How JJMDC helped Intermountain Healthcare streamline supply chain operations
When Intermountain Healthcare had problems with stockouts for crucial surgical supplies, it turned to its supplier, the Johnson & Johnson Medical Devices Companies (JJMDC), for help. JJMDC deployed a specialized supply chain team to help the health system diagnose what the problem was and discover a solution.
"We've got a stockout." When it comes to crucial surgical products and medical devices, those are words that no hospital administrator, clinician, or supply chain professional ever wants to hear.
Unfortunately for Intermountain Healthcare, a not-for-profit health care system of 23 hospitals in Utah and Idaho in the United States, it was hearing those words far too frequently for certain surgical products from the Johnson & Johnson Medical Devices Companies (JJMDC).1 "Traditionally, our solution was to increase our safety stock and carry more inventory," explained Heber Everitt, demand planning manager at Intermountain Healthcare. "But that strategy was no longer working and was impacting overall efficiency."
Intermountain, which serves thousands of patients annually, wanted to act quickly to restore confidence among its supply chain and surgical personnel in the supply chain integrity of JJMDC products. To solve the problem, Intermountain approached JJMDC about how the two organizations could collaborate to identify process improvements that would reduce stockouts and improve customer service while also making the supply chain more efficient. Intermountain wanted the effort to focus specifically on Ethicon Inc. sutures.
Both organizations knew that delivering high-quality, efficient health care requires significant supply chain expertise. Afterall, understanding demand within a health system's supply chain can be a complex challenge requiring sophisticated and accurate data, as well as trust and transparency between many parties, including suppliers, distributors, and clinicians. To help diagnose and solve the complex problems that were causing stockouts of Ethicon sutures, the JJMDC team leveraged CareAdvantage from the Johnson & Johnson Medical Devices Companies—a holistic approach to help health care systems realize better care by aligning JJMDC's broad capabilities to customers' individual needs. It seeks to support a hospital system's goals of delivering "whole health" by reducing costs, improving outcomes, advancing patient satisfaction, and developing a healthier workforce.
Leveraging CareAdvantage, the JJMDC team starts by talking with the customer to understand its specific objectives, priorities, and challenges. The team then combines these insights with deeper, data-driven analyses to identify opportunities to make the most impact. A rigorous onsite assessment validates these findings to deliver a focused action plan with targeted metrics linked to each of the health system's goals.
Solving starts with listening
A fundamental component of CareAdvantage is the belief that solving starts with listening. With that as a focus, a key first step for the JJMDC team was to fully understand the challenges that Intermountain was facing and how it was currently managing its suture inventory. Together, JJMDC and Intermountain conducted a series of fact-finding meetings with the clinical supply chain specialists at the hospitals in order to understand pain points that interrupted supply flow. These fact-finding meetings are a best practice that Intermountain had already been using to assess its own supply chain efficiency. The JJMDC team spent time onsite within the health system to study product flow, map processes, and quantify system-level supply dynamics.
During the joint-planning meetings, both organizations recognized room for improvement in their own processes, including taking a more proactive approach to data gathering and improving transparency and communication. To help them work toward better aligning their processes and systems, the two companies used the Gartner Five-Stage Demand-Driven Maturity Model as a roadmap.2 The Gartner model helps companies to identify the current maturity level of their supply chain organizationand provides a standard series of steps for improving their supply chain sophistication.
1. React: In the first stage, business units operate autonomously in silos. There is no cross-divisional standardization of supply chain services and little coordination. Typically, systems are disconnected, and processes are often manual.
2. Anticipate: This stage focuses on creating standardized processes and centralizing some supply chain functions. These efforts typically begin to improve operational efficiency and productivity. Logistics and supply chain activities and performance are now being captured and reported on an organization-wide level, which enables the supply chain to better anticipate demand.
3.Integrate: The focus now is on integrating processes and systems across the overall supply chain. There is increased consideration of how logistics and supply chains will affect customer service and procurement.
