Vibra Healthcare uses its vast knowledge to ensure its supply chain supports a strong continuum of care throughout the system.
By Staci Davidson, Senior Editor at Knighthouse Publishing
Few people look forward to going to a hospital for a procedure or visiting a doctor for a checkup. Medical care is critical, but can be daunting to many patients. Vibra Healthcare understands this, and with its objective of “getting you back to better,” wants patients to feel comfortable in its care while they are at one of its facilities. The company aims to achieve this by creating a seamless continuum for patients and physicians, ensuring everyone gets the best care possible. The supply chain plays a critical role in this objective.
Based in Pennsylvania, Vibra Healthcare operates three types of facilities in 19 states: long-term acute care (LTAC) hospitals, rehabilitation hospitals and skilled nursing facilities. In total, the company has 65 locations, more than 2,900 licensed beds and more than 9,000 people working in its system across the country. Vibra continues to look for opportunities for growth in markets that need improved patient care and physician support, and it currently has 10 hospitals in various stages of development. The company also is combining its assets with those of Ernest Health Inc., adding to its service level. The supply chain is structured to ensure a strong continuum of care for its established facilities and those that come into the organization through growth.
“Our corporate office takes care of the contracts and the group purchasing organization (GPO) work, and our facilities work independently within the contract structures,” explains Ray Lanas, executive vice president of supply chain and construction. “We recently partnered with another company and they will be consolidated into our purchasing group. Eventually more of the existing group will be brought into the consolidation because we keep working toward that consolidation model. The new group puts us at higher purchasing volumes and gives us a more standardized item master for compliance, control and better standardized care.”
The Next Wave
Vibra Healthcare understands building the consolidated purchasing model is a huge undertaking, Lanas notes, but it is all part of continuously improving the level of care it provides, as well as managing costs. The Ernest partnership brought 25 inpatient rehab and LTAC hospitals to the Vibra organization, in markets such as Arizona, Colorado, Idaho, Indiana, Montana, New Mexico, Ohio, South Carolina, Texas, Utah and Wyoming. Consolidating its purchasing efforts will be key in Vibra’s ability to standardize buys throughout the system while also responding to market needs.
“Healthcare is not always cutting-edge with inventory, but by utilizing a new ordering platform will enable us to use smartphones and iPads to do inventory counting,” Lanas explains. “The camera helps with the inventory count, and standardization will be a huge benefit for us. Soon we will be able to walk into any of our hospitals in the country and do a standardized inventory count. We really see it as the next wave in how we do what we do. Just as texting made communication so much faster, now this new system allows us to collect more information and we can move inventory anywhere we want it to go.”
To manage inventory at all of its facilities, Vibra uses dynamic ordering systems, and although hard data is important, Lanas explains, there’s more to it than that in the healthcare world. “There is definitely a bit of magic involved,” he says. “In healthcare, you learn to understand there are seasonal occurrences that happen that no computer can predict – it’s just something you learn. For example, nine months after a hard winter, you get blizzard babies. The summertime is hot and people drink more sugary drinks, so urology cases go through the roof. In December, there’s not a lot of sun, so the need for neurology goes up. In the fall, the flu strikes, so we have to plan for more ventilators.
“It’s crucial that we plan ahead for all of this,” he continues. “No computer can tell you this is going to happen, it’s just what you learn by being in this business. You learn to understand human nature and that these things happen, so you set calendar alerts. Dynamic ordering systems flatten out the averages, but humans don’t work on average. We have to be flexible and really focused on what we are doing.”
In addition to acquisitions, Vibra’s system is growing with new construction, and that demonstrates another need for greater control of inventory and standardized purchasing. In early 2019, Vibra will start construction on a new medical rehabilitation hospital in Sacramento, Calif. The two-story facility will have 50 patient beds and will provide treatment for patients with a number of neurological injuries and diseases, such as Multiple Sclerosis, Parkinson’s, strokes, traumatic brain injuries and spinal cord injuries. The hospital will have the capabilities to provide care for those with amputations, arthritis and orthopedic needs such as hip fractures, joint replacements and osteoporosis. It will complement the services currently provided by Vibra’s nearby LTAC hospital in Folsom, Calif.
