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Designing Hospital Spaces for Tomorrow's Challenges · Taking The Supply Chain Pulse

• 0:04
  Speaker 1: Welcome to Taking the Supply Chain Pulse, the podcast where innovation meets impact in the world of healthcare, by exploring today's most pressing issues.
• 0:11
  Speaker 1: I'm Megan, with St Onge Company here to introduce our guest, albert Nakansa.
• 0:15
  Speaker 1: As a project manager with St Onge Company, albert has been at the forefront of transforming how hospitals manage their supply chains.
• 0:23
  Speaker 1: Stay tuned as we unpack the future of healthcare logistics.
• 0:26
  Speaker 1: And here's your host, fred Kranz.
• 0:31
  Speaker 2: Let's see if I got this right, because you may have gotten promoted Senior Healthcare Engineer at St Onge.
• 0:35
  Speaker 2: Is that title correct, or have you been promoted since then?
• 0:38
  Speaker 3: I'm Project Manager now, oh, project Manager, the official title yeah Well, let's see.
• 0:43
  Speaker 2: Tell your boss that you have not updated your LinkedIn page.
• 0:46
  Speaker 2: I'll write that right down, albert.
• 0:51
  Speaker 2: It's always great to have you here.
• 0:52
  Speaker 2: What I wanted to do, albert, you work a lot of projects and, without naming the customer's name, I'd like to find out some things, just for folks out there that may be interested and maybe they are thinking of getting some work done.
• 1:07
  Speaker 2: What kind of projects are you working right now?
• 1:11
  Speaker 3: Yeah, no, thanks for asking.
• 1:12
  Speaker 3: So one of the biggest things that I'm really working on is some design projects.
• 1:16
  Speaker 3: So we have, you know, new different hospitals and ambulatory surgery centers especially offsite centers as well are being built.
• 1:24
  Speaker 3: So I'm working on some of the design when it comes to their sterile processing departments, as well as doing some of the design on their docks, their supply chain, storerooms and warehouses, and so I'm really participating in some of that from a design standpoint and assisting architects in those aspects.
• 1:42
  Speaker 3: I'm also doing an analysis of these off-site centers.
• 1:48
  Speaker 3: So actually, two various projects I'm working on right now is two different health systems really wanted to look into the potential for an off-site center, what that looks like, what the feasibility is, what the business case is, and so really looking into does it make sense for them?
• 2:02
  Speaker 3: I think one of the big pieces that we do here at St Ange and that I've done pretty successfully is because we're not vendor focused.
• 2:10
  Speaker 3: We're very, you know, no, we're not bought by anyone, we can give it to you straight.
• 2:15
  Speaker 3: We're not going to kind of come in here and tell you you have to do an offsite when you don't have to.
• 2:18
  Speaker 3: Famously, I worked with a health system in the Midwest some years ago where they thought they needed an offsite center, an offsite SPD.
• 2:27
  Speaker 3: We came in and really told them that actually if you fix A, b and C, even as you're growing, you shouldn't need to.
• 2:35
  Speaker 3: And so that's where we're in the process in right now for a couple of locations, currently, one in the east and one in the west, and so so that's a couple of them, a couple other pieces that I'm working on right now is also kind of working through a full, detailed assessment of a sterile processing center, where we're really going and getting in the nitty gritty when it comes to looking at the staffing right.
• 3:02
  Speaker 3: Is their staffing model correct?
• 3:04
  Speaker 3: Do they need to right at the staffing right?
• 3:05
  Speaker 3: Is their staffing model correct?
• 3:06
  Speaker 3: Do they need to right-size their staffing?
• 3:06
  Speaker 3: How are their processes in decontamination and clean work and sterile storage right?
• 3:11
  Speaker 3: And case picking how are their interactions with the OR staff and the nursing staff there?
• 3:16
  Speaker 3: So really, I mean it's, you know, a wide-ranging pieces of projects, but we're really into it overall.
• 3:24
  Speaker 2: Yeah, there's two things that came up in that uh and while you were talking.
• 3:28
  Speaker 2: Number one is um, how many times do you get what I would call, uh a jeopardy decision, where they've already decided they want a certain uh approach?
• 3:38
  Speaker 2: Uh, where you, and where, uh, you're stuck with the decision?
• 3:43
  Speaker 2: Well, do I give them what they want because they're paying for it, or do I do my job and, you know, do a real assessment and tell them that what they want may not be what they need?
• 3:54
  Speaker 2: A?
