Supply chain executives, distributors and manufacturers in Texas and Florida recently shared their hurricane stories with Share Moving Media, publisher of Repertoire and the Journal of Healthcare Contracting. Below are several of those stories. To view others, and to hear accounts of the storms from Izzy Pascau of Concordance Healthcare Solutions and Ed Lewis of Texas Childrens Hospital, go to the Repertoire blog at http://www.repertoiremag.com/storm-stories.html.
High alert
A conversation with Michael Boyd, EMS account manager, Concordance Healthcare Solutions.
Repertoire: What preparations did you and your customers make in the days immediately preceding Harvey’s landfall on Aug. 25?
Michael Boyd: Preparations on our side included sending numerous quotes to customers for needed supplies, specifically to the shelters and EMS departments. Supplies included over-the-counter medications, clothes, blankets and drinks (Pedialite, Ensure, etc.). Another delay was getting orders packaged and shipped via overnight by coordinating with FedEx, and other private delivery methods.
Repertoire: What were you doing at the height of the storm?
Boyd: Finding the most needed items and getting them to the end user as fast as possible. Once we depleted our stock at the closest warehouse, we pulled from another. We staggered the orders to have multiple small deliveries, based on need, spread out over the coast of Texas, specifically, San Antonio, Beaumont, etc. We had an emergency conference between our order department in Florida, warehouse manager in Louisiana, myself in Texas, and the vice president of our department, Rich Hawkins in St. Louis, to see how could best tackle the supply chain issues.
Repertoire: Describe how the storm affected your company and your customers, and its immediate aftermath.
Boyd: The storm struck the most crucial areas, which caused delays. The I-10 had multiple shut-downs from Beaumont through Houston, which caused issues when moving supplies from Baton Rouge to Texas. Our warehouse in Baton Rouge was on high alert from the storm. Our whole team worked late and came in early to help process orders in every part of our company. Our Florida office worked overtime completing orders; our warehouse employees picked and packaged orders, hours after they were to head home during the event. I coordinated with the shelters and EMS departments.
Repertoire: What were your greatest challenges (and those of your customers) in the 7-10 days following the storm?
Boyd: The greatest challenge my customers faced after the storm was finding long-term care for evacuees; the San Antonio shelters accepted over 2,000 people from Houston through the Port Aransas areas. This included keeping supplies, employees, and evacuees moving in a forward direction.
Repertoire: Lessons learned, either for other suppliers or providers, should they face a natural catastrophe such as Harvey?
Boyd: Increase your most common-used items during the volatile months to counter the possibility of hurricanes and other unforeseen events. That is a balancing act that requires constant movement due to the shelf life of each product. (The average expiration date accepted for most items is 24 months.) I am very proud of my entire division and I know how hard we all worked to band together in this time of need.
Duck boat
A conversation with Andy Leaders, vice president, provider services, Owens & Minor
Repertoire: What preparations did you take in the days leading up to Irma’s landfall on Sept. 10?
Andy Leaders: Preparation for Hurricane Irma started Monday, Sept. 4, with first landfall in the Florida Keys Sunday, Sept. 10. Preparations were truly a team effort in conjunction with our provider partners. Our focus the beginning of that week was to work with our provider partners in getting incremental supplies picked, packed, and shipped prior to landfall. For the most part, this included providing 48-72 hours of daily use supplies to prepare for the possibility of travel delays due to wind speeds and road closures due to Irma.
In addition, the entire O&M team put a lot of work in preparing themselves and their families for Irma. This was critical to ensure the safety of our teammates, but also so that we would be in a position to service our providers once we were able to resume work post-landfall.
The team put in a tremendous amount of work to expedite products into the state of Florida prior to the storm all the way up till Saturday, Sept. 5. Starting Wednesday evening and going through the weekend, we were still focusing on getting supplies to our provider partners, but work started to shift to our preparedness in the response of Irma. This included working with our manufacturer partners to divert shipments into our Atlanta facility. This allowed us to get replenishment product into our three distribution centers more quickly.
We also compiled pallets of water for teammate and provider use, along with extra batteries and other essentials. And, we facilitated the leasing of an all-purpose military delivery vehicle and an amphibious “duck boat.” We planned ahead to secure help for our DCs, which included lodging arrangements and additional tractor-trailers for the anticipated increase in delivery needs post Irma. At the end of the week, a lot of work was put in by both O&M and providers to cope with the relocation of patients within the state. We obtained a number of last-minute supplies that we needed for critically ill patients who were transferred into larger healthcare entities better equipped to handle these patients during Irma. This led to several unplanned deliveries on Saturday, Sept. 9.
My hat goes off to all O&M teammates and our supply chain teams of our providers for making these accommodations in the face of the imminent landfall of the hurricane. The O&M operations, IT and home office support teams did all they could to help us and supported us throughout the storm.
