Nearly 90% of healthcare providers are contributing to stockpiles of critical medical supplies and drugs intended to last as long as 90 days, according to a recent survey conducted by healthcare improvement company Premier.
As new COVID-19 hotspots emerge, however, the survey shows local efforts to build stockpiles must be supported with a national strategy to avoid redirecting supplies away from front-line caregivers, and exacerbating ongoing product shortages.
Either the health system or the state is directing the majority of stockpiling efforts, the survey found, although product backorders are inhibiting requests to replenish stockpiles and provide timely care.
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The products that providers cited as heavily backordered include N95 masks and bouffant caps (both cited by 53% of respondents); isolation gowns and shoe covers (49%); testing swabs and test kits (40%); surgical gowns (35%); exam gloves (32%); surgical masks (30%); and syringes (7%).
WHAT'S THE IMPACT
Premier is advocating for the creation of a national standard that integrates stockpiling needs at the federal, state and health system levels. It recommends a hub-and-spoke model that leverages the Strategic National Stockpile as well as a network of state and health system stockpiles, with an emphasis on collaboration and coordination between the entities maintaining inventories of supplies.
The recommendations are meant to enhance transparency within the SNS and create a national standard for all stockpiles, including those at the state or local level, to ensure consistency and interoperability.
Among the specific recommendations are that the SNS maintain a minimum 90-day supply of critical medical supplies and drugs -- as dictated by surge demand from hot spots such as New York and Washington -- and that the administration work with the private sector to create a streamlined and efficient process for states to access supplies and drugs from the SNS.
The SNS should also partner proactively with group purchasing organizations to forecast demand and increase capacity to avoid shortages, according to Premier, and should ensure that critical medical supplies and drugs are located as close to the delivery of care as possible, including exploring opportunities to leverage health system warehouses.
Health systems or regional buying groups could be considered as potential stockpile operators. These organizations would be responsible for managing the stockpile for the providers in a region, allowing for an efficient means to rotate inventory and assure accountability for the stockpile.
Other recommendations include the creation of a customized stockpile for nursing homes with appropriate supplies, drugs and other needs; and an integrated data infrastructure that uses clinical and supply predictive analytics to forecast geographical disease progression and surge demands to provide real-time insights to supply needs.
THE LARGER TREND
In May, Advocate Aurora Health partnered with Premier to acquire a minority stake in Prestige Ameritech, the largest domestic manufacturer of face masks, including N95 respirators and surgical masks. The system is among 15 across the country joining this initiative to invest in domestic and geographically diverse manufacturing aimed at ensuring a robust and resilient supply chain for essential medical products.
In addition to an equity investment, Advocate Aurora Health will commit to purchase a portion of all masks used annually from Prestige Ameritech for up to six years, inclusive of a three-year renewal option. The financial terms of the agreement were not disclosed.
The organizations hope domestic PPE production will curb an overreliance on Asia for manufacturing and source materials.
ON THE RECORD
"During the pandemic, the nation experienced a fragmented approach to securing supply that led to competition rather than coordination," said Blair Childs, senior vice president of public affairs at Premier. "States and health systems need to feel confident in their ability to access an emergency stock of supplies, but absent a clear national strategy, we risk not being able to support providers through a regional surge in cases. To protect our front-line workers and patients, we must reinforce providers' efforts with a national strategy that ensures coordination and reliability across stockpiles."