4. Collaborate: This stage is characterized by a focus on fostering collaboration and visibility across the value chain network in a manner thatgoes beyond providing simple transactional services. Value chain partners have a shared supply chain management vision and recognize the trade-offs between profitability and customer value.
5.Orchestrate: The supply chain facilitates processes across an ecosystem of partners to capitalize on unique business opportunities. As a result, information flows across the supply chain network in real time. This enables better visibility, which helps organizations make fact-based decisions in a timely manner.
Changes drive significant results
To solve the stockout problem, the two organizations took a number of steps to improve end-to-end customer service and operational efficiency, which also helped to raise their supply chain maturity level. They began to track the on-time performance and consistent weekly deliveries of shipments. They also improved how they shared supply chain information between the two organizations. For example, they increased the number of usage reports for Ethicon surgical products from monthly to weekly, and sometimes even daily. Additionally, they revised their business planning processes and implemented prediction accuracy measurements, which allowed them to assess and then improve the accuracy of their demand and supply forecasting.
In addition, Intermountain implemented a "dock-to-stock" system, where deliveries of Ethicon sutures would be sent directly to Intermountain's distribution center dock for stocking. This lean process helped to eliminate lead time. The company also reduced lead time by switching to a 7:00 a.m. delivery time, when there is less congestion in the distribution center. These actions led to improved efficiencies at the distribution level and enhanced transparency among all partners. Specific results included:
Reduced inventory-stocking lead time from dock to stock from 48 hours to 4 hours
Reduced stockouts by 40 percent
Reduced overall product lead time
Increased early payment discounts from 40 percent to more than 90 percent
Increased supply chain transparency
Improved confidence and trust
There were other benefits, as well. Using the Gartner self-assessment tool, the organizations found they had progressed to stage 4 in their partnerships: Collaborate. But they aren't resting on their laurels. Both have their sights set on the collaboration reaching the highest stage of the Gartner Supply Chain Maturity Model: Orchestrate (stage 5), where logistics and the rest of the supply chain facilitate processes across an ecosystem of partners to capitalize on unique business opportunities.3
Five questions
We believe these learnings can provide a framework for other supply chain managers—in both the health care industry and beyond—to consider. To assess your organization's supply chain optimization, here are five key questions to get a conversation started:
Are you and your customers confident about supply inventory?
How reliable are your forecast capabilities?
What are your metrics for stockouts, end-to-end customer service, and operational efficiency?
How do you rank on the Gartner Five-Stage Maturity Model?
What are your goals for your supply chain?
By asking these questions of your organization and your partners' organizations, you will have a better chance of streamlining your supply chain operations and, in the case of health care systems, delivering better value-based care.
Notes:
1.The Johnson & Johnson Medical Devices Companies comprise the surgery, orthopedics, and cardiovascular businesses within Johnson & Johnson's Medical Devices segment.
Container imports at U.S. ports are seeing another busy month as retailers and manufacturers hustle to get their orders into the country ahead of a potential labor strike that could stop operations at East Coast and Gulf Coast ports as soon as October 1.
Less than two weeks from now, the existing contract between the International Longshoremen’s Association (ILA) and the United States Maritime Alliance covering East and Gulf Coast ports is set to expire. With negotiations hung up on issues like wages and automation, the ILA has threatened to put its 85,000 members on strike if a new contract is not reached by then, prompting business groups like the National Retail Federation (NRF) to call for both sides to reach an agreement.
But until such an agreement is reached, importers are playing it safe and accelerating their plans. “Import levels are being impacted by concerns about the potential East and Gulf Coast port strike,” Hackett Associates Founder Ben Hackett said in a release. “This has caused some cargo owners to bring forward shipments, bumping up June-through-September imports. In addition, some importers are weighing the decision to bring forward some goods, particularly from China, that could be impacted by rising tariffs following the election.”