• 3:55
  Speaker 3: lot.
• 3:56
  Speaker 3: Actually, I think a lot of the times when these projects are done right, everybody has their own hypotheses, and I do too, right, right from the very beginning, when I have a site visitor assessment, a lot of times I say, okay, based off of what I just saw, this is what I think is going to happen.
• 4:10
  Speaker 3: But we have to do our due diligence of doing the actual analysis.
• 4:14
  Speaker 3: We're using data, using our historical knowledge, putting it together and figuring out what is actually necessary.
• 4:20
  Speaker 3: I do think a lot of the times, people come in and say this is what I think we need, this is what I think needs to happen, and what ends up happening is is that, through the root of the project, we will either confirm some of the things that they already do about themselves and they already thought they needed, or we'll say, hey, actually this is the reasons why we think we should go in the opposite direction, right, and then from that point, it's up to you know, the people that have hired us, the end users and the project team to either accept that analysis or say, with that we still want to go this way and that's fine.
• 5:00
  Speaker 3: That happens too, right, like, if that's, if there's a situation where it's like, given everything you told us, we still feel like this other avenue is the right way to go.
• 5:04
  Speaker 3: Then we were.
• 5:04
  Speaker 3: You know, we I have still worked in helping them, the end user, accomplish what they want to accomplish, even if I don't 100% agree with the rep right, because at the end of the day it's not, it's really not our decision.
• 5:14
  Speaker 3: We're just providing the recommendation and the analysis.
• 5:16
  Speaker 3: But if they can go, they want to go to a different way.
• 5:18
  Speaker 3: We're still going to help them in that, in that pathway.
• 5:20
  Speaker 3: But it does happen a lot where you know what the data is telling us, what our analysis is telling us, what our assessment is telling us, may go against what is wanted.
• 5:28
  Speaker 3: Flip side of that, there's some other times where they thought one thing we show them what our assessment is backing up and that you know we're able to.
• 5:35
  Speaker 3: They're able to kind of see the light there and say, you know, actually we agreed we can move in this route.
• 5:39
  Speaker 3: So it kind of works both ways.
• 5:42
  Speaker 2: Yeah, the second thing that you talked about, and I'll do a hypothetical here.
• 5:48
  Speaker 2: So say I'm an IDN that has six acute care, acute hospitals okay, and I've got six sterile processing operations.
• 5:58
  Speaker 2: I can tell you from my experience that every one of those six has got opportunities number one, and I would also imagine that among the six, you have different levels of expertise and capability within each of them.
• 6:15
  Speaker 2: So if you go into a system that's trying to decide what it wants to do with sterile processing decide what it wants to do with sterile processing how do you go about assessing each of the components, telling them where they are and then leading them to the best decision for themselves?
• 6:33
  Speaker 3: Yeah.
• 6:33
  Speaker 3: So another good question.
• 6:34
  Speaker 3: So with that, in that scenario there a lot of the times, especially when there is, you know, a continuity, right, so everyone's within a system they all want to do, you know, make sure they're all operating.
• 6:44
  Speaker 3: Uh, in a certain way, I think one big thing that is still, I think, a gap across the industry is is is the lack of standardization, especially within systems.
• 6:54
  Speaker 3: So I think one piece is is that looking at, okay, well, what is you know hospital a doing differently than hospital d and what are hospital d doing differently than hospital C?
• 7:03
  Speaker 3: And what is establishing that baseline?
• 7:06
  Speaker 3: What do we want everybody to do?
• 7:08
  Speaker 3: What are some things that, especially in cell processing, we're not always going to have?
• 7:12
  Speaker 3: Like, if Dr Muhammad goes to hospital C, he's going to go to and he only goes to hospital C and he has a tray and he does 30% of their ortho cases, I'm sorry, they're going to keep that tray right.
• 7:24
  Speaker 3: We're not going to be able to standardize his ortho tray right, and so that's always going to be the case.
• 7:28
  Speaker 3: There's going to be certain differences that are always going to stand.
• 7:31
  Speaker 3: But what processes can we standardize across the board?
• 7:33
  Speaker 3: And then a lot of it, and I just mentioned offsides there.
• 7:36
  Speaker 3: So if there is an eye towards an offside, again, even with those six sites, that doesn't always mean it has to be an offsite, right?
• 7:44
  Speaker 3: If there could be certain aspects where the space that they have in place is not, you know, not feasible going towards an offsite?
