Contracting Professional of the Year: With Trust Comes Success

For Teresa Dail, chief supply chain officer at Vanderbilt University Medical Center, building relationships is key to being an effective leader.

By Laura Thill

Teresa Dail is well aware that, without the support of her physicians, it can be next to impossible to mobilize supply chain protocols. To a large extent, she credits her clinical background for her ability to engage Vanderbilt’s physicians and clinicians in the IDN’s contracting and standardization strategies. Long before joining the ranks of contracting executives, she worked as an ICU registered nurse for 15 years, followed by positions as a nursing leader in intensive care, step-down and cardiac. It wasn’t until she joined a large private practice as a clinical practice administrator that she was exposed to vendor/physician relationships and the dynamics between private practice physicians and hospital administration.

“I started in supply chain in a clinical resource management role, and then became the corporate director of materials management at Orlando Health – a seven-hospital system at the time,” says Dail. “I believe strongly that it is my background that has allowed me to build relationships and be effective in my role as a supply chain leader. In fact, I was originally recruited into the clinical resource manager role to build and foster relationships that did not exist during the early 2000s between physicians/clinicians and materials management. Today, I believe – and try to instill in my team – that supply chain needs to be a strong partner with the operational and clinical leaders; that with these relationships come trust; and that, with trust, comes success.”

Her ability to leverage such relationships has enabled Dail to mobilize key protocols at Vanderbilt, such as its Supply Chain Services program, which has enabled the IDN to work with non-owned hospitals and systems; and her current agenda – to engage supply chain in the IDN’s patient care centers and their bundled initiatives.

A collaboration
Dail joined Vanderbilt in 2007 as administrative director of supply chain. Three years later, she was assigned to serve as interim administrative director for perioperative services, with oversight for daily clinical operations while the IDN recruited a permanent replacement to fill the position. “I was actually asked to do this because of the collaborative relationship I had been able to develop with the perioperative team during a major initiative between our two areas that I was the project manager for,” she explains.

“I had the privilege of being named the chief supply chain officer at Vanderbilt in June of 2012,” Dail continues. “We had several changes in leadership in the months leading up to that. While there were a number of opportunities that I could have pursued at the time, I had a vision of where I wanted to take the supply chain at Vanderbilt, so it made my decision to pursue the CSCO position a very easy one. Having spent the previous five years building a solid, fundamentally strong foundation, I wanted the opportunity to maximize our position as a health system, while beginning to explore externally how we could drive additional value for ourselves and others in the effort to better position all of us for the challenges we are facing.”

Today, she oversees all areas of operations related to Vanderbilt’s supply chain, including four hospitals, 151 employed physician clinics and some joint ventures. “This [requires] a strong self-contracting model; procurement; GPO oversight; capital acquisition and data base development; asset management; distribution and logistics for just-in-time delivery; an LUM model with over 400 ship to’s on- and off-site; materials system maintenance, which includes point-of-use technology in every clinical department; equipment management; post office; copy center; and clinical engineering,” she says. “I also have supply chain responsibility for a 50,000-square-foot off-site case cart operation center, which does all of the case picks for our adult hospital (including 76 operating rooms following expansion planned in 2014). I see the entire clinical enterprise as our customer, and have worked to instill the impact of the value of the work we do with our team members as it relates to direct patient care.

“It is a huge compliment that when someone needs to find a solution or to get something done, our phone rings,” Dail continues. In addition to the above responsibilities, she is the executive chair of the medical economic outcome committees, which is a paired leadership model with Vanderbilt’s physicians and clinicians charged with managing the introduction of new products and technology into the system.

Driving value
The past seven years have kept Dail busy. “There have been multiple projects that have touched every aspect of supply chain,” she says. “We are constantly evaluating our performance and how we can drive value for the organization through the use of technology, clinical engagement, internal and external benchmarking, and peer best practice modeling.” A recent project involved the launch of the Vanderbilt Supply Chain Services (VSCS) program, which enables the IDN to work with non-owned hospitals or systems. “We currently have 11 hospitals in the program, with a focused growth plan to add participants,” she explains. “Our goal is multi-faceted. We know that we can bring value to these entities through the self-contracting model that we have in place and our ability to drive compliance. By working on behalf of these organizations, it is our goal to help them improve their margins so that they can continue to provide services within their communities.

“With the changes occurring today in healthcare, we have to find a way to allow these small-to-medium-size community hospitals to keep their doors open,” Dail continues. “We hope the program we have put in place, which will require ongoing support by our industry partners, will help. We will also work to share best practice and innovative approaches to [facilitate the] management of complex supply chain issues. Our goal is to position the supply chain within any organization to be a strong, integrated member of the healthcare team in the effort to drive quality and reduce cost. And, if requested, [we will] offer our services and expertise to supplement or support a given process within an organization.”

The pace in the coming year shows no hint of slowing down. “We have a very robust new product and technology program that embraces physician and clinician leadership and engagement, which has been in place for six years,” says Dail. “While the committees have been very successful in supporting standardization, centralized contracting, cost reductions and new technology assessment/acquisition, we realize that we need to evolve beyond that. Internally, we are working closely with our senior leadership team to understand how the committees – and supply chain in general – can help support the Patient Care Centers as they become more engaged in episode-of-care (bundled) initiatives, focused growth and centers of excellence. “This collaboration, where everyone is evaluating cost, quality and outcomes to drive value, is critical for organizations going forward,” she says.

“While we work to take our committees to this next level, we would like to help those entities working with us under the Vanderbilt Supply Chain Services (VSCS) program to implement a version of the model that makes sense for them,” she says. “This can be done in a community-based setting or an academic environment, with or without employed physicians. Ultimately, as the VSCS evolves and matures, I would love to see a collaborative forum that allows physicians and clinicians, no matter at what institution they practice within our network, to be engaged in subcommittee work, helping to make contracting decisions on behalf of the participants that can be incorporated into best practice care models. This is not an insignificant endeavor, as it is going to require a completely different mindset by both the physicians and their respective hospital leadership teams.

“Evidence can and should drive decision making,” she continues. “I equate this to when I was asked to take my first nurse manager role in a step-down unit. I had a very prominent physician tell me that the unit couldn’t be fixed and that he would never admit his patients there. I asked him to give me six months and then [we could] talk again. Before that six months passed, he was admitting his patients to my unit. Things that are worth doing require a lot of work, but you shouldn’t shy away from trying, simply because some many believe it can’t be done.”

Vanderbilt University Medical Center, Nashville, Tenn.

• Four hospitals.
• 151 employed physician clinics, as well as miscellaneous joint ventures.
• 1065 beds.
• $500 million supply chain spend.