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Engineering the Future-Ready Healthcare Infrastructure · Taking The Supply Chain Pulse

• 0:03
  Speaker 1: Welcome to today's episode of Taking the Supply Chain Pulse.
• 0:06
  Speaker 1: Our guest, Tom Redding, is the Executive Vice President and Healthcare Practice Lead at St Ange Company.
• 0:12
  Speaker 1: With a reputation for blending operational insight with architectural collaboration, Tom brings a unique perspective to the challenges and innovations driving healthcare infrastructure today.
• 0:22
  Speaker 1: Let's get into it.
• 0:23
  Speaker 1: Here's your host, Fred Krantz.
• 0:28
  Speaker 2: Tom, welcome back.
• 0:29
  Speaker 2: Thanks, Fred, always a pleasure to see you.
• 0:32
  Speaker 2: Congratulations, tom.
• 0:33
  Speaker 2: Has been leading the healthcare practice since January of this year, so did you get a corner office, a bigger window or anything like that?
• 0:42
  Speaker 3: Nothing changed, Fred.
• 0:43
  Speaker 3: Ah you think you know, it's all good stuff.
• 0:49
  Speaker 2: Well, tom, I know that in leading our practice, you know pretty much virtually everything that's going on every place we're working, all the types of projects we're doing, and one of the things that you know has been sort of eating away at me over the last few weeks is, with all this disruption and uncertainty in the environment out there in healthcare, I think there's a strong case to be made for people to take stock of where they are and, you know, create a plan for the future.
• 1:20
  Speaker 2: So I wanted to talk to you today about reasons why people would want to take a pause and look at things and get a little more into that whole concept.
• 1:32
  Speaker 2: So why would someone want to take a pause and sort of benchmark where they are today?
• 1:38
  Speaker 3: That's a good question, fred.
• 1:39
  Speaker 3: I mean I think in general every health system should take a pause at some point along their journey because there's again a lot of changes that are happening.
• 1:49
  Speaker 3: You know whether they're acquiring facilities.
• 1:52
  Speaker 3: You know there might be, you know, selling facilities.
• 1:56
  Speaker 3: It could be new leaders coming into certain roles from the outside.
• 2:01
  Speaker 3: It could be again, there could be additional services they're offering.
• 2:06
  Speaker 3: And all those different things that health systems are doing require someone to take a moment in time to say are we still on the right path?
• 2:14
  Speaker 3: We've, you know, added more facilities, we've done all these different things.
• 2:19
  Speaker 3: You know when is a chance to do that and you know, I think, as somebody, especially if somebody's a new leader coming into an organization, I would say you have about two years to kind of make that turn.
• 2:28
  Speaker 3: You know, maybe the last leader retired or maybe they were forced to leave, or there could be many reasons in between.
• 2:35
  Speaker 3: But again, it's their chance to kind of again create their legacy at that organization.
• 2:41
  Speaker 3: And I think it's important to again create that plan and kind of assess where you are today and identify where you need to go in the future and what you have to invest in.
• 2:49
  Speaker 3: That could be people, process technology could be infrastructure could be a lot of things.
• 2:54
  Speaker 2: Yeah, you know.
• 2:55
  Speaker 2: If you walked into these places to do plans or do assessments, have you ever asked to see if they already had one?
• 3:05
  Speaker 3: We do.
• 3:05
  Speaker 3: I mean, more times than not, they had something that was made to say was done for them on the cheap or it was free or whatever you want to say, and you know they maybe just didn't see the value in it.
• 3:15
  Speaker 3: I think that's kind of step one.
• 3:17
  Speaker 3: I think there's times where you know somebody had these ideas or they, you know, did a small kind of six-sign project, you know within their organization, and they identified some things but they just didn't really think about.
• 3:29
  Speaker 3: You know the context of you know what they're doing today and how the business is changing and how do these recommendations align to the future?
• 3:36
  Speaker 3: So yeah, I mean certainly everyone's.
• 3:38
  Speaker 3: You know people have different versions, some have nothing and again, I think it's that's again not a bad thing.
• 3:44
  Speaker 3: Sometimes you're walking in with a, with a I hate to say, a blank sheet of paper.
• 3:48
  Speaker 3: You can kind of help, kind of navigate and help define what the future looks like for them.
• 3:54
  Speaker 2: Yep.
• 3:54
  Speaker 2: So how do I know what areas to include when I when I say I'd like to have a an assessment of my operations done?
• 4:06
  Speaker 3: I think there's, maybe, there's, maybe.
• 4:07
  Speaker 3: The first step is you know, there's always a you know, are you you know it's always about saving money.