• 7:52
  Speaker 3: Or maybe the space they have in place and staff they have in place in all their places and all of their areas is already conducive to stay and they just need to standardize their processes and update their processes.
• 8:02
  Speaker 3: Right?
• 8:03
  Speaker 3: The example I gave before where we told that hospital in the Midwest they didn't necessarily have to go towards one.
• 8:07
  Speaker 3: They have three separate sterile processing facilities.
• 8:10
  Speaker 3: There was a thought that they needed that offsite.
• 8:12
  Speaker 3: That was their opinion.
• 8:13
  Speaker 3: Coming in was like, oh, we're probably going to need one and really what ended up happening is is that there was.
• 8:19
  Speaker 3: They had some space at their site that you know, when it came to managing vendors properly, space at their site that you know, when it came to managing vendors properly, they had some space in their site that was adjacent to SPD that they could use for some of their quote-unquote lack of space.
• 8:29
  Speaker 3: Right, there was locations within the main facility that could be utilized more than spending X amount of dollars and adding trucking into it and doing all that other stuff for store processing locations.
• 8:43
  Speaker 3: So that's what I kind of mentioned.
• 8:44
  Speaker 3: Even with those six, I think the first thing we're going to do is take a look at all six of those sites see individually, then take a look at all six of those sites as a system and then see what else can be done to improve both.
• 8:56
  Speaker 2: So, once again, when you go into a multi-hospital system or even within a single place, you can find sort of disparities in competency among the staff, among the processes they use.
• 9:12
  Speaker 2: So I've hired you to come in and I think I've got the greatest sterile processing thing operation going on and you find some gaps, some big gaps that could actually be very dangerous.
• 9:25
  Speaker 2: Sterile processing is a life-threatening operation really.
• 9:29
  Speaker 2: When you think about it.
• 9:30
  Speaker 2: How do you go about delivering that kind of news to customers when you need to do that?
• 9:40
  Speaker 3: It's got to be fact-based.
• 9:41
  Speaker 3: That's the.
• 9:42
  Speaker 3: It has to be fact-based.
• 9:43
  Speaker 3: I think one of the and I'll give a shout out to Jim Cruza, who said this statement to me some years ago, jim Cruza, one of the directors here at St Onge.
• 9:52
  Speaker 3: He said you know, one of the things that makes us an engineering firm is that we are very fact-based.
• 10:01
  Speaker 3: We're database.
• 10:02
  Speaker 3: We're not telling you what we think, we're telling you what we know, right.
• 10:05
  Speaker 3: And so I think with that, we recently and I'll give it to you straight there was an assessment we were currently finishing up where it was very much, and then they didn't think they had the best SBV in the world.
• 10:16
  Speaker 3: They knew that there were some challenges there, findings we had in saying these are the standards that are being violated.
• 10:23
  Speaker 3: This is what we see.
• 10:24
  Speaker 3: These are the pictures that we're showing of the standards from Amy's standards being violated, right?
• 10:33
  Speaker 3: So this isn't a scenario where it's us thinking this is the picture showing the bio burden.
• 10:36
  Speaker 3: This is the standard itself and what it calls to in there.
• 10:39
  Speaker 3: This is the number of the standard.
• 10:41
  Speaker 3: This is what it says in that book and we're talking about it through that aspect.
• 10:44
  Speaker 3: This is the number of the standard.
• 10:45
  Speaker 3: This is what it says in that book and we're talking about it through that aspect Right, going through and using assessment matrix, matrices that are popular throughout the industry, that is known in health care Right, so that everybody's familiar with that.
• 10:57
  Speaker 3: And really, and even when it comes to recommendations on equipment, right, using a database set model that says, hey, we're all we're doing is we're taking your case logs, right, we're taking your case logs.
• 11:07
  Speaker 3: We're taking your equipment, we're taking the spec sheets from the manufacturers and this is what we're using to formulate and recommend how much equipment that you're actually going to need in current state and then what you're going to need, provided the growth measures that you have for your facility, right, so everything that we are doing is fact-based, it's database.
• 11:25
  Speaker 3: And then even using our historical knowledge, even saying that from our experience and some of the things that we're seeing, that is, you know, making sure that there is buy-in.
• 11:33
  Speaker 3: And hey, you know, when we're in a clean work and an SPD, you know best practice is typically to use a bore scale.
• 11:42
  Speaker 3: That's not a standard, that's not something that you have to have.
• 11:46
  Speaker 3: However, it is best practice, and if there is at least that understanding of this is all right, we have that understanding there.