The stakes are high, since a potential strike would come at a sensitive time when businesses are already facing other global supply chain disruptions, according to FourKites’ Mike DeAngelis, senior director of international solutions. “We're facing a perfect storm — with the Red Sea disruptions preventing normal access to the Suez Canal and the Panama Canal’s still-reduced capacity, an ILA strike would effectively choke off major arteries of global trade,” DeAngelis said in a statement.
Although West Coast and Canadian ports would see a surge in traffic if the strike occurs, they cannot absorb all the volume from the East and Gulf Coast ports. And the influx of freight there could cause weeks, if not months-long backlogs, even after the strikes end, reshaping shipping patterns well into 2025, DeAngelis said.
With an eye on those consequences, importers are also looking at more creative contingency plans, such as turning to air freight, west coast ports, or intermodal combinations of rail and truck modes, according to less than truckload (LTL) carrier Averitt Express.
“While some importers and exporters have already rerouted shipments to West Coast ports or delayed shipping altogether, there are still significant volumes of cargo en route to the East and Gulf Coast ports that cannot be rerouted. Unfortunately, once cargo is on a vessel, it becomes virtually impossible to change its destination, leaving shippers with limited options for those shipments,” Averitt said in a release.
However, one silver lining for coping with a potential strike is that prevailing global supply chain turbulence has already prompted many U.S. companies to stock up for bad weather, said Christian Roeloffs, co-founder and CEO of Container xChange.
"While the threat of strikes looms large, it’s important to note that U.S. inventories are currently strong due to the pulling forward of orders earlier this year to avoid existing disruptions. This stockpile will act as an essential buffer, mitigating the risk of container rates spiking dramatically due to the strikes,” Roeloffs said.
In addition, forecasts for a fairly modest winter peak shopping season could take the edge off the impact of a strike. “With no significant signs of peak season demand strengthening, these strikes might not have as intense an impact as historically seen. However, the overall impact will largely depend on the duration of the strikes, with prolonged disruptions having the potential to intensify the implications for supply chains, leading to more pronounced bottlenecks and greater challenges in container availability, " he said.
A coalition of freight transport and cargo handling organizations is calling on countries to honor their existing resolutions to report the results of national container inspection programs, and for the International Maritime Organization (IMO) to publish those results.
Those two steps would help improve safety in the carriage of goods by sea, according to the Cargo Integrity Group (CIG), which is a is a partnership of industry associations seeking to raise awareness and greater uptake of the IMO/ILO/UNECE Code of Practice for Packing of Cargo Transport Units (2014) – often referred to as CTU Code.
According to the Cargo Integrity Group, member governments of the IMO adopted resolutions more than 20 years ago agreeing to conduct routine inspections of freight containers and the cargoes packed in them. But less than 5% of 167 national administrations covered by the agreement are regularly submitting the results of their inspections to IMO in publicly available form.
The low numbers of reports means that insufficient data is available for IMO or industry to draw reliable conclusions, fundamentally undermining their efforts to improve the safety and sustainability of shipments by sea, CIG said.
Meanwhile, the dangers posed by poorly packed, mis-handled, or mis-declared containerized shipments has been demonstrated again recently in a series of fires and explosions aboard container ships. Whilst the precise circumstances of those incidents remain under investigation, the Cargo Integrity Group says it is concerned that measures already in place to help identify possible weaknesses are not being fully implemented and that opportunities for improving compliance standards are being missed.
By the numbers, overall retail sales in August were up 0.1% seasonally adjusted month over month and up 2.1% unadjusted year over year. That compared with increases of 1.1% month over month and 2.9% year over year in July.
August’s core retail sales as defined by NRF — based on the Census data but excluding automobile dealers, gasoline stations and restaurants — were up 0.3% seasonally adjusted month over month and up 3.3% unadjusted year over year. Core retail sales were up 3.4% year over year for the first eight months of the year, in line with NRF’s forecast for 2024 retail sales to grow between 2.5% and 3.5% over 2023.