• 4:13
  Speaker 3: So contracting and sourcing is always one that comes, you know, comes to mind.
• 4:15
  Speaker 3: I think, from our perspective, again, we spend most of our time in the operations improvement world.
• 4:20
  Speaker 3: So again, I think it's a matter of you know.
• 4:23
  Speaker 3: Do you have, is it very clear on you know, what are the expectations for that department?
• 4:29
  Speaker 3: Are you very clear on you know, the performance of your current department?
• 4:32
  Speaker 3: And if the answer is, I have no idea the performance of my department and it's not you know, how much inventory do I have on my shelves?
• 4:39
  Speaker 3: You know some of the basic financial measures it's getting into the from a service standpoint of delivery times and frequencies and to be able to meet those service expectations.
• 4:49
  Speaker 3: So I think for us it's thinking about the logistics, the overall movement of materials through a health system, sometimes internal to a facility and external between facilities.
• 4:58
  Speaker 3: It's also thinking about how do you leverage your distributor and your maybe some offsite warehouses you have or internal storages you have to facilities, thinking about how is inventory set up and how is it managed across the enterprise.
• 5:11
  Speaker 3: I think there's also a component around just organizational structure.
• 5:16
  Speaker 3: So I would just say do you have the right positions to support your future, do you have the right people in those positions, do you have the right measures associated with those individual positions?
• 5:26
  Speaker 3: You know again what's expected to.
• 5:28
  Speaker 3: Again, if we're not meeting expectations is because of, you know, volume increases and you don't have enough staff to support it.
• 5:37
  Speaker 3: There's kind of many different aspects of it, but I would say those are three minutes.
• 5:40
  Speaker 3: It's logistics, it's, you know, the distribution aspect of it and just kind of the overall inventory management structure.
• 5:48
  Speaker 2: And then they um, from a staffing standpoint, you have the right people in the right roles yeah, and I would say that, um, you know, over the time that I've been in supply chain, which is way before it was called supply chain um, things have evolved from a situation where purchasing literally did run everything.
• 6:07
  Speaker 2: It was called purchasing.
• 6:08
  Speaker 2: Um, distribution may have been there, may have been a department called distribution, but it was actually purchasing, was the guy that was in charge.
• 6:16
  Speaker 2: Then along came the term materials management and then ultimately supply chain.
• 6:21
  Speaker 2: So you know, it's like a three-step approach to get to what is a supply chain.
• 6:25
  Speaker 2: But it was very simple.
• 6:27
  Speaker 2: We just basically had to order stuff, receive it, unload the truck and push it to where it needed to go.
• 6:33
  Speaker 2: And now, as things evolve, with decentralized facilities all over the place here in Northeast Ohio I checked the Cleveland Clinic has over 100 caregiving sites.
• 6:47
  Speaker 2: So that requires a knowledge of transportation and logistics that wasn't even vaguely required when I started out.
• 6:56
  Speaker 2: And how do people know what to do unless they take a look at that?
• 7:02
  Speaker 2: The same thing is true with you know uh inventory strategies.
• 7:06
  Speaker 2: We had very simplistic inventory strategies and and now with uh service to different places that do different things, each these places has individually different inventories of stuff that only they use perhaps so you're having people with the skill sets is probably would be refreshing to me.
• 7:25
  Speaker 2: I would not allow myself to be hired to run a supply chain unless I had demanded before I started that we would commission an assessment of where we are, because I wouldn't want to find out what I didn't know the hard way.
• 7:41
  Speaker 2: You know what I mean.
• 7:43
  Speaker 3: Yeah, yeah, if you're somebody new and you're coming in, you might have a lot of experience.
• 7:46
  Speaker 3: You know you might look at some health systems where the senior leader is really strong in you know contracting, sourcing, if you want to call it that and you have others that are more on the operations side and you know some are somewhere in the middle where they have some kind of a blend of experience.
• 8:02
  Speaker 3: So I think if somebody is coming in to a new facility or new you know health system, it's like, again, I would say, get two years to to to make your mark.
• 8:10
  Speaker 3: I think after that you always you'll find yourself.
• 8:14
  Speaker 3: You know folks might question what you're doing.
• 8:16
  Speaker 3: Or you know, have you moved enough?
• 8:18
  Speaker 3: Have you moved the needle?
• 8:19
  Speaker 3: You know you might've shared some you know experiences from you know shared some.
• 8:22
  Speaker 3: You know experiences from you know from the past and what you can do to help move the needle on the health system.
• 8:26
  Speaker 3: And I think if you don't have you're grounded on what you're doing today, what you're doing well and not doing well, I think you're probably off to the wrong.