• 11:53
  Speaker 3: Well, in that case, if you feel that's not best practice none of your assembly stations in clean work have borescopes then that's how you have that level of understanding there.
• 12:03
  Speaker 3: Because you know there is those times where, even when you know a lot of the times for SPD assessments especially if you're coming to us for an SPD assessment you at least know there's some gaps.
• 12:12
  Speaker 3: But there are some times where the some gaps you think may extend to a lot more, sometimes where it's less.
• 12:17
  Speaker 3: But it's our job to kind of tell you, not again, not what we think, but what we know.
• 12:21
  Speaker 3: This is the facts and this is the data and this is the analysis and this is these are the pictures, and this is everything there from what we are, what we saw and what we know.
• 12:29
  Speaker 3: And so I keep that quote very dear to mind.
• 12:32
  Speaker 3: As far as it's not what we think but what we know, I think it explains what we do and who we are.
• 12:40
  Speaker 1: Before we dive back in, you may be asking yourself is my supply chain future ready?
• 12:44
  Speaker 1: At St Onge Company, we don't just optimize logistics.
• 12:47
  Speaker 1: We engineer smarter, leaner and more resilient systems from end to end, from manufacturing to retail to healthcare.
• 12:54
  Speaker 1: Our experts bring decades of experience and cutting-edge strategies to transform your operations.
• 12:59
  Speaker 1: Visit and discover how we're shaping the future of supply chain, one solution at a time.
• 13:07
  Speaker 2: As I am listening, I would think of this as a really exceptional side benefit to someone who says hey, I've got five central sterile processing functions here, maybe I should centralize.
• 13:19
  Speaker 2: Then you come in to do an assessment and undoubtedly you may be the first time that an assessment has ever been done on any of these operations and they may have been operating for years, sort of blissfully unaware of things they're not doing.
• 13:37
  Speaker 2: So the work you do there to just tell them where they need to improve their procedures alone would be valuable for an engagement in and of itself.
• 13:49
  Speaker 2: Yeah, absolutely so.
• 13:52
  Speaker 2: As you're out and about, when you go into a building you have to walk around in places other than where you're supposed to be working.
• 13:59
  Speaker 2: Working, what kind of issues do you hear them talking about and what kind of?
• 14:08
  Speaker 2: What are you seeing and what opportunities for operational improvement do you see in the organizations you're going into?
• 14:12
  Speaker 2: Albert?
• 14:13
  Speaker 3: Yeah.
• 14:14
  Speaker 3: So I think one thing is that a couple well, a couple things.
• 14:19
  Speaker 3: One is, I think, as we are progressing in, you know, getting older, right, so as buildings are getting older, as infrastructure is getting older, one of the things that we're seeing is that buildings that have been built in the 70s, the 80s, the 90s, the 60s, way back when right, are pretty locked in right, and so what's happening is that when but those little buildings are locked in, people are not.
• 14:44
  Speaker 3: People are expanding right, the more babies are still coming in, more people are still going to certain areas, right, I live in Houston right now.
• 14:51
  Speaker 3: Houston as a city is expanding exponentially, florida is expanding exponentially, things like that, and so now what you're seeing is that these buildings that were built and set for, let's say, 10 ORs well, now, the need is for you to have 20 ORs, right, but however, though the need is for you to have 20 ORs, you may not have the money to do so.
• 15:15
  Speaker 3: So what happens is you build OR rooms, but you don't necessarily build the supply rooms to match it.
• 15:20
  Speaker 3: You build beds, but you don't build the infrastructure to match it, or the EVS rooms to match it.
• 15:23
  Speaker 3: You build, um, you know, beds, you don't build the, the, uh, the infrastructure to match it, or the evs rooms to match those things like that.
• 15:28
  Speaker 3: So because of that I think that's what some of the things that we are we're seeing just, we had a health system that came to us that basically had that problem, where they were like, hey, we, when they first built this hospital, they built it for 80rs, we 16.
• 15:41
  Speaker 3: However, the hallways are the same.
• 15:44
  Speaker 3: We don't have the SPD is still the same size, the supplies, the supply storeroom is still the same size, and so now we are just jam packed with everything.
• 15:54
  Speaker 3: And most in the biggest issue was they have equipment everywhere, right, and so we had to go in and really do that equipment assessment of where can we put all this equipment everywhere, right, and so we had to go in and really do that equipment assessment of where can we put all this equipment?
