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SPECIAL FOCUS


processes and re-engage with clinicians following the clinical, financial and operational pain points of the pandemic response. HPN’s brief but pointed interviews explore how both recognized the need for and value of supply chain strategies and tactics as an integral component of effective and efficient patient care and a critical contributor to optimal outcomes.


KIMBERLY AMRAMI, M.D.


Vice Chair, Department of Radiology, and Medical iec ffice f l Chain Management and Healthcare Technology Management Mayo Clinic Rochester, MN


HPN: In context of the success with Supply Chain you have cultivated and enjoyed over the years, why do you feel it has been – and sometimes still is – so challenging and divisive for clinicians to become more directly involved in supply chain issues? What are some of the issues that clinicians may have with Supply Chain (the department) that makes them so resistant to Supply Chain advice and recommendations? AMRAMI: I think that supply chain management (SCM) issues have sometimes been seen as “administrative” functions not requiring clinical input – and sometimes SCM professionals have not understood the added value that clinicians can bring to SCM in healthcare. It is more about a lack of communication and mutual understanding of the benefits of the engagement of both groups than anything else. Sometimes physicians have the impression that SCM is there to get the lowest price without regard to quality or clinical preferences or to push back on physician preferences for brands or specific tools. gain, this is a lack of understanding of what drives both sides of this equation – which is procuring the best tools for the best outcomes at the best price. It’s important to recognize two things – that SCM in healthcare exists because physicians care for patients – and that physicians cannot care for patients without the support of SCM. You can’t turn the light on in your exam room unless you have the light bulbs someone bought, but you don’t need the exam room if you don’t have patients to care for.


One major friction point between Supply Chain and clinicians tends to be product brand preference. Why do you believe clinicians are so hesitant – if not


resistant – to change product brands if/ when necessary, particularly if patient outcomes and user safety are comparable or equivalent? Conflicting perceptions? Control and influence? Something else? Physicians are like other people – they are comfortable with what they know and may be particularly concerned with using tools they are trained to use. It takes time and effort to assess new tools, to get evidence or data about equivalence or improvement and then to train, especially when we are talking about physician preference items like catheters or surgical tools. lso, these assessments need to be made in the context of the practice you have and not the practice the vendor or others think you have or should have. We had an in-depth review of suture vendors that was broadly rolled out in our practice. Transplant surgeons had a very different need compared with neurosurgeons. It is not one size fits all, and all parties have to be prepared to put in the time and effort to really be sure that a change makes sense. In a fee-for-service model that can be a challenge. Our model of salaried physician compensation at Mayo makes it easier, but most of the time when physicians are included in these processes they participate. Cost alone cannot be a motivator – that really is a problem for physicians who are ultimately accountable for the care of their patient. If there is a failure with a new tool, it won’t be the contract manager who is sued. I think sometimes SCM professionals wanting physicians to make changes don’t appreciate that part of the equation.


Looking back, what do you feel has been your proudest moment in working with Supply Chain to date and why? My proudest moments in SCM are in two categories. One, of course, is the way that SCM really stepped up during the COVID crisis to make sure that as a practice we had all of the personal protective equipment (PPE) and other tools we needed to continue to care for patients safely during a worldwide pandemic. I am in awe of the incident command processes set up in response to COVID and how well it worked. I spent some time seeing the actual command center, which had an element of controlled chaos as the team looked at non- traditional sourcing options for PPE and other supplies, but that never was visible to providers who never had to individually worry about any of this. I also saw their ability to rapidly pivot away from what had been a just-in-time approach at some of our sites to a more resilient warehousing model. In the practice we really never felt the kind of shortages that other institutions may have had and we really have the diligence


and commitment of our SCM group to thank for that.


The other category of pride is less of a moment and more of an ongoing pride in how SCM at Mayo is integrated into the practice as a partner, directly in some of our high-spend departments and in general as a resource and support for all of the activities at Mayo. I am so proud to be part of an organization that is so committed to the Mayo value of the needs of the patient always coming first.


What is the most surprising thing you have learned when working with Supply Chain and why?


I had been involved in capital equipment selections but had not really worked directly with SCM before becoming their Medical Director. What really surprised me was the


AMRAMI IN REAL LIFE


What makes her lose track of time: Email! I get about 300 a day, and if I am not careful, I miss meetings trying to catch up. Since COVID hit I am getting to work a little earlier than usual to get a head start and that has been helping.


For what other people (within Supply Chain or outside) always thank her: For representing them to my clinical col- leagues – a large part of my role is to be a bridge between the clinical practice and SCM. When I can make that happen it makes me feel useful and I think it benefits my SCM colleagues. I am very fortunate to work with such fantastic people who always are appreciative.


What motivates her when she’s most productive: I want to say cupcakes, but really for me it is when I can sit down and really concentrate. Getting things done is a huge motivator. It’s very satisfying to have things fall off of your to do list.


Best compliment she ever received: The best compliment I have ever received was from my oldest granddaughter when she was three. She told me I was her favorite person in the world! She is 15 now, and I hope she still feels the same way.


What she loves to do for others: At this stage of my career what I really love is mentoring others and helping them with their career development. That is just so sat- isfying, seeing people grow and learn. And I have to admit, I really, really love getting better pricing and discounts on equipment and supplies when we are negotiating with vendors. I just wish I could apply that skill to all of my shopping experiences.


Page 12 hpnonline.com • HEALTHCARE PURCHASING NEWS • July 2021 11


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