would you offer and what kind of proactive steps would you offer them to take to handle this?

Stephanie Marquez
Mm-hmm. Yeah.

Yeah, absolutely. I think it’s important to note that there’s always competing priorities when it comes to health care. So implementing just a few strategies and having some guidelines to follow can really help to mitigate in those, you know, dire times. I would say first off, make sure your value analysis committee is having these types of conversations regularly. Again, just from my experience working in supply chain, we partnered with our VA team all the time. You know, whether that be through conversations with a new rep.

So you had your clinical representation, you had your supply chain representation. It just was a relationship that really, it fostered over time, but they really do make a huge impact. The next one, I think, is certainly relying on the data within your system to help drive decisions. There is so much information that we can collect from the data within our systems that can help us make informed decisions, which is what we want. And certainly evaluating existing inventory tracking and inventory processes for potential improvement.

So earlier I mentioned cycle calming, right? That’s one that we kind of, it gets overlooked because it can be overwhelming to kind of get started. We have a colleague that we work with and he worked in supply chain management as a director in healthcare facilities. And that organization when he arrived there, they didn’t have any type of cycle coming.

So they had so much overstock and understock and so he implemented that and over time they were able to save the system millions of dollars but it increased efficiency within supply chain. Again, impacting the patient care down the line because they didn’t have the type of issues, you know, as a result of implementing that process as they had before.

Stephanie Marquez
another little story when I worked in supply chain. During Hurricane Maria, we did experience those shortages as I mentioned. And at the time we didn’t really have a policy or a procedure in place. So it became very reactive. It was almost like an all hands on deck type situation. At the time I was working in contract management and we quickly were able to assemble a team of people that included our value analysis folks, buyers, our sourcing managers,

Chris Arey
Wow.

Stephanie Marquez
and those clinicians to help us leverage everyone’s knowledge because everyone has a pocket of knowledge within that area and coming together to source out those alternatives. You know, it wasn’t without challenge for sure because we weren’t the only system facing, you know, the issue. It was a nationwide impact. It was, it was difficult and we were, you know, limiting what we were bringing in because we knew other facilities also needed products. So you’re not trying to hoard

Chris Arey
Yeah.

Stephanie Marquez
things, right? Because then that doesn’t serve somebody in another state, it challenges them. So it became really working on almost like a national level as well, leaning into those vendors who have contacts outside of just your state or local area.

Chris Arey
That’s great. Thank you for sharing that. From what I’m hearing here is that this situation that you talked about in Puerto Rico, is it right? Being reactive is never ideal, I feel. You want to be proactive and get ahead of these things because it makes the difference. And something else you mentioned there, you don’t want to be hoarding supplies. You need the right amount and your healthcare facility has been doing this long enough now that the data is there.

You can lean in, you can really take a closer look. You can find out what that number is. And that’s gonna make a difference in the long run,

Stephanie Marquez
Great.

Yeah, definitely. Like I said, it’s not an exact…science, it’s not a one size fits all, but you know if your health care system has many different hospitals within your region, I would bet to wager one of them is more geared towards critical care, you know, and when one may be less critical care, so maybe the volumes are different, but again there’s just, like you said, there’s the information, there’s the data to collect, there’s the analysis to be done, and decisions to be made. Yeah, yeah.

Chris Arey
Do it. Don’t wait to do it. Just do it now. Do it before it’s a problem.

Stephanie Marquez
Exactly. Yeah, exactly.

Chris Arey
Well, thank you so much, Stephanie, for hanging out with me this afternoon. Before we wrap up, as you know, I’d like to ask my guests if they could offer one actionable takeaway from today’s discussion to our audience. What would you have to share there?

Stephanie Marquez
Yeah, absolutely. So I think one key takeaway, shortages will happen. And those things are beyond our control, both from a supply chain perspective and a clinical perspective.

But there are things that can be done proactively to help reduce the impact. And those steps can be taken and implemented really at any time. So if you’re listening to this and you’re like, huh, now might be the time to think about implementing cycle counting, it is. And at the end of the day, supply chain is really just the entry point for clinicians being able to provide patients with that potentially life-saving care.

Chris Arey
Thank you so much for sharing that Stephanie. Always love to hear your insights. If you need help with cycle counting, for those of you listening in today, Stephanie Marquez is your go-to resource. If you have a question about our segment or you want to learn more about best practices for managing supply chain ahead of any shortages like the one we’re facing now, we invite you to contact us at podcast@rpic.com. Again, that’s podcast@rpic.com.

This is RPI Tech Connect and I’m Chris Arey. We’ll see you next time.

Stephanie Marquez
Thank you so much.