• 16:05
  Speaker 3: What opportunities do we have with all the equipment?
• 16:05
  Speaker 3: And there were some egress violations that were in there, right, because it's just that there was an emergency.
• 16:10
  Speaker 3: I remember they had all of their vendor totes filled up an entire exit hallway, which is, you know, it can't have happened.
• 16:18
  Speaker 3: So I think that's one of the biggest things and I think it's consistently happening to where it's older infrastructure that hasn't caught up to the new issue, the new problems.
• 16:26
  Speaker 3: And a lot of the times you just say, well, let's add an OR, or let's add a clinic bay, or let's add this, that to add.
• 16:43
  Speaker 3: You know, increase your supply room, increase your SPD, increase some work for equipment, storage, right Staffing, because then with every and not understanding that piece.
• 16:48
  Speaker 3: So I think that's where one of the places where we come in, and then also I mentioned as far as patients, so in a lot of these locations again, patients are increasing and you have a stagnant ED.
• 16:58
  Speaker 3: Your ED is the size your ED has always been, but your patient population in the area has doubled in the last 10 years, right, covid, especially, right, a lot of people moving to certain areas.
• 17:08
  Speaker 3: It's exponentially increased.
• 17:09
  Speaker 3: Well then, now what do you do?
• 17:10
  Speaker 3: Now your ED is overflowing and so having an assessment, you know, understanding of what is the ED process, because you now, especially if you're locked into your situation, you cannot continue with the same process that you always happen, or what possibilities do you have to expand your ED?
• 17:27
  Speaker 3: So I think those are a couple of the things.
• 17:28
  Speaker 3: It's really just upgrading infrastructure, adjusting to the new normal.
• 17:35
  Speaker 3: But at the same time you can't just not everybody has the liberty to just build a new building that opens up in the next six months right to be able to handle that, even the new buildings.
• 17:45
  Speaker 2: I would ask this because you know I'm naive in this because I haven't ever worked with architects myself but do they give you enough space in their design before you come in the architects to say, hey, are you given enough space to do what you need to do, or do you have to reeducate the architect sometime?
• 18:07
  Speaker 3: So, contrary to popular belief, space costs money.
• 18:12
  Speaker 3: So, because space costs money, where there's always going to be, even with a new building, there's always going to be space constraints.
• 18:20
  Speaker 3: Right, and so I think it's our job, working with the architects, to make sure that everybody understands what is required.
• 18:29
  Speaker 3: What do we have to have?
• 18:31
  Speaker 3: Right, if I come in and I'm designing an SPD, I'm saying no, we have to have a hand wash, eye wash sink in decon and, depending on the size of the decon, you may need to have multiple.
• 18:42
  Speaker 3: Right, we have to have one in clean work by the entrance and you may need to have multiple, depending on the size.
• 18:47
  Speaker 3: Right, you have to have an EVS closet to be able to clean some of these areas.
• 18:50
  Speaker 3: Right For a store, a supply chain store, well, you have to have a certain amount of storage racks based on the SKUs that are coming in.
• 18:58
  Speaker 3: And so, under making sure the architects understand what is a requirement, what has to have Right, making sure the architects understand what is a requirement, what has to have right, because a lot of the times you know if and I say this for sterile processing more than anything, because I think, if you're a healthcare architect designing a supply chain docks or warehouse or storeroom is a lot more common than designing a sterile processing department, right, and so with that, it's very much a question of and I get this question a lot of oh well, you know, do we really need an EVS closet or do we really need a hospital I worked with in the South a few years ago.
• 19:35
  Speaker 3: This is a big question.
• 19:36
  Speaker 3: Well, do they need offices at this offsite?
• 19:37
  Speaker 3: Well, yes, you need a supervisor office in there.
• 19:41
  Speaker 3: They have to be able to.
• 19:41
  Speaker 3: You know, you need supervisor offices in there.
• 19:42
  Speaker 3: You need a supervisor office in there.
• 19:43
  Speaker 3: They have to be able to see how.
• 19:43
  Speaker 3: You need supervisor offices in there.
• 19:44
  Speaker 3: You need a manager office.
• 19:45
  Speaker 3: They're going to be in this place long term.
• 19:46
  Speaker 3: They're not going to be walking around.
• 19:47
  Speaker 3: They're going to need to be able to do these things.
• 19:49
  Speaker 3: They have to have this Right.
