Contracting Professional of the Year

Supply chain is Alisha Hutchens’ window into excellent patient care

Today it’s all about value: Supply chain executives expect value from their suppliers; and they expect their team to provide value to their internal customers (caregivers and other service providers) and most important, the patients they serve.

That search for value calls for a long view of procurement and product usage, comprising:

• A thorough vetting of new technologies.
• Assistance from key members of the clinical staff, such as nursing, when implementing a conversion.
• Monitoring and acting on product recalls in a systematic way.
• Expecting support, including data, from the vendor on product performance.

The best results occur when much of that analysis is done at the front end of product and equipment procurement. It’s what Alisha Hutchens calls a “front end approach to value analysis,” that is, one that considers the full scope of contracting, utilization and product performance and quality all within the scope of supply chain.

Hutchens, who was promoted in May 2016 to vice president of professional and support services at Novant Health, Winston-Salem, N.C., is this year’s Contracting Professional of the Year. The IDN’s supply chain is responsible for supporting 14 acute-care hospitals and 480 outpatient facilities.

Luck of the draw
Ever since she was a kid in Shoals, N.C. (“hardly a blip on the map”), Hutchens knew what she wanted to do. “I wanted to be a female leader in healthcare,” she says. “I consider myself one of those odd individuals who actually does what they went to school for.” She graduated with a business degree – with a concentration in healthcare management – from Appalachian State University in Boone, N.C.

What she didn’t know was that her future would involve supply chain.

“That was the luck of the draw,” she says. Seeking a local summer internship as part of her undergraduate work, she found one at Wake Forest Baptist Health. Working in the storeroom might not have been on her radar prior to the internship, but “it opened my eyes and broadened my horizons about what healthcare management really is,” she says. “I learned about inventory management, and I learned about the sheer volume of supplies needed to manage a hospital and for patients to get what they need. I also learned how you procure supplies, what you do in an emergency. And I learned that if you don’t have supplies – guess what – you have problems taking care of patients.”

After graduation, she got a job at Wake Forest Baptist as a financial coordinator for three nursing units. After a year and a half, she became assistant manager of central sterile supply, reporting to supply chain. From there, she transitioned into contract administration. She joined Novant Health in 2008 as a strategic sourcing manager.

A front-end look at new products
In 2010, Hutchens was named director of new product introduction. “At the time, we needed to develop a process to vet new products,” she recalls. Although the strategic sourcing department was successful negotiating contracts for innovative clinical products, the fact was, new widgets appeared (and still do) all the time. “Everybody wanted to try them. But we didn’t have a great filter to vet them. So, we found ourselves adding to contracts right and left, and cutting into the cost-savings we had achieved through our contracts.”

Hutchens hired an additional FTE – Cindy Talley – as manager of new product introduction. Together, they developed a process for vetting new technology. “We were saying, ‘Stop, why do we need this?’ Don’t we already have this product or something similar in the system?’

“It wasn’t that we didn’t want to bring in new technology, but it was a huge cost driver, and we lacked an appropriate process to vet a new product’s quality, clinical efficiency, performance expectations or potential revenue.”

In late 2014, after Hutchens was named senior director of supply chain administration, the team partnered with Novant Health’s chief medical officer and vice president of medical affairs, along with a key physician consult and surgical services administrator, to fine-tune the process. “Our program was getting quite cumbersome; the review period was too long,” she says. “Physicians often need new technology quickly, especially if needed for a particular patient population or case mix. You don’t want to bog down the process with a long and sometimes unnecessary review period.”

So they adopted an approach to get key physicians involved early in the selection process, “to make sure we looked at value upfront,” she says. The team developed an executive steering committee for new product introduction, many of whose members were senior physicians from surgical services, from whom many new-product requests originated. They also expanded the program, so it was not merely facility-based, but Novant Health-based. In May 2015, Novant Health received the President’s Award of Honor from VHA (now Vizient) for its work on clinical effectiveness and supply-chain sourcing and resource management, based on the program for new product introduction.

Training
Selecting clinically effective and cost-effective products is an important component of any contracting program. But it is only a first step. Ensuring that staff are trained on new products, and that those products perform as expected are Steps 2 and 3. The Novant Health team, under Hutchens’ direction, addressed both.

It’s not uncommon in many hospitals and IDNs to find a nurse or two employed by supply chain to help with product selection. “But we took it a step further,” says Hutchens. “We asked them to go out and be leaders in product conversion.” Nurses bring clinical knowledge and credibility to the supply chain team, she says. They can be true listeners and prioritize clinicians’ concerns about new technologies. “They can tell [supply chain], ‘We need to pump the brakes here, because we have a problem; this isn’t working as expected.’ Or they can come to our strategic sourcing teams and say, ‘This perceived conversion problem is being overstated; it’s not a real issue.

“Typically, when that happens, we find there is a problem, but it wasn’t necessarily with converting products. It’s more likely the packaging, or some other misunderstanding regarding the product’s intended use.”

After identifying the need for a more thorough and systematic approach to managing recalls, Hutchens and the supply chain team worked with general counsel, risk management and the chief medical officer to develop a systemwide recall policy that streamlined communication pathways and synchronized action throughout the system, using a series of checks and balances.

Work continues on the program under the direction of Senior Vice President Mark Welch. “They are pushing the envelope,” says Hutchens. Welch and his team are enlisting the help of clinicians to develop supplier scorecards that look beyond fill rates and backorders, at product performance, especially recalls.

Managing recalls
“Recalls have a huge ripple effect,” she says. “They can actually stop our patient-care processes, leaving us to figure out a new process or procedure to care for certain patient populations. They also require engaging [alternate suppliers].” For that reason, the Novant Health supply chain team now works with the vendor community to address potential recall-related issues prior to and during the contract period. The team wants to make sure a backup plan always exists, and that vendors support Novant Health during the recall process. “They need to be accountable for their product performance.”

“We need more transparency upfront,” she says. “We need information about product performance. Novant Health has set a high bar for analytics. We are pushing our vendors to meet us in the middle. I would hope that suppliers are coming to the table more prepared to provide that detailed analytical information, which includes product performance tracking/metrics.

“We are extremely proud to be providing our organization with this increased focus on a front-end approach to value analysis, which considers the full scope of contracting, utilization and product performance and quality, all within the scope of supply chain,” says Hutchens. “Mark Welch has an excellent team that continues to raise the bar in supply chain. They are truly an amazing team, and now that I am on the receiving end of the work they do every day, I am so honored and proud to have worked with such an innovative team. They continue to do amazing things.”

An ‘awesome’ field
Healthcare supply chain “is an awesome field, a broad field,” says Hutchens. “There are so many supply chain benefits of which industry – even the healthcare industry – is unaware. But it is truly a remarkable support department. It launched me into a career I never thought I’d be in. It has helped me identify with patient care.”

She would urge young people just starting a supply chain career to get out of their offices and get to know their customers, the patient care providers, whether they be nurses, doctors or guest services representatives. “You need to know them and provide service excellence. Learn what they need from you in order to provide a remarkable patient experience, and always think forward. Look for new, innovative strategies that can be applied to your work. The learning opportunities are endless.

“Supply chain has an important place at the table. I would not change my career path for anything. I am honored and pleased to say I was able to work in it.”