“These numbers show the continued resiliency of the American consumer,” NRF Chief Economist Jack Kleinhenz said in a release. “While sales growth decelerated from last month’s pace, there is little hint of consumer spending unraveling. Households have the underpinnings to spend as recent wage gains have outpaced inflation even though payroll growth saw a slowdown in July and August. Easing inflation is providing added spending capacity to cost-weary shoppers and the interest rate cuts expected to come from the Fed should help create a more positive environment for consumers in the future.”
The U.S., U.K., and Australia will strengthen supply chain resiliency by sharing data and taking joint actions under the terms of a pact signed last week, the three nations said.
The agreement creates a “Supply Chain Resilience Cooperation Group” designed to build resilience in priority supply chains and to enhance the members’ mutual ability to identify and address risks, threats, and disruptions, according to the U.K.’s Department for Business and Trade.
One of the top priorities for the new group is developing an early warning pilot focused on the telecommunications supply chain, which is essential for the three countries’ global, digitized economies, they said. By identifying and monitoring disruption risks to the telecommunications supply chain, this pilot will enhance all three countries’ knowledge of relevant vulnerabilities, criticality, and residual risks. It will also develop procedures for sharing this information and responding cooperatively to disruptions.
According to the U.S. Department of Homeland Security (DHS), the group chose that sector because telecommunications infrastructure is vital to the distribution of public safety information, emergency services, and the day to day lives of many citizens. For example, undersea fiberoptic cables carry over 95% of transoceanic data traffic without which smartphones, financial networks, and communications systems would cease to function reliably.
“The resilience of our critical supply chains is a homeland security and economic security imperative,” Secretary of Homeland Security Alejandro N. Mayorkas said in a release. “Collaboration with international partners allows us to anticipate and mitigate disruptions before they occur. Our new U.S.-U.K.-Australia Supply Chain Resilience Cooperation Group will help ensure that our communities continue to have the essential goods and services they need, when they need them.”
A new survey finds a disconnect in organizations’ approach to maintenance, repair, and operations (MRO), as specialists call for greater focus than executives are providing, according to a report from Verusen, a provider of inventory optimization software.
Nearly three-quarters (71%) of the 250 procurement and operations leaders surveyed think MRO procurement/operations should be treated as a strategic initiative for continuous improvement and a potential innovation source. However, just over half (58%) of respondents note that MRO procurement/operations are treated as strategic organizational initiatives.
That result comes from “Future Strategies for MRO Inventory Optimization,” a survey produced by Atlanta-based Verusen along with WBR Insights and ProcureCon MRO.
Balancing MRO working capital and risk has become increasingly important as large asset-intensive industries such as oil and gas, mining, energy and utilities, resources, and heavy manufacturing seek solutions to optimize their MRO inventories, spend, and risk with deeper intelligence. Roughly half of organizations need to take a risk-based approach, as the survey found that 46% of organizations do not include asset criticality (spare parts deemed the most critical to continuous operations) in their materials planning process.
“Rather than merely seeing the MRO function as a necessary project or cost, businesses now see it as a mission-critical deliverable, and companies are more apt to explore new methods and technologies, including AI, to enhance this capability and drive innovation,” Scott Matthews, CEO of Verusen, said in a release. “This is because improving MRO, while addressing asset criticality, delivers tangible results by removing risk and expense from procurement initiatives.”
Survey respondents expressed specific challenges with product data inconsistencies and inaccuracies from different systems and sources. A lack of standardized data formats and incomplete information hampers efficient inventory management. The problem is further compounded by the complexity of integrating legacy systems with modern data management, leading to fragmented/siloed data. Centralizing inventory management and optimizing procurement without standardized product data is especially challenging.
In fact, only 39% of survey respondents report full data uniformity across all materials, and many respondents do not regularly review asset criticality, which adds to the challenges.