• 19:51
  Speaker 3: And so, talking through, so that's certain things that an architect may want to value, engineer or may want to potentially remove, and I think it's understanding what is a requirement, what is, and then what is on the flip side, what is it nice to have, what is something that could be beneficial?
• 20:05
  Speaker 3: But listen, if money is an issue, if we're talking about space, we're losing space.
• 20:09
  Speaker 3: This is something that, yeah, we'd love to have it, but it's not necessarily a requirement, because we are going to be kind of a lot of times stuck in that box and then flip side.
• 20:18
  Speaker 3: You know, I, as much as I like to work with the architects, work on the theme of the project, I want to make sure that any department I'm designing is fruitful for the facility, and so I'm definitely going to kind of fight and err on the caution of the patient and see, well, what is the best way to make sure that this building succeeds as best as possible.
• 20:36
  Speaker 3: And I have and I have no problem with putting my hand up and saying, like, this is not going to work in this capacity.
• 20:41
  Speaker 3: Yeah, I don't know where it's going to come from.
• 20:47
  Speaker 3: We we can talk about with the rest of the building, but it's not going to work in this capacity.
• 20:49
  Speaker 3: We got to find some, whether it's space or a reorientation of space, because not all space is good space, right, uh, but this is just something kind of work in this aspect and and so sometimes you've got to kind of have to fight on the on the side of the hospital against the architect to make sure it's working properly so it's never as easy as it looks, right never.
• 21:07
  Speaker 2: Nobody's ever given me a blank checkbook and said design any spd or supply chain warehouse or evs storeroom that you want, all right, there's always some parameters yeah, well, my last question on this before I go to my final question is uh, you know, you're you're aware what's going on in other industries and what kind of technology they're using.
• 21:28
  Speaker 2: And so I'm building a hospital today or I have an existing place.
• 21:33
  Speaker 2: An existing place is probably really difficult to add space for things like robots and stuff if they don't already have a place for them there.
• 21:45
  Speaker 2: How much latitude are you giving for being able to plan for future new technology when you build a new place?
• 21:56
  Speaker 3: So nowadays, designing a new place, you've got to have automation as a thought.
• 22:00
  Speaker 3: You've got to bring it up when it comes to robotics, when it comes to the type of equipment you're bringing in and really garner the desire for automation.
• 22:10
  Speaker 3: Not everybody has a strong desire for automation, right?
• 22:13
  Speaker 3: I mentioned this before, but I think a lot of people are surprised, and healthcare is a pretty conservative industry when it comes to, you know, innovation and automation and things of that nature, right, like, even when thinking about storerooms and supply chain warehouses.
• 22:28
  Speaker 3: You know the things that we're broaching right now.
• 22:30
  Speaker 3: As a healthcare industry, distribution has been doing for the last 10, 15 years, right, and so I'm working pretty conservative as an industry.
• 22:39
  Speaker 3: But with these new buildings, I think you have to make, you have to, at the very least, build for whether it's building for day one or building for future, right?
• 22:48
  Speaker 3: If there's any desire to have automation in the future, you've got to design with that in mind, and I think and most you know engineers we talk to, most architects we talk to want to make sure we're building something with automation in mind, and it's really more of the level of automation, right?
• 23:04
  Speaker 3: So is it a scenario where a person touches it when it comes off the truck and you don't see it again?
• 23:09
  Speaker 3: A person doesn't see it again until it gets into the storeroom, right, there's some operations like that or is it an operation like a follow bot?
• 23:16
  Speaker 3: A follow bot, for example, is where I am picking things off the shelf and I'm putting, instead of using a push cart, I give it to the robot and the robot just follow me and it reduces the strain from the staff.
• 23:26
  Speaker 3: They're not pushing something or pulling something, right, all I'm doing is walking and doing.
• 23:30
  Speaker 3: I'm just doing my job, which is picking supplies, stocking supplies, you know, putting away supplies, but it's not dealing the actual physical labor, laborious task and taking that away.
• 23:42
  Speaker 3: That's one of my favorites, just because any way we can reduce staff strain, I think is a really good piece.
• 23:48
  Speaker 3: But you got to think about automation in that aspect.
• 23:50
  Speaker 3: So robotics is a big piece there.
• 23:52
  Speaker 3: Robotics is a big piece there, I think.
• 23:54
  Speaker 3: Another thing, as we kind of think about, artificial intelligence is a popular buzzword in the last year, I would say, which is predictive analytics, right, and so using AI, using these predictive analytics features to really gauge what can be expected in the next day, next two days Right, we had, this was our census today.
