ORIGINAL ARTICLE
Digitally enabled supply chain as a strategic asset for the COVID-19 response in Alberta
Healthcare Management Forum 2022, Vol. 35(2) 90–98 © 2022 The Canadian College of Health Leaders. All rights reserved.
Anne Snowdon, PhD1 ; and Alexandra Wright, MPA2
Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/08404704211057525 journals.sagepub.com/home/hmf
Abstract This provincial case study, one of seven conducted as part of a national research program on healthcare supply chain management during COVID-19, focuses on Alberta. With a history of emergency preparedness, Alberta’s unique context, one that includes having an already established, centralized, and digital healthcare supply chain strategy, sets this case apart from the others in terms of pandemic responses. A key challenge navigated by Alberta was the inadequacies of traditional sourcing and procurement approaches to meet surges in product demand, which was overcome by the implementation of unique procurement strategies. Opportunities for Alberta included the integration of supply chain teams into senior leadership structures, which enabled access to data to inform public health decision-making. This case demonstrated how Alberta’s healthcare supply chain assets—its supply chain infrastructure, data, and leadership expertise, especially—contributed to resilient supply chain capacity across the province.
Introduction and review of the literature The COVID-19 pandemic has shone a bright light on the critical importance of healthcare supply chain as a strategic asset that enables safe work environments for the health workforce and quality care delivery for Canadians. Supply chain and logistics infrastructure is a strategic asset in health systems that makes it possible to respond to unexpected events, such as surge in demand for care during a pandemic, to ensure that healthcare workers have the products and equipment necessary to deliver care during surge events to achieve the best possible outcomes for patients. Supply chain in health systems includes the sourcing and distribution of products that ensures healthcare teams have access to the right products at the right time, in order to deliver safe and effective patient care.1 In health systems, supply chain teams source a complex and diverse array of products and equipment, from ventilators and intravenous pumps, to medications, vaccines, and Personal Protective Equipment (PPE). Supply chain disruptions can occur due to natural disasters and public health crises, resulting in severe consequences that put health workers and patients at significant risk. For example, during Hurricane Maria in 2017, electrical grids were wiped out in Puerto Rico, which impacted the production of IV bags manufactured by Baxter.2 The resulting shortage in supply of IV bags skyrocketed globally, causing an increase in cost by 600%.2 Similarly, a flood in 2012 impacted Sanofi Pasteur, the supplier of the cancer drug ImmuCyst. The result was significant delays in cancer treatment to patients as manufacturers could not increase production of the drug rapidly enough to meet the demand.3 Public health crises, such as the SARS epidemic, also put pressure on health system supply chains, due to increase in demand for critical products to keep health workers and patients safe. These crises put the physical health of essential workers at risk—three of the 44 Canadians who died from SARS were healthcare workers,4 and emerging evidence identifies significant impact on the mental health of the workforce
when real or perceived supply shortages occur during these public health events. The inadequate supply of PPE and the uncertainty these supply shortages create among Canada’s healthcare workforce directly impacted their mental health during the COVID-19 pandemic.5 Healthcare supply chain management and infrastructure lag significantly behind the well-developed supply chains in other business sectors.6-8 Supply chain and logistics have been well researched and developed in the private sector; however, significant gaps in research still exist in the healthcare sector.9-12 One reason for the paucity of research in this sector is the fact that there are features that are unique to healthcare supply chain that do not apply across sectors. Healthcare supply chains involve many more stakeholder groups compared with other business sectors, including patients, clinicians, suppliers, healthcare organizations, group purchasing organizations, distributors, and insurers, making them highly complex systems.13,14 Both the range and complexity of products in healthcare supply chain are also unique when compared with other sectors. Unique features of the healthcare supply chain make it particularly complex,13 limiting the applicability of supply chain research from other sectors to healthcare.10 Of most significance perhaps is when the healthcare supply chain breaks down, the result is a direct impact on human life.15-17 The COVID-19 pandemic has highlighted the urgent need for healthcare supply chain specific research, to further understand the nuances evident in this sector. This paper reports on case study research of the province of Alberta’s response to the COVID-19 pandemic, revealing 1 2
University of Windsor, Windsor, Ontario, Canada. University of Toronto, Toronto, Ontario, Canada.
Corresponding author: Anne W. Snowdon, University of Windsor, Windsor, Ontario, Canada. E-mail: anne.snowdon@uwindsor.ca