Letter Re: Kanban: America’s Ubiquitous “Just in Time” Inventory System–A Fragile House of Cards

Having both worked in a hospital and worked for hospitals for the last 18 years I must loudly concur with “Mike the MD in Missouri”. As a service specialist in an un-named Level 1 trauma center I had access to almost every inch of the facility(s) including the warehouses where we stored our unused equipment and all the patient care products. Naturally I was able to assess the on hand stock versus the use and replenish rates at a glance. I was always amazed at how little there actually was for a hospital in a city of
150,000 people.
Let me assure everyone that Mike the MD is absolutely correct. This, is due largely to the hospitals spiraling cost of doing business. The paltry or sheer lack of adequate funding to healthcare facilities has caused management to resort to Just in Time (JIT) inventories. Lean stock management is a necessity for all but the largest big city hospitals and even those are lean.
The small rural hospitals are, by far, the leanest and also will be the hardest hit if there is a disruption in transportation. Anyone remember the phrase “the sacrifice of the few for the benefit of the many”? This mentality applies to rural hospitals. The big inner city hospitals will get resupplied (albeit perhaps scantly) first.
It is incumbent upon each and everyone of us to have the appropriate, on hand, quantities of prescription medicines, symptomatic medications (helpful for those manning a LP/OP), med supplies in the form of gauze pads, bandages, tapes and wound closures including the “medical grade super glue” style, cleaners, skin preps, splints, wraps, towels, antiseptics, soaps and shampoos (un/minimally scented), tooth past and brushes, gloves, sutures (if possible), ointments, tools (medical and dental) of all sorts. Don’t forget crutches, walkers, (if possible) a wheelchair, feminine hygiene
products, et cetera. Diabetic folks need to stock up heavily on syringes and needles. [JWR Adds: And they should absolutely stock as much insulin and test materials as possible without using them beyond their expiration dates. Be sure to label and conscientiously rotate these supplies on a first in, first out (FIFO) basis.]
Thanks to Mike the MD for broaching this topic and thanks also Jim for the platform to which the topic can be addressed. – Joe from Tennessee