• 24:14
  Speaker 3: Right, this is the amount we had in the emergency day next two days right, we had, this was our census today.
• 24:17
  Speaker 3: Right, this is the amount we had in the emergency room today.
• 24:18
  Speaker 3: What can we expect tomorrow?
• 24:20
  Speaker 3: And using that to order, using that to fill supply rooms, using that to maybe even call in staff ahead of time some of those or PRN staff ahead of time, and saying, hey, we know we're going to have a little bit more tomorrow.
• 24:37
  Speaker 3: And being more proactive than reactive.
• 24:39
  Speaker 3: I think that's a lot of problems that some facilities get into is, as I'm getting into, more of a staffing thing of like oh man, we did not expect the census to be up like this today.
• 24:48
  Speaker 3: Right, we got to figure out a way to reactively do this.
• 24:53
  Speaker 3: So what if, a day, two days ahead of time, you said you know what?
• 24:56
  Speaker 3: According to particular analytics, thursday is going to be crazy.
• 24:59
  Speaker 3: So because Thursday is going to be crazy, let's go ahead and make sure that we have the extra supply chain staff on hand that we have working part-time.
• 25:07
  Speaker 3: Let's make sure we have a couple more nurses working in the OR, because we know we're going to have more.
• 25:12
  Speaker 3: There's more likelihood for there to be additional add-ons on Thursday, right, stuff like that.
• 25:16
  Speaker 3: We know that the emergency room was crazy today and, according to some of the things that were put in, we know there's going to be potential for more inpatient OR cases that are going to come in tomorrow, so let's make sure we have that ready to go, and so I think predictive analytics is a big one.
• 25:40
  Speaker 3: And then, of course, just using robotics, using automation and new and improved robotics.
• 25:42
  Speaker 3: You mentioned some of the infrastructure that's already in place.
• 25:43
  Speaker 3: I do think that is a misconception, that you can't just put automation in an old building.
• 25:46
  Speaker 3: You can't.
• 25:47
  Speaker 3: So now automation is updated to the point where you can use these autonomous mobile robots in an older infrastructure.
• 25:53
  Speaker 3: Now that may require a little bit extra finagling there, but you can absolutely incorporate that in there with the desire to.
• 26:01
  Speaker 3: But the name of the game is all of this costs money, that's true.
• 26:06
  Speaker 3: There's a financial component to it, so understanding the return on the investment of whatever you invest in it is important.
• 26:13
  Speaker 2: We've covered a lot of ground here today, Albert.
• 26:15
  Speaker 2: The one thing I wanted to ask before we go this is the last question.
• 26:20
  Speaker 2: A couple weeks ago, I introduced you to a guy named Reggie Gardner, a master's degree student at University of Tennessee, probably the next wave of supply chain specialists, the next wave of supply chain specialists.
• 26:36
  Speaker 2: What do you think, based on your interaction with Reggie, should we be hopeful about the new crop of young folks that are coming into the business.
• 26:46
  Speaker 3: Absolutely, Absolutely, I think.
• 26:47
  Speaker 3: So I have.
• 26:48
  Speaker 3: So Reggie, first of all, Reggie's a bright guy, very bright guy.
• 26:53
  Speaker 3: We got a chance to talk a little bit.
• 26:54
  Speaker 3: He's a bright guy, very bright guy we got a chance to talk a little bit Definitely a passionate and definitely has a passion to keep going Right, he's very ambitious and that's fantastic.
• 27:05
  Speaker 3: I think, when it comes and I also have, you know, a couple of people on my team that are also fresh out of college, fairly fairly new youngsters as well as well I think it's interesting when it comes to supply chain, that I would say that I'm the last of one generation in the beginning of another, right, so I would argue that I'm the last of the generation of people that get thrown in the supply chain my first job in supply chain.
• 27:28
  Speaker 3: You know it's not like I came in in college with a supply chain degree and was like I'm going to be a supply chain director, right.
• 27:34
  Speaker 3: I kind of was like hey, there's an opportunity for you working in supply chain Right out of college.
• 27:39
  Speaker 3: I worked in manufacturing.
• 27:41
  Speaker 3: Like oh the supply chain thing is actually pretty cool.
• 27:43
  Speaker 3: And then I was able to transfer over into healthcare using this knowledge right.
• 27:47
  Speaker 3: But I didn't grow up necessarily wanting to be this supply chain savant, right.