Flexibility is key for Vibra because the healthcare industry is always changing, and Vibra may be changing more than is standard because of its growth strategy. Even so, change is the standard in which Vibra operates, and its supply chain must ensure ongoing support. The company has an Innovation Collaborative, which is an interdisciplinary team of Vibra staff members and external experts who work together to solve issues in the organization, uncover new opportunities and test solutions.
The Vibra supply chain organization employs a similar strategy when physicians, caregivers and staff members need new products and devices to ensure a high level of care. It works closely with them to fully understand the clinical needs, ensuring it chooses the best products that provide efficient and high-quality care.
“With our centralized model, we have the ability to encourage product standardization,” Lanas says. “We work closely with our vendors to ensure products are equivalent across the board. For example, we had been using industry standard isolation gowns, but the patent is up on that material. So we worked with our distributor to find an alternate vendor source that is just as effective, and we ended up saving $200,000 a year. It’s important that we work with our vendors and GPO during our consolidation efforts throughout the standardization process. It helps us get everything we need and still maintain a level of service that our patients and clinicians expect and deserve.”
The entire Vibra organization puts patient experience and satisfaction first, and an important aspect of that is ensuring clinicians and staff have the products and tools they need to provide quality care. The comprehensive healthcare provider serves medically complex patients who require extended stays and additional medical attention, so its facilities are equipped with what they need to provide patients with services typical acute-care or general hospitals cannot offer. Vibra’s patients have an average length of stay of 25 days, and the organization continues to innovate and find new ways to deliver high-quality treatments.
The company is working with its GPO to scrub its data and find new opportunities for the supply chain, Lanas says, whether that means finding savings or evaluating new vendors. He notes, however, that the supply chain consolidation will help to streamline the organization’s requisition process.
“Healthcare is never static, and we are involving more people in the decision-making process to provide the best clinical outcomes,” Lanas explains. “We have been in discussion to beta site a new vein visualization system that helps nurses visualize the veins in patients. They are like eyeglasses and nurses can wear them to help ensure IVs are inserted properly. We team up with the clinical staff to get the best products that help them do their jobs more easily. With this system, patients don’t get stuck with a needle three or four times, and that provides are more pleasant experience. In healthcare, it’s very easy to think ‘would I want them doing that to a member of my family?’ It becomes very personal because we know our patients are important to someone’s family and they are important to us.”
With its dedication to working closely with clinicians and staff members to best understand their needs, Vibra’s supply chain operation has become “like the Wikipedia of the organization,” Lanas says, because his staff provides answers for a variety of different product lines and processes. At the same time, with all of this knowledge, Vibra’s supply chain staff is encouraged to keep thinking of new ways to improve the business.
“In supply chain, we have a culture of ‘no idea is a bad idea,’” he says. “Anything you do can be undone, so we encourage people to throw ideas on the wall and see what sticks. Whatever they discuss might redefine a product or a process in some way, so let’s see what works. This is an open-discussion culture and no one is afraid to speak up. This is apparent everywhere in the company and we really try to enforce it in our department. With creative thinking, sometimes we find the way we are doing it is the best way, but nuances can be changed.”
When working with clinicians, Vibra’s supply chain staff has a mantra of “collaborate, communicate and cooperate,” he adds. They worked with a number of product lines, for example, to develop branded kits for the nurses that incorporate the Six Sigma way of thinking. When nurses open the kit, the first thing they need to treat a patient is on top, and as they move through the care process, they move further into the kit to get the next tools. Lanas notes it was a new idea to Vibra’s manufacturer, but it has made the nurses’ care easier and faster.
“I’m very proud that we help enable people to get better,” Lanas says. “I’m extremely proud of my team and the confidence they inspire in others, as well as the trust that has developed because they are such a good resource of information. The collaborative environment is very strong here. We first work with the corporate clinical administrative team to try out something new, then we do clinical trials in a hospital, and then more doctors and nurses take the product and put it through its paces. We will get feedback almost instantly if it’s good or not, and that is critical in our purchasing.”