Resuscitation Perspectives: 6 Questions With Materials Management

Code Blue events bring a new meaning to the concept of “a team effort.” When a code is called, a patient’s life is — quite literally — in the hands of the clinicians who respond. And to make matters more complex, code teams are often composed of clinicians from a variety of backgrounds and disciplines who