by Neil Horton
MS, RN, Consulting Director, Clinical Advisory Solutions

We’ve all heard the saying, “walk a mile in someone else’s shoes” as a way of understanding another’s experiences, challenges, thought processes and perspectives. Seeing someone actually do it is a unique experience. Cathy Gray, director, clinical support supply chain at Sentara Healthcare, started her career with Sentara as a registered nurse and over the course of the next several years she served in different nursing roles in both inpatient and outpatient settings and on various clinical committees. It was while serving on those committees where she saw the gap between the clinical and supply chain worlds.

When an opportunity presented itself to move to the supply chain team, Gray jumped at the chance. She’s been “walking in someone else’s shoes” ever since. Recently, I asked her to share some of her insights and how her nursing skills had actually prepared her for the challenges ahead.

Q: What were some of your more formidable challenges?

A: One of the first challenges was overcoming misperceptions between supply chain and the nursing staff. Supply chain felt nursing was unaware of the costs associated with getting supplies and services in for patient care. Because of my experience, I knew this was untrue. I also knew that clinical personnel thought supply chain only focused on saving money, and that wasn’t true either. 

It was also challenging to discover what’s not written down into a formal process. So much knowledge resides in employees’ minds: history, processes, resources, stakeholders, to name a few. For example, one nursing department had been through a number of recent managerial changes. Because of those changes, staff members had solved problems and developed processes in a vacuum.

Another significant challenge is the health care system has experienced rapid growth in a relatively short period of time. With a footprint extending across two states, this multiplied the challenges of standardizing processes and centralizing decision-making.

I found the key to solving all of these challenges is developing good relationships. My success is less about my own authority and more about evidence, goodwill and trust.

Q: What skills from nursing did you find valuable in your new role on the supply chain team?

A: Nursing is very process-oriented and a lot of that rigor is directly applicable to supply chain. However, a shared-governance concept was unfamiliar and it wasn’t a great fit right away. While it’s still a work in progress, I’m hoping the inclusive philosophy we adopted to work hand-in-hand with nursing will improve job satisfaction, streamline processes and help develop and grow our staff.

Transparency is another nursing value that has the potential to improve the way we work in supply chain. When I hear our teams using value analysis language and concepts, I realize the approach is working.

Product variance is practice variance where doing a variety of steps to reach a positive outcome is the goal. Now we are looking to reduce that unjustified variation by streamlining the process towards utilizing one procedure that achieves the ideal goal quite nicely which is costs savings.

Q: Who was receptive to changing their processes to achieving cost savings?

A: Our chief nursing officer was very interested in how nursing could be effective in reducing the cost of care. Being at the corporate level where cost savings have a prominent place on the agenda, she wanted nursing to contribute to the solution. She was instrumental in including cost-savings initiatives in the strategic nursing goals. Also, she understood that if nursing didn’t address their own savings opportunities, someone else would. Taking ownership like this is part of Sentara’s Magnet philosophy: the nursing staff is empowered to find the best way to accomplish the organizational goals and achieve the desired outcomes.

Another valuable ally was our nursing vice president. She worked with supply chain to understand our processes and then helped identify opportunities that we then brought to the chief nursing officer and the nurse executive council for consideration.

Our vice president of supply chain was also extremely supportive. He gave me a wide berth and I was constantly probing to find out:

  • Who are the key stakeholders?
  • What are the steps in the process? 
  • What value was achieved by doing it this way?
  • Where was the waste?

Q: Any advice to those who may want follow in your footsteps from a clinical role to a role in the supply chain?

A: The approach I adopted involved networking, joining professional organizations, reaching out to other hospitals and really immersing myself in supply chain in every way that I could. This helped with relationships and growth in knowledge and it also helped me create a resource network. Much of what goes on in supply chain is complex and taking the time to understand those complexities is important. But, I’m extremely proud to be helping break down barriers, and promote communication and trust so that two very different departments can partner together for the benefit of the hospital and ultimately, the patient.

About the author. In his role as consulting director for clinical advisory solutions at Vizient, Neil Horton uses his extensive experience in value analysis, perioperative nursing, surgical services, account management, contract negotiation and functional assessment to help one of the company’s largest members redesign their value analysis process. His background in various clinical areas, combined with Lean Six Sigma certification and training in value analysis, project management, change management and team facilitation has provided him with a keen understanding of how to implement a robust, evidence-based, transparent process to drive growth and help achieve occupational objectives.

Published: February 18, 2019