Repertoire: How did you/your provider customers fare during the storm itself?
Leaders: In total, the majority of our customers fared very well. Hospitals were forced to use backup power, some experienced flooding, and all of them experienced long work days by clinicians and supply chain teams across the state of Florida.
Repertoire: What were your greatest challenges (and those of your customers) in the 7-10 days following the storm?
Leaders: Inventory recovery was our major challenge. This was partly due to the path of the storm, which put a moratorium on inbound shipping into the state for quite a few days. We were fortunate that – through pre-planning and diverting inbound freight – we were able to mitigate many of these issues for our provider partners.
Repertoire: Longer-term problems or challenges?
Leaders: Even after the storm, we continued to see power outages in isolated areas, and a few of our teammates suffered major structural damage during the storm. I feel that we are all fortunate that there was much more time to plan and prepare for this storm. Improvement in meteorology forecasting is helping to save lives.
Repertoire: Finally, any lessons learned to share with your colleagues?
Leaders: Having a plan prior to a storm like Irma puts all parties in a better situation. Open and honest communication leads to improved outcomes. Last, but not least, remain flexible, as even the best laid plans do not capture all scenarios.
T-minus
A conversation with Scott Nelson, senior vice president of supply chain, North America, Cardinal Health. (Penske Logistics provides trucks and drivers for Cardinal Health’s medical segment.)
Repertoire: What preparations did you take in the days leading up to landfall?
Scott Nelson: For these types of situations, we use a “T-minus” planning schedule, which begins roughly a week prior to landfall. The purpose behind that is to integrate efforts that span a number of areas, including operations, inventory, transportation, facilities, employees, customers and communications.
One of the first steps we took was to prepare and fill emergency orders in advance, so customers were stocked-up prior to the storm in the event there were disruptions. Penske has been Cardinal Health’s partner operating our private transportation fleet for the last nine years, so we worked closely with [Penske Operations Manager] Mike [Wallin] to identify drivers who had deep knowledge of the road systems and personal relationships with our hospital customers, to ensure we had the best expertise available to execute on alternative routing plans, so customers’ needs would be met.
At the Distribution Center, we also stocked-up on key supplies (food, water, generator fuel) to accommodate employees who might get stranded.
Lastly, we identified and made arrangements for a support team from other Cardinal Health locations to travel to the impacted location and stay at a hotel near the Distribution Center, so we could maintain operations and process emergency orders as quickly as possible. We did the same with key local operations staff.
Repertoire: How did you/your provider customers fare during the storm itself?
Nelson: Given the circumstances and severity of the storm, we feel everyone fared surprisingly well. Our major JIT customers enacted their hurricane preparedness plans and pre-ordered prior to the storm hitting. This helped tremendously, as it lessened the pressure for the first two to three days following the storm.
There were obvious challenges with flooding, which cut off access to certain areas for an extended time and caused some facility issues, and a few hospitals had to evacuate patients and shut down. Overall I’d say providers reacted quickly, and we were able to shift supplies as needed.
We did coordinate efforts with the National Guard and Penske to deliver emergency supplies during this time of need. A few of Mike’s drivers courageously volunteered to navigate the flooding to get the hospitals their supplies.
Repertoire: What were your greatest challenges (and those of your customers) in the 7-10 days following the storm?
Nelson: The greatest challenge was scaling back up to full operations as the recovery took hold. I mentioned the support we brought in from other Cardinal Health Distribution Centers to ensure continuity while our employees were tending to their families and homes. We also had moved a significant amount of our order fulfillment for non-metro accounts to neighboring distribution centers, so we had to gradually transition back to a normal staffing and fulfillment model.
We experienced delays in inventory replenishment orders, particularly with port closures, and getting deliveries into the Distribution Center. Many carriers were not operational and would not deliver or accept freight coming to the affected area.
I would say our customers experienced much of the same, as their employees had to balance dealing with personal challenges as well as logistical and freight delivery delays while supporting a ramp-up in patients being treated in their hospitals.
Repertoire: How about longer-term problems or challenges?
Nelson: One of the more significant challenges will be around staffing. Many people lost everything and were displaced from the area. As the city begins its reconstruction, labor required for clean-up and restoration work will place further demands on an already constrained labor market.
Repertoire: Finally, any lessons learned to share with supply chain colleagues?
Nelson: Plan early and involve your customers and key business partners in that process. Look beyond what could come up as an immediate need during the situation itself and plan for multiple contingencies. Without the joint planning I described earlier between Cardinal, Penske and the providers we serve, this story would have had a very different ending.