• 8:33
  Speaker 3: You're off to the wrong direction potentially.
• 8:37
  Speaker 2: Yeah, and things are constantly changing too.
• 8:39
  Speaker 2: So basically, I mean, I think the areas that I saw in a slide somewhere that you know are areas that probably should have individual strategies are like inventory, distribution, transportation, your systems and technology facility infrastructure.
• 8:57
  Speaker 2: I mean, to me I close my eyes and think of all the hospitals in my geography and many of them are old and many of them need to have repairs made, and I have to think about that Automation strategy.
• 9:16
  Speaker 2: Do you have one?
• 9:17
  Speaker 2: Do you need one?
• 9:17
  Speaker 2: Labor?
• 9:18
  Speaker 2: Labor is a huge problem.
• 9:21
  Speaker 2: I mean, if you're looking at the warehouse and distribution, I guarantee you that here in Cleveland, with I think there's two Amazon distribution centers here in town those guys pay better, even though they work you to death.
• 9:36
  Speaker 2: They pay probably much better than many of the healthcare organizations.
• 9:40
  Speaker 2: So now I've got to compete with them if I'm a supply chain leader.
• 9:44
  Speaker 2: Performance management Do we have tools?
• 9:48
  Speaker 2: Do we have KPI that we measure?
• 9:49
  Speaker 2: And I think one thing you said two things.
• 9:57
  Speaker 2: Number one is the skills and knowledge of my people.
• 9:59
  Speaker 2: That I would think an outside person would be able to be more objective in assessing the skills and knowledge of the folks there.
• 10:13
  Speaker 2: Is that fair?
• 10:15
  Speaker 3: Yeah, I think so.
• 10:16
  Speaker 3: I mean, I think it depends on you know what you're trying to, what your end game is.
• 10:21
  Speaker 3: I mean, I think if you're trying to get and do you have the right positions, you have the right people we get.
• 10:27
  Speaker 3: Sometimes somebody is you know they're, they're really strong in certain areas of position, but the other part they're not, and sometimes we find even maybe breaking the position into two separate job functions might be, might be applicable, you know, depending on the situation.
• 10:41
  Speaker 3: I think the thing that always comes up more times than not is the culture of the organization and their ability to you know, assess risk and know you know where you really need to drive and do you have the again, the right talent to be able to get to that point?
• 10:58
  Speaker 3: I think that's, I think it's real, I think that as more and more of these systems are put in place and technologies, I think that's a whole other level of capability that health systems have to think about.
• 11:09
  Speaker 3: And, again, knowing where you are and what you need to do and where those gaps are is incredibly important.
• 11:14
  Speaker 3: You can't just keep plugging away and hoping something will change.
• 11:18
  Speaker 3: It won't.
• 11:20
  Speaker 2: So, when you go in, what are the questions that you usually ask, or that should be?
• 11:25
  Speaker 3: asked.
• 11:26
  Speaker 3: Yeah, I think the first question for us is you know, again, how are you measuring the performance of your department?
• 11:34
  Speaker 3: Again, that's maybe function by defunction, like how are you, how are you measuring performance?
• 11:38
  Speaker 3: If the answer is you know, I don't really know, or you know, I we're measuring.
• 11:44
  Speaker 3: You know this financial metric and this is kind of because the CFO wants to see it.
• 11:48
  Speaker 3: I think that's kind of the step one.
• 11:50
  Speaker 3: I think you know, as, as we look at multiple facilities, again, our big thing is understanding consistency of.
• 11:57
  Speaker 3: Again, if I was today was my first day and I worked in facility A versus facility B, would I have similar workflows between the facilities, regardless if it's a hundred bed or a 400 bed?
• 12:08
  Speaker 3: I understand there's complexities between the different sizes, but I think that's kind of another aspect of it is you know, are there consistencies, are there nuances, are there all these kind of manual workarounds that happen on a daily basis?
• 12:23
  Speaker 3: Because, again, there might be a lot of times we're finding, especially from an operation standpoint, is that the item master might be I hate to say, for lack of a better word garbage.
• 12:33
  Speaker 3: Nobody's managing it.
• 12:34
  Speaker 3: That requires somebody.
• 12:36
  Speaker 3: You know they're constantly like having errors and issues and that's causing a bunch of workarounds and folks are trying to circumvent the system.
• 12:43
  Speaker 3: So there's.
• 12:43
  Speaker 3: The big thing fundamentally is how consistent are you?
• 12:47
  Speaker 3: What is your performance today?
• 12:49
  Speaker 3: Do you even know your performance today?
• 12:51
  Speaker 3: The third one is do you even know what's expected of you as one, as a leader and as department managers?