• 27:52
  Speaker 3: But at the same time, when I was in school, was the beginning of these supply chain degrees, right, and so that's why I say I'm the beginning of that aspect.
• 28:02
  Speaker 3: So nowadays, people like Reggie, people like Caroline and Abby that work on my team here, they kind of come in right, and Caroline and Abby are both industrial engineers they come in with this thought of supply chain, this thought of ways we can make distribution a little bit better.
• 28:21
  Speaker 3: I'm going to bring Jim up, back up again, because it's funny.
• 28:23
  Speaker 3: He always talks about how the degree he got at Penn State is now considered a supply chain management degree.
• 28:28
  Speaker 3: When he was there it was something else, a completely different title, and so I think that the biggest difference between the new crop is that the new crop comes in with that as a thought, from the time that they're 17, of like I want to do supply chain, I want to do optimize operations and supply chain, right, you and I both talked before as far as we, you know, just kind of got thrown into the wind as far as like, hey, this is an opportunity for you, and then see if you like it.
• 28:51
  Speaker 3: And we ended up liking it to where, I think this new crop?
• 28:54
  Speaker 3: Because they already know ahead of time what they're going to school for, they're understanding it from the very beginning, and so they can use that knowledge to create new innovative ideas, new bright ideas, ways to push forward.
• 29:09
  Speaker 3: And they're very excuse me and they're very ambitious.
• 29:12
  Speaker 3: I think that's another good thing, I think, as our role as leaders is to steer that ambition in the right way.
• 29:20
  Speaker 3: Right, and make sure that ambition is geared towards not necessarily a selfish ambition, but a selfless ambition.
• 29:26
  Speaker 3: Right, where you are kind of thinking about not only the people that you're working with, the people you're working for, but and through that I mean I'm a big believer in if you do right by everyone you'll be taken care of.
• 29:37
  Speaker 3: Right, if you make sure that you're the team that you're working on is well, your co-workers are are performing well and you're helping them out, that you're the projects that you're working on, your end users, like I mentioned, I'll fight on behalf of the hospital against the architect if I need to.
• 29:50
  Speaker 3: I'm making sure that the site that I'm working with is optimal and good.
• 29:54
  Speaker 3: I'm a believer that you handle all of that.
• 29:56
  Speaker 3: You don't have to worry about yourself, and so, I think, steering that in the same way for the new generation that is so ambitious and does want to be successful in their own right, but making sure that their desire to be successful is funneled in a way that everything around them is just as successful.
• 30:11
  Speaker 3: They're ambitious in other aspects as well.
• 30:12
  Speaker 3: Everything around them is just as successful as they want to be just as successful.
• 30:14
  Speaker 2: They're ambitious in other aspects as well Everything around them is just as successful as they want to be.
• 30:17
  Speaker 2: Well, albert, I steered Reggie in your direction because I thought you would be a good mentor for him, and nothing in the answer you just gave leads me to believe that I was wrong about that.
• 30:28
  Speaker 2: I appreciate it.
• 30:29
  Speaker 2: I think people like you that are willing to help give some guidance to the new folks coming in are so important to what we do.
• 30:40
  Speaker 2: And, albert, as always, it's a pleasure talking to you, it's a pleasure having you on the podcast, and we're going to have to do it again sometime.
• 30:49
  Speaker 3: Oh, absolutely, absolutely.
• 30:51
  Speaker 3: Listen for you, fred.
• 30:53
  Speaker 3: I block off everybody else.
• 30:54
  Speaker 3: I say you know what?
• 30:55
  Speaker 3: I can't do it.
• 30:56
  Speaker 3: I'm sorry, I'm booked with my man, fred kranz, over here, so I make sure of it.
• 31:02
  Speaker 2: Okay, albert, how much do I owe you for that one?
• 31:03
  Speaker 2: Put it on my tab, okay, guys.
• 31:10
  Speaker 2: Well, thank you.
• 31:10
  Speaker 2: Uh, thanks, albert, have a Thank you.
• 31:12
  Speaker 2: Thanks, albert, have a good one.
• 31:16
  Speaker 1: Well, that's all for today.
• 31:17
  Speaker 1: Thanks again for joining and, as always, don't forget to subscribe and connect with us online, where you can find all of our episodes.
• 31:24
  Speaker 1: If you have a topic you would like to discuss or want to be a guest on the show, you can reach out to Fred directly at fcrT-O-N-G-E dot com.
• 31:35
  Speaker 1: See you next time.