Communicate realistic expectations with your customers. We were committed to being fully operational as quickly as possible; however we set a clear foundation that it would not be “business as usual” and there would be challenges with inbound freight and outbound volume surges from the backlog. That candor and opportunity to jointly prioritize actions to achieve stabilization built a stronger relationship with our partners.
Lastly, take care of your employees first, and they will make sure that the customer is taken care of. The Penske drivers were rock stars throughout this ordeal. They were so willing to put their personal challenges aside and safety in question so our customers would get what they need.
Team effort
A conversation with Enrique Sanabria, regional sales manager for lab distribution at Cardinal Health.
Repertoire: What preparations did you take in the days leading up to landfall of Hurricane Harvey on Aug. 25?
Enrique Sanabria: At the start of hurricane season, we always increase stocking levels of critical supplies, like PPE items. Then we:
- Set a plan for ensuring employees were accounted for during the storm.
- Worked on emergency orders, so customers were prepared prior to the storm in case of inability to service. We stocked up supplies (food, water, etc.) at the DC for emergency if employees were stranded there.
- Tested our onsite generator and topped off the tank.
- Arranged for an out-of-town support team to stay at a hotel near the DC, along with an operations manager, so we could process as quickly as possible. Although a small group, we were functioning and processing emergency orders right away.
- Began making daily calls with key customers three days before estimated landfall. We discussed and encouraged them to order extra supplies to prepare for the possibility of interrupted deliveries.
- Conducted twice-daily conference calls with Cardinal Health corporate and local teams to include our DC Houston and DC Grand Prairie director of operations, customer service, inventory teams, global security and Penske Logistics to ensure all needs internally and with our customers were met before, during and after the storm.
Repertoire: How did you/your provider customers fare during the storm itself?
Sanabria: Both Cardinal Health and our customers were successful during the storm. Despite obvious challenges – such as flooding and a few hospitals having to move patients and shut down – we reacted quickly and we were able to shift supplies as needed.
To mitigate any crisis, during our internal, twice daily calls, we discussed our daily delivery schedule and uploaded emergency orders as needed to ensure stock was delivered to the facilities with the most need at that time. For example, we made deliveries to at least five of the 12 hospitals in one major health system every single day throughout the duration of the storm. As the waters began to recede, we increased the number of deliveries each day until we returned to business as usual.
Repertoire: What were your greatest challenges (and those of your customers) in the 7-10 days following the storm?
Sanabria: Many of our customers were affected personally at home and at work by this tragedy. They understood many of the challenges we were facing because they were facing the same challenges.
The greatest challenge for us and our customers was with logistics, inventory of products, returning to “normal” schedules and tempering expectations post-storm.
Scaling back up to full operations at the Houston DC, which services the Houston metro area and southeast Texas, was a challenge. This was where the brunt of the storm hit. Many of our carriers were not operational and would not deliver or accept freight coming to the Houston area. In fact, many carriers stopped delivering two days before Harvey made landfall, and did not begin delivering again until almost 10-12 days after the storm.
We brought in 40 people from out of town to support the DC while our employees were getting back into operations. Our teams did everything they could to mitigate programs and ensure success.
Repertoire: Longer-term problems or challenges?
Sanabria: Many people lost everything and were displaced from the area. Now, there are many reconstruction job openings in the market, so although we are a permanent job with benefits, the availability of the clean-up and restoration work may compete with our ability to secure local job applicants.
Repertoire: Finally, any lessons learned to share with your colleagues?
Sanabria: Yes:
- Take care of your employees first, and they will ensure the customer is taken care of.
- Plan early and be prepared: focus on the needs beyond what could come up as an immediate need during the situation itself and plan for multiple contingencies.
- Communicate realistic expectations with your customers. For example, at the Houston Medical DC, we were committed to being up as quickly as possible, but we set a clear foundation that we would not be able to open our doors for business as usual from day one. I think that built a stronger relationship with our partners. Communication and planning are critical before, during, and after the storm. Our teams were constantly on the phone working to ensure each hospital had the supplies needed to treat their patients.
- Ensure you are preparing for these types of events during the “off” season to be as prepared as possible when it does happen. For example, ask key customers to compile a list of the most critical items to have available during a crisis like this, so we can add additional stock at the beginning of each hurricane season moving forward.
Enrique Sanabria wanted to make clear the story isn’t his alone, but that of an entire team, including: Donnie Jackson, territory account manager for lab distribution, Cardinal Health, Houston and Southeast Texas; Kimberly Barrett, director of operations, Cardinal Health, Houston Medical Distribution Center; Michelle Fort, core account manager, Cardinal Health, Houston; Freddie Bloomfield, strategic account executive, Cardinal Health, Houston; Janet Russell, field service consultant, Cardinal Health; Kelly Thrash, field service senior specialist, Cardinal Health; and many more folks.