After 18 months, COVID-19 continues to wreak havoc on hospitals and health systems and the individuals caring for patients. We reached out to four Vizient’s experts to get their insights about the challenges of the current COVID surge, what members need to know and resources that are available.
You’ll hear from Tomas Villanueva, DO, MBA, FACPE, SFHM, Vizient principal, clinical operations and quality. Dr. Villanueva is the host of Vizient’s Modern Practice Podcast, which shares ideas and approaches for the latest strategic trends and clinical challenges, including COVID. Dr. Villanueva also counsels Vizient members about employee vaccine hesitancy and has provided updates to Vizient employees since the pandemic began.
Vizient’s Dan Kistner, PharmD, group senior vice president, pharmacy solutions, has been on the forefront of helping shore up the hospital supply chain for essential medicines and address drug shortages overall. Early in the pandemic, Kistner was a vocal advocate to Food and Drug Administration (FDA) and the media about the challenges related to shortages of drugs needed for ventilator patients which raised awareness to move manufactures and FDA to take steps to help ensure that component of the supply chain.
You’ll hear from Margaret Steele, Vizient senior vice president, sourcing operations, who has led a 70-person team in working to address shortages of essential supplies that occurred during the beginning of the pandemic. Steele’s team efforts include vetting PPE suppliers, expanding current supplier offerings and sourcing through alternative suppliers and/or providing support for expanding manufacturing lines.
Vizient’ Julie Cerese, PhD, RN, MSN, group senior vice president, performance management and national networks, established the COVID-19 Vaccine Management webinar series (access via your Member Dashboard) where members share insights in a series of panel discussions on best practices and lessons learned in the management of COVID-19 vaccines. During 2020, some 1,500 members dialed into these webinars to collaborate and learn.
Here’s what they had to say when we asked them:
What is different about the current COVID-19 surge?
Dr. Villanueva—We now have a vaccine. Unfortunately, we don't have enough people in our country that have been vaccinated to prevent further variant forms. This has resulted in a more infectious virus compared to last year and it is affecting a larger proportion of those individuals that have not been vaccinated. The major concern is without expanding our vaccinations in our country and in the world, we can expect further variants that will elude our current vaccinations and continue this vicious cycle.
Kistner—While there are differences, I think the biggest challenge that has remained is the toll the pandemic continues to place on providers and the communities they serve. Health care systems and their employees are worn out fighting COVID and other disasters (e.g. hurricanes). We are doing everything we can to help members and limit the number of issues they must resolve. One area where we have had great success is with the availability of essential medications, particularly those used to care for critically ill patients. Through the Novaplus Enhanced Supply Program, the availability of critical care, injectable products like sedatives and pain medications has remained consistently improved. We also have partnered with pharmaceutical suppliers to house domestically an additional 95 million vials of essential drugs and our sourcing and clinical teams continue to provide clinical insights regarding all of the medications associated with COVID.
Steele—While much of the country is experiencing surges, members seem to be in a much better position regarding personal protective equipment, facial protection and respiratory supplies needed to treat COVID patients. Many have up to six months of critical supplies in a stockpile. Our contracted suppliers have readily available supplies to accommodate increased needs as several have increased manufacturing capacity. In addition, we have also vetted non-contracted supplies that can serve as a backup if needed. In addition, the Novaplus Enhanced Supply Program guarantees supply in some of the most needed categories such as N95 respirators, isolation gowns and exam gloves.
Cerese—The timing of the impact has been variable across the country.
What are the key things that members should know during this current COVID-19 surge?
Dr. Villanueva—Compared to last year, patients requiring hospitalization are younger and therefore, will require more resources. Compared to last year, health care professionals are exhausted mentally and physically. Staffing issues will continue to be a major burden. This pandemic has forced the current trajectory towards outpatient ambulatory care as a preference.
Kistner—We encourage members to reach out to us for help. Whether it is to a designated pharmacist representative, client executive/manager or simply sending an email to the general pharmacy mailbox, we are here to support members with information regarding essential medications, accessing the Novaplus Enhanced Supply Program inventory, or remaining up-to-date with the latest clinical and sourcing information concerning COVID treatments and therapeutics. We know the pandemic is by no means over. We are here to help members find solutions and manage the additional workload of COVID while also working to preserve as much routine care as possible.
Steele—Vizient is much more than a contracting partner. We work hard to ensure members get the right products at the right time. When an unavoidable supply disruption occurs in the market, our team is experienced in each category and know where to seek and attain alternative and clinically acceptable substitutions. Regardless of the event or cause, we are focused on greater visibility into the end-to-end supply chain to ensure we can seek alternatives as soon as possible, so as to minimize any disruption in the delivery of high-quality patient care by our members.
Cerese—Because of the increasing volumes of COVID cases, hospitals need to have criteria-based decision making for admission, including clinical condition and risk factors. Criteria ensure the appropriate use of valuable beds. In addition, develop and provide to individuals guidelines for self-care when they test positive for COVID.
Are there any Vizient information/resources that are available that would be especially helpful to members during this time?
Kistner—Our recently published Pharmacy Market Outlook (press release, members-only report) provides insights about how members should prepare clinically and financially into 2022 for continued pandemic mitigation and ongoing recovery. Whether it is COVID or other significant challenges, much of the response of health care providers is based upon legislative intervention. Therefore, we also encourage members to visit the legislative and regulatory priorities webpage. Finally, we know that people’s time for reading can be limited. As a result, Vizient’s virtual platform includes our VerifiedRx podcast, which continues to cover all manner of concise commentary on clinical pharmacy practice issues.
Steele—Vizient publishes a Budget Impact Projection report two times a year that provides unique insight into what’s ahead regarding raw material availability, inflation and other indicators like the cost/availability of freight. The Sourcing team also publishes a monthly Market Insights report. This report provides members with a line of sight to product allocations, recalls, markets to watch and market challenges such as freight delays and post closures. Our Disaster Response email mailbox remains active at all times for members to submit requests and questions, which allows us to quickly identify growing concerns.
Cerese—Members that participate in the Vizient Community online collaboration platform are connecting with colleagues each and every day to discuss the evolving efforts including vaccine mandates, staff shortage, retention strategies and alternative care delivery models. Member Networks can help quickly identify issues and problems, find answers faster and implement solutions more rapidly