Continuous resilience in Arizona health care

Researchers, clinicians, and industry experts gathered to discuss innovative plans and programs to support sustainable resilience in the health care business.

The COVID-19 pandemic impacted health care business on a global scale. At the second annual Arizona Business and Health Summit on Nov. 30, W. P. Carey partnered with the Arizona Biomedical Research Corporation to invite researchers, clinicians, practitioners, policymakers, and community partners to advance business and health throughout Arizona through increased collaboration. The Arizona Department of Health Services (AZDHS) funded the event.

The summit, themed "Implementing Programs for Resilience: Lessons for Sustained Change in Health Care Provider Organizations," focused on progressive practices implemented in academia and industry to improve resilience in health care business. Jeffrey Wilson, associate dean for research and inclusive excellence, and Department of Supply Chain Management Professors Mikaella Polyviou and Gene Schneller led the committee that organized the event.

During his welcome speech, Ohad Kadan, Charles J. Robel Dean and W. P. Carey Distinguished Chair in Business, reflected on the 2020 health care and supply chain crisis.

"I don’t know what the next crisis is going to be, but I do know that one is going to happen, and it will probably be different than past crises," said Kadan. "So we'd better start thinking about it. This is what I hope we are going to do today."

Polyviou described resilience in business as proactively anticipating disruptions, reacting by containing damage and recovering quickly, and learning from disruptions to transform and adapt to new environments.

"Let's think of disruptions as opportunities," she said. "How did we fare? What did we do? How can we do things better in the future?"

Resilience in health care business

ASU is a leader in working to assure the safety of its students, faculty, and stakeholders. In response to the need for timely and accurate COVID-19 viral testing in early 2020, the Biodesign Institute was one of the first labs in the nation to begin saliva-based testing for ASU students, staff, and faculty at the university's ASU Biodesign Clinical Testing Laboratory (ABCTL). In collaboration with the AZDHS, ABCTL provided free saliva-based testing throughout Arizona at more than 100 locations per week. During the summit's first presentation, Vel Murugan, associate director of research and associate research professor at the Virginia G. Piper Center for Personalized Diagnostics, shared his team's experience creating the lab and testing processes. Since the beginning of the pandemic, ABCTL has tested over 1.5 million samples and reported over 99 thousand positive cases.

Murugan called for increased collaboration and communication in the supply chain to track manufacturing requirements and deliveries to ensure the availability of goods during emergencies. He proposed a move from "just-in-time to just-in-case" inventories to better prepare organizations and society for future crises.

Murugan was one of 18 presenters and discussants who covered topics ranging from the importance of backup power generators at health care facilities, implementing emerging technologies to encourage long-term sustainability and resilience in health care organizations, and innovative company policies that improved employee morale and increased efficiency during the pandemic.

Leaders from multiple companies and sectors demonstrated how they provide unique value to the system. Sean Griffin, CEO of Disaster Tech, focused on the criticality of the power of infrastructure to meet needs during disasters; Adam Randolph, managing director for strategic alliances at Abbott Laboratories, discussed how one of the world's largest medical diagnostic companies approached the challenges posed by the pandemic — both domestically and globally. Chris Luoma, chief strategy officer at GHX, emphasized the importance of information to meet the needs of hospital customers. To be sure attendees understood the importance of keeping technology working during disruption, Mark Penniman, chief commercial officer, and Jason Lu, chief technology officer and chief information officer at CSAT Solutions, stressed the importance of technology continuity so hospitals and outpatient facilities could continue to operate during the pandemic.

Presenters echoed Murugan’s call for rethinking preparation for future disruptions, citing global supply chain failure and lack of emergency preparedness as major issues during the crisis.

Andrew Van Sumeren, founder of the Lean Six Sigma education company Ripple Improvement Outfitters, service director at Danaher, and a former leader at GE HealthCare, described facing sudden materials shortages and staff safety concerns while supporting the rapid increase in ventilator production at the start of the pandemic. Van Sumeren credited Lean Six Sigma methodologies with tripling GE Healthcare's ventilator production. These practices created faster, sustainable production processes and built a resilient company culture through consistent cross-unit communication, present leadership, and the celebration of daily wins.

Health care personnel also faced supply chain bottlenecks. As hospitals reached capacity, traveling nurses filled staff shortages across the country. But as the pandemic entered its endemic phase, these nurses were less likely to travel long distances on short notice.

"It's a classic supply chain logistics problem, but it's harder because nurses are people," said Jonathan Helm, associate professor at the Kelley School of Business at Indiana University and former ASU faculty member. "Nurses are not products, and there are a whole lot more considerations."

Helm presented a system he piloted that deployed travel nurses — whom the app gave improved travel notice — to high-need facilities by anticipating patient demands. The system aims to staff facilities anticipating higher rates of illness while preserving hospital funds and, most importantly, creating a sustainable schedule and workload to increase nurse satisfaction and avoid burnout.

The summit concluded with a panel discussion led by Denis Cortese, director of the ASU Center for Health Care Delivery and Policy, on implementing research, education, and practice to improve resilience in health care. The panel featured Olivia Liu Sheng, professor and W. P. Carey Distinguished Chair, Kristen Will, assistant dean and clinical associate professor at the College of Health Solutions, and Judith Karshmer, dean of the Edson College of Nursing and Health Innovation.

"We prepare a lot of health professionals here. Our goal is that when they graduate, they go into systems that value their decisions, their ability to make change, and their ability to collectively come up with a better way of doing things," said Karshmer. "If the system does not allow that, you are setting up a non-resilient system."

Schneller concluded the summit by emphasizing that it takes a community of diverse companies to manage disruptions and "orchestrate the supply chain for resilience." He reflected that virtually no health care provider has the term "preparedness" in its mission statement and that he hopes, going forward, resilience will be not just a platitude but part of what organizations in the health sector do to hard-wire resilience strategies, tactics, and technologies to meet the care of patients and communities.