In search of PPE — and everything else a hospital needs

Health care providers up and down New Jersey undoubtedly cheered the news Sunday that the state had acquired 500 more ventilators — the piece of medical equipment that’s most desperately needed.

But the ventilator itself is just one part of the apparatus that helps patients who are severely compromised breathe.

“We hear about ventilators, but there are products that are required to support those ventilators,” Gerard Crosbie said. “There’s different types of breathing treatments and suction supplies. There’s a lot of those products that are downstream effects.

“There are products that are required to continually clean and maintain and manage single oral mouth care type products for patients on ventilators. Those are things that are much higher demand now than they were yesterday.”

Crosbie is the director of purchasing and materials management at CentraState Healthcare System in Freehold Township.

And don’t be confused. Having to find the support products for ventilators is a good problem to have — much better than searching for the ventilator, too. But that doesn’t make the challenge any easier.

Gerard Crosbie of CentraState Healthcare System.

Crosbie said the entire global supply chain is stressed and stretched. Getting any of the necessary products health systems need every day is an all-day challenge.

“A patient who’s on a ventilator obviously isn’t able to eat,” he said. “So, there are feeding pumps that feed the patients certain nutritional products through nasal gastric tubes or other devices. And, where an organization might have needed five or six of them normally at a community hospital, you might need 25 or 30 now. So, the availability of both those pumps, very much like a ventilator, and the products to support them are stressed.”

Crosbie has been at CentraState, a single-hospital entity, for just over a year. He previously worked at Hackensack Meridian Health, one of the state’s largest health systems. And even though the quantity of supplies they both need differs, Crosbie said the search for product is no different.

“I think, regardless of what organization you’re in right now, we’re all being tested,” he said. “The supply chain is broken in many respects because it’s just overly stressed. The dam has broken, so now we have a bad combination of demand shock and supply shock.

“There’s an increased demand to an extent that most would have never expected. As much as I prepared pandemic inventories in the past, we’ve never expected the volumes required today.”

This leads to the next problem. Finding product is one thing, verifying that it actually exists — and, more importantly, it meets the proper standards — is another.

“In the course of this conversation I’ll get a dozen messages from somebody who knows somebody who knows somebody,” he said. “You’ve got to vet that, because our focus here doesn’t change in the fact that we’re still trying to protect our clinicians and our patients.

“So, when somebody says they have something, I have to make sure it’s the right item, it meets certain FDA guidelines and the recommendations of the CDC so we’re offering people the right product at the right time and not something that can harm them further.”

Crosbie said he has six on his purchasing team, three of whom spend a large part of their day trying to follow up and verify leads.

Because of the strain on the system, Crosbie said they have to source more items from unfamiliar places. And, because of the extra strain on the system, they need to do more ordering.

“I would say we’re probably doing six months’ worth of ordering work each week,” he said.

And, while ventilators and personal protective equipment are the ultimate worry — and the ultimate prize — Crosbie said it’s not the only aim.

“Everybody talks about the personal protective equipment, but the things that go beyond that are somewhat obvious, but not always spoken about,” he said. “We still have other patients, and these patients need general care and services that go beyond the COVID event.

“So, maintaining our day-to-day needs exist in addition to this.”

For now — for today — Crosbie said CentraState is making it work. And he’s hopeful that some of the more restrictive social distancing measures will help. He knows it’s only the first step.

“We talk about bending the curve and that’s nice, but these patients won’t just disappear in two weeks if we’re blessed with the curve being bent,” he said. “I would say today we’re holding strong right now, and I think we’re blessed in that regard. But it’s a day-to-day check.”

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