• 12:57
  Speaker 3: Do you even know what's expected of you?
• 12:58
  Speaker 3: Because, again, if you don't know what's expected, how are you ever going to be successful in any of these things if you don't know what's expected?
• 13:05
  Speaker 3: So I think those are kind of the three main.
• 13:07
  Speaker 3: There's probably hundreds and hundreds of questions, but I think to get a quick assessment of whether somebody has any idea which direction they're going or whether how consistent they are or whether they can manage expectations internally, but then also within within the overall organization.
• 13:23
  Speaker 3: I think it's important because one of the things we find the leaders that can communicate well and can get in front and speak to the executive team and communicate what the challenges are, getting the additional support they need to.
• 13:36
  Speaker 3: Either you know if it's inventory or if it's systems, or if it's the people aspect of it, or you know there could be multiple things that are tied to it.
• 13:49
  Speaker 3: But communicating what's happening and building consensus on the need.
• 13:53
  Speaker 3: I think if we stay in this transactional mode where you're just kind of whack-a-mole from thing to thing every single day and it's just going to keep your head down, you're never going to advance the ball, you're never going to get ahead and, quite frankly, you'll probably just get frustrated and leave.
• 14:07
  Speaker 3: So I think that big thing is having a leader that can think about what's next and have the and communicate and build consensus, you know, with the organization.
• 14:16
  Speaker 3: It's about building trust.
• 14:17
  Speaker 3: At the end of the day, it's incredibly important.
• 14:28
  Speaker 2: And if you've got several disparate, formerly stand-alone community hospitals that have been acquired and forming a larger IDN, you probably have a myriad of operational practices for every function in it there that has to be sorted out and standardized.
• 14:42
  Speaker 2: First they need to be identified and then it takes time, after you've identified them, to start to standardize the operation.
• 14:51
  Speaker 2: I mean I look at sterile processing as my favorite I go.
• 14:55
  Speaker 2: If you've got 15 hospitals, each working three shifts, you have 45 different ways of doing things at uh those 15 hospitals and sterile processing, because each shift usually does things uh its own way to at least a little bit, you know so absolutely yeah, yeah, no.
• 15:13
  Speaker 3: You look at pharmacy, look at sterile processing, look at any of those support services.
• 15:17
  Speaker 3: Yeah, there's a lot of these things just kind of knit it together and you know, and it's again I think it's a matter of taking a step back and getting where do you invest in technology or if you're investing in the human capital aspect of it.
• 15:28
  Speaker 3: I will say a lot of the assessments we find is that you know the departments that we're looking at.
• 15:35
  Speaker 3: So it might be, again, supply chain or sterile processing, or pharmacy.
• 15:38
  Speaker 3: We might look at lab, we might look at what I would call typical non-clinical support services and again, they're all undersized.
• 15:46
  Speaker 3: They all have their challenges.
• 15:47
  Speaker 3: There's a number of a series of advancements that have been made across those departments and they might not have incorporated them.
• 15:54
  Speaker 3: So I think it's a matter of looking at them and helping them identify where they need to make investments, and I would say investments is not purely in space or in equipment.
• 16:05
  Speaker 3: Again, it comes back to the people aspect of it.
• 16:07
  Speaker 3: I can't say that enough, because we have all these conversations about AI.
• 16:11
  Speaker 3: What does that mean?
• 16:12
  Speaker 3: And at the end of the day, I mean it will help augment and move things along, but we still have people.
• 16:17
  Speaker 3: We still have a people business.
• 16:20
  Speaker 3: We're delivering care to people.
• 16:22
  Speaker 3: So again, I think we have to be mindful of who's the who's the customer and do we have a customer service oriented approach to the work we're doing?
• 16:32
  Speaker 1: Before we dive back in, you may be asking yourself is my supply chain future ready?
• 16:36
  Speaker 1: At St Onge Company, we don't just optimize logistics.
• 16:39
  Speaker 1: We engineer smarter, leaner and more resilient systems from end to end, from manufacturing to retail to healthcare.
• 16:46
  Speaker 1: Our experts bring decades of experience in cutting-edge strategies to transform your operations.
• 16:51
  Speaker 1: Visit and discover how we're shaping the future of supply chain, one solution at a time.
• 16:58
  Speaker 2: You know, when you say do we have the right people?
• 17:00
  Speaker 2: Do we have the right positions identified too?
• 17:03
  Speaker 2: I mean, with the supply chain becoming more sophisticated, we need positions filled that we didn't have to fill before, things like demand planning.
• 17:16
  Speaker 2: We never really had formal demand planning.
• 17:19
  Speaker 2: We always reacted to whatever was going on out there and we counted on our distributor to save the day for us.
• 17:27
  Speaker 2: Or if you're in a place like Canton, ohio, where I was with Timken Mercy and Altman both there if we didn't have something at Timken Mercy, we'd call Altman or Broward for them and pay them back later.
• 17:38
  Speaker 2: I mean, those type of naive and immature approaches can't work anymore.
• 17:45
  Speaker 2: You have to have people with skill sets, you have to have people understand, and this is the other thing that you know.
• 17:53
  Speaker 2: I know we'll get to later.
• 17:54
  Speaker 2: If I'm that supply chain leader coming in and I know all these things, I'm going to count on whoever does my assessment to tell me what I need, because I have to take what you guys do to the senior leadership and say here's where we are, here's where we have a gap, here's where we're short.
• 18:11
  Speaker 2: This is what we need.
• 18:12
  Speaker 2: To replace it, I need resources, I need to be able to make a case to move that forward.
• 18:18
  Speaker 2: Is that fair to say?
• 18:20
  Speaker 3: It is.
• 18:20
  Speaker 3: I think that the thing that comes up a decent amount of times is that when we're doing these assessments, everybody says you know saving money.
• 18:28
  Speaker 3: I think there's a saving money aspect of it, but there's also the service aspect.
• 18:34
  Speaker 3: Are you delivering service?
• 18:36
  Speaker 3: Are you able to do things efficiently with the resources you have?
• 18:39
  Speaker 3: And sometimes we might find out that they have to invest in again.
• 18:43
  Speaker 3: I keep going back to it, but it's like they have to invest in new equipment because the equipment doesn't have the right throughput.
• 18:48
  Speaker 3: You know like it's sterile processing.
• 18:50
  Speaker 3: Older equipment has less throughput and it's like some of those things are hamstringing them and it's like, yeah, you have to spend money to to refresh your equipment or whatever it is.
• 19:00
  Speaker 3: And sometimes you're like, well, wait a minute, I thought I was just going to save money.
• 19:04
  Speaker 3: I didn't want to spend any money.
• 19:05
  Speaker 3: So I think sometimes you have to spend money to save money and that's not always easy to share with a CFO or some of the senior leaders, but that's the fact.
• 19:14
  Speaker 2: Sometimes these departments are underinvested for decades Yep are under, under invested for decades yep.
• 19:24
  Speaker 2: I mean some of the uh, some of the things that that you're looking at is how will the continued migration to a decentralized model impact the delivery of uh support services?
• 19:29
  Speaker 2: I'm I'm sure that many folks have never had to deal with that because they were standalone community hospitals that may have had three or four clinics out there and that's it, and now they're part of a big mega IDN.
• 19:42
  Speaker 2: Yeah, exactly.
• 19:44
  Speaker 2: And the other thing is what about home care and telehealth, things like that?
• 19:50
  Speaker 3: Well, that's going to change the game Again.
• 19:52
  Speaker 3: I said this at a conference last year and everybody laughed at me.
• 19:55
  Speaker 3: But I just said the delivery of care in the next 10 years is going to be focused around logistics.
• 20:01
  Speaker 3: And today, if you're, if you're a patient, you come in, you wait in a waiting room or whatever it is in the future, as, depending on the, you know how far things go to the home, you know the provider or the nurse or whoever is going to be the one waiting.
• 20:17
  Speaker 3: So, like you, don't you have to think about efficiency Again, the cost and the availability of all those technicians and others getting harder and harder, or whoever is going to be the one waiting.
• 20:19
  Speaker 3: So, like you, don't you have to think about efficiency Again, the cost and the availability of all those technicians and others is getting harder and harder.
• 20:24
  Speaker 3: And if you're going to again force some of that to go to the home and that's going to cause, it's going to cause a lot more challenges.
• 20:31
  Speaker 3: And if your logistics infrastructure is not, you know humming along, you know the delivery of materials.
• 20:36
  Speaker 3: I would just say, like you, think about the delivery of DME or pharmaceuticals to supplies, to wearables, to whatever.
• 20:45
  Speaker 3: Like you can go on and on and on and that coordination is going to be incredibly important to make sure that it's not.
• 20:51
  Speaker 3: You know, generally speaking, is a separate group of companies.
• 20:55
  Speaker 3: Pharma is separate, the medical-surgical is separate.
• 21:06
  Speaker 3: All those things are all these little silos, and they've kind of optimized what they're doing.
• 21:10
  Speaker 3: There's some kind of overlap, but generally speaking there's a lot of silos there and it's like trying to create a service-oriented business when you have a siloed supplier network is problematic.
• 21:21
  Speaker 3: And again, I think the more collaboration that happens between the health systems and their you know suppliers and vendors is going to be paramount.
• 21:31
  Speaker 2: Yeah, I think you just sort of hit on something that's probably one of the big characteristics of health care in this country, and that is that up until recently, every community hospital had every department managing its own operations.
• 21:47
  Speaker 2: So there was a food service supply chain, there was an environmental services supply chain, there was a pharmacy supply chain.
• 21:54
  Speaker 2: Everyone was different.
• 21:55
  Speaker 2: Every department director had his or her own kingdom to try to manage services supply chain.
• 21:56
  Speaker 2: There was a pharmacy supply chain.
• 21:56
  Speaker 2: Everyone was different.
• 21:57
  Speaker 2: Every department director had his or her own kingdom to try to manage.
• 22:00
  Speaker 2: And, uh, if it all worked together, that was just by uh dumb luck rather than by uh by design so uh and we?
• 22:08
  Speaker 2: we can't afford.
• 22:08
  Speaker 2: We can't afford to do that anymore.
• 22:10
  Speaker 2: It's just you can't yeah you can't, and and I think that you know the idea of creating a burning platform to bring forward to the C-suite the real thing that so many places are in the throes of right now.
• 22:25
  Speaker 2: And I had read this morning that a system in Pennsylvania that has 2,600 employees, that's been around for a long time and was well-respected, it's closing its doors and Orlando Health sold another one of its hospitals, and so you know the reason I feel so strongly about doing an assessment and all this stuff is because if you wait until the house is mostly burned down to call for help, you ain't going to be able to put it out.
• 22:59
  Speaker 2: But if you, if you plan well so it doesn't catch fire, then you're going to be able to make it.
• 23:04
  Speaker 2: You know and what?
• 23:06
  Speaker 3: exactly so.
• 23:06
  Speaker 3: This is the thing that is always fascinating because, again, we do a lot of, you know, facility planning projects, designing new hospitals or you know ambulatory surgery centers, whatever, and every one of the health systems we're working with they have a facilities strategic facilities master plan.
• 23:24
  Speaker 3: They're looking at the next 10 years, the next 20 years, whatever it is, and do they have the right infrastructure to support the organization's growth and their plans, or its decentralization or centralization?
• 23:35
  Speaker 3: Organization's growth and their plans, or its decentralization or centralization, whatever it is?
• 23:38
  Speaker 3: There's an intentionality to it that I don't think the operations team really thinks that way.
• 23:43
  Speaker 3: It's kind of like well, the facilities is like, well, we're going to build, it's going to take us years to do it and it takes maybe billions of dollars.
• 23:49
  Speaker 3: But I think the operations teams need to think the same way.
• 23:53
  Speaker 3: They have to think about you know, what am I doing and where is it changing and what's the next five years and 10 years look like.
• 23:59
  Speaker 3: And again, you have to align all these things.
• 24:03
  Speaker 3: If the facilities team is looking at it and the operations team is just like, has no idea, again you're shooting yourself in the foot, you know.
• 24:11
  Speaker 3: I mean you have to.
• 24:12
  Speaker 3: The ones that I've found that are more progressive, the ones that do their master plan, their operations master plan, and they're feeding that information to the facilities team to make sure that all of their needs are met, you know, based on their specific department.
• 24:28
  Speaker 3: And those are the ones that are that are, quite frankly, the ones at the table having the conversations and helping drive the boat.
• 24:34
  Speaker 3: They're not sitting in the back, you know, with the fishing rod watching the, you know, the seagulls.
• 24:39
  Speaker 3: I mean, I think it's a matter of making sure that they have the seat at the table.
• 24:44
  Speaker 2: Yeah, and you know a lot of a lot of places they live.
• 24:48
  Speaker 2: They live in the past.
• 24:49
  Speaker 2: I mean, I, I I came from Corning, new York, and Corning Glass was the big industry there, right, and in the post-World War II manufacturing era people started when they got out of high school and they worked for 30 years and they retired.
• 25:04
  Speaker 2: You know, john Deere, the same way in Iowa and at 48, they had a nice retirement boom and they thought things were always going to be the same, they were never going to change.
• 25:14
  Speaker 2: My parents worked in a plant that made vacuum tubes for television sets.
• 25:19
  Speaker 2: Guess what Transistors came along no more factory and transistors ultimately got replaced by what?
• 25:26
  Speaker 2: Circuit boards and stuff.
• 25:27
  Speaker 2: Those things went out and people were not ready for the change.
• 25:31
  Speaker 2: And the proactive organizations are smart enough not to trust the present.
• 25:39
  Speaker 2: And that's the message that I'm trying to get out for us in this podcast is you've got to keep your eyes open.
• 25:50
  Speaker 2: You really have to keep your eyes open, you know.
• 25:55
  Speaker 3: Well, I think you have to have, I think you have the mindset of wanting to stay relevant.
• 25:58
  Speaker 3: You know, I understand there's, you know there's the basics.
• 26:01
  Speaker 3: I got to do a job, I have to, you know, get pay, I have to feed my family, do all those things.
• 26:07
  Speaker 3: But at some point you have to say, like some folks have that drive and want to be able to, like you know, leave a legacy or make a major impact or, you know, whatever it is, in a positive way, Others kind of just along for the ride.
• 26:20
  Speaker 3: And I think it's just a matter of making sure you have the right leader and the folks that are thinking about these things and challenging the organization to again stay on the forefront.
• 26:28
  Speaker 2: Yeah, and there's something else that we haven't mentioned and I always use the example of surgical linens and that is wraps and sterile processing.
• 26:40
  Speaker 2: You know disposable versus reusable.
• 26:42
  Speaker 2: I never had a situation where a vendor was not willing to do a free assessment for me, and if it was the reusable linen vendor, they had documentation that proved that the reusable product was more cost-effective than the disposable.
• 27:00
  Speaker 2: And if it was the disposable vendor, they always had documentation that the disposable product was better and more cost-effective than the reusable.
• 27:10
  Speaker 2: So talk just for a second about the importance of hiring someone that is objective and has nothing in the game except to do a good job.
• 27:22
  Speaker 3: Yeah, I mean you explained it well.
• 27:23
  Speaker 3: I mean, I think you know, I think too often folks get enamored with with the word free, but again, nothing is free and there's always a downside to it.
• 27:50
  Speaker 3: So I think for us, I mean, I think as we we work with health systems around the country, I think it's trying to educate them on getting an opinion, sure that, as an operations manager, somebody's your voice and somebody's there being there to support you and make sure that you're getting those things you need.
• 28:04
  Speaker 3: And, quite frankly, I think it's also making sure it's like you always say, it's jeopardy purchasing.
• 28:08
  Speaker 3: I think we want to make sure that folks are buying the right things.
• 28:11
  Speaker 3: I mean, we've had times where somebody said, hey, I need to buy a.
• 28:14
  Speaker 3: You know a 3D, you know MAMO and MAMO machine, you know CT, and we find out that it's a workflow issue.
• 28:20
  Speaker 3: It has nothing to do with the actual equipment capacity.
• 28:24
  Speaker 3: It's really about workflow and scheduling, which was really the driver.
• 28:26
  Speaker 3: And in some of those things you would have spent $3 million and the reality is like you really just need to, you know, fine tune your scheduling or some of your workflows to get more out of the existing infrastructure and again, it's real dollars that you're potentially wasting and not getting any additional value out of it.
• 28:42
  Speaker 3: So I think for us it's like you know what is in the best interest for you.
• 28:46
  Speaker 3: How do you make sure that you guys are doing what's right for your patients and, quite frankly, for the bottom line?
• 28:51
  Speaker 3: Again, health systems have very, very low margins.
• 28:54
  Speaker 3: Health systems have very, very low margins and again, the ability just to say, hey, I want to just try this or waste money on this, just because it's because we're being nice.
• 29:01
  Speaker 3: They don't have that luxury and VFRS is helping them through it.
• 29:05
  Speaker 2: The world is changing.
• 29:06
  Speaker 2: I mean, the movement away from the hospital and into the home requires different skill sets.
• 29:12
  Speaker 2: It requires different skill sets and I just wanted to be able to make it so that someone could avoid the results of the story I told you earlier, and that was about the guy who got hired to run a supply chain and the fellow that had been there before him had left in a hurry.
• 29:31
  Speaker 2: And the new guy comes in and he sees a little note on his desk that says look in your top right-hand drawer, I've left you three envelopes.
• 29:40
  Speaker 2: Whenever situations come up that you have a crisis, take a look at the envelopes.
• 29:46
  Speaker 2: They're numbered.
• 29:46
  Speaker 2: Open them in order when you need them.
• 29:49
  Speaker 2: And so the guy got in there and he was there for about a year and a crisis came and all of a sudden he was.
• 29:57
  Speaker 2: The crisis is always this I'm afraid I'm going to lose my job.
• 30:00
  Speaker 2: It's not the organizational crisis, it's always a personal one.
• 30:04
  Speaker 2: And so the guy goes to the drawer, pulls out the thing with number one on there, opens it up and it says blame your predecessor.
• 30:12
  Speaker 2: So the guy goes out, goes to the boss and says, hey, it's not my fault, tom Redding was here before me and he did this, this and this, and that's what the problem is.
• 30:20
  Speaker 2: And the boss goes oh, that sounds right.
• 30:22
  Speaker 2: He wasn't that good of a guy anyway, so that's why we got rid of him, you're probably right.
• 30:27
  Speaker 2: So he got himself another year.
• 30:29
  Speaker 2: Second crisis comes up, goes right to that desk, pulls out number two, opens it up and says reorganize.
• 30:35
  Speaker 2: And so he goes to the boss and says boss, you're right about this, I need to completely redo the way the organization looks.
• 30:42
  Speaker 2: Comes up with a reorganization that lasts for another year.
• 30:46
  Speaker 2: Finally, year three big crisis again.
• 30:49
  Speaker 2: He goes directly to the drawer, pulls out envelope number three, opens it up and it says prepare three envelopes.
• 30:56
  Speaker 2: Oh, my goodness.
• 30:59
  Speaker 3: It's true, Brian.
• 30:59
  Speaker 2: Yeah, it's true.
• 31:00
  Speaker 2: That's what a lot of those hospitals that were formerly 500-bed community hospitals and I'm thinking right here in my own geography that are now part of either university hospitals or the Cleveland Clinic system.
• 31:15
  Speaker 2: That's what happened to them.
• 31:16
  Speaker 2: They didn't plan, they didn't prepare, they weren't proactive in their thinking or progressive in their thinking, and so that's why I wanted to talk about the need for an assessment.
• 31:30
  Speaker 2: What did I leave out?
• 31:31
  Speaker 2: What would you add to what we've talked about that someone should sort of keep in their crock to think about?
• 31:40
  Speaker 3: Yeah, I mean, I think we covered a lot, fred, but I think the thing that if I was a leader in a healthcare organization I would again go back to is like when is my when is that door for me to bring it up?
• 31:51
  Speaker 3: When is it the door to kind of take a step back and think about it, whether it's the first crisis you mentioned, or is it the door to kind of take a step back and think about it, whether it's the first crisis you mentioned, or is it the second crisis you mentioned, or is it to get to a point where it's again?
• 31:59
  Speaker 3: I think you have that two year window when you start a new role, that there's a certain level of expectation there, and I think anybody that's that's in that new role to take a step back and say do I have a solid understanding of what's working, what's not working and ultimately, where is the organization going and what do I need to do to better support the organization that I'm working for?
• 32:24
  Speaker 3: I think that's incredibly important.
• 32:25
  Speaker 3: And, again, anybody we see a lot of changes, people going from health system to health system.
• 32:27
  Speaker 3: It should be the first thing that crosses your mind what to do and again you might say I've been around for many years, I'll figure it out myself.
• 32:34
  Speaker 3: And again, once you get into the role, there's again, there's the daytime job, and then there's how do you, how do you keep the lights on and ultimately, how do you define the future and help figure out what to do next?
• 32:45
  Speaker 3: I think sometimes it's a tall.
• 32:47
  Speaker 3: It's a tall order for somebody that's brand new to an organization.
• 32:49
  Speaker 3: So again, bringing somebody from the outside to again share their perspective, talk about best practices, you know, helping kind of define that future need and the future requirements for them is paramount.
• 33:02
  Speaker 2: Yep, and you know, you just said something that I remember.
• 33:05
  Speaker 2: When I was young, you know, I thought I knew a lot, but I also thought that I was supposed to know everything, and that's the biggest mistake that anyone can make.
• 33:18
  Speaker 2: I think the beauty of maturing is that you understand that you not only don't know everything, but you're not supposed to.
• 33:27
  Speaker 2: And real wisdom is when you get the wisdom enough to say, hey, I need to bring someone else in to give me a different perspective here.
• 33:35
  Speaker 2: Hey, I need to bring someone else in to give me a different perspective here.
• 33:39
  Speaker 2: And that's what this episode was all about from my perspective.
• 33:44
  Speaker 2: So, tom, thanks for sharing your experience with the assessments you've done.
• 33:47
  Speaker 2: Congratulations on your promotion.
• 33:50
  Speaker 3: Oh, thanks, Fred.
• 33:51
  Speaker 2: And, you know, look forward to seeing what we've got going on in the future.
• 33:55
  Speaker 2: Thanks a lot, buddy.
• 33:59
  Speaker 1: Well, that's all for today.
• 34:01
  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.
• 34:08
  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 F-C-R-A-N-S at S-T-O-N-G-E dot com.
• 34:19
  Speaker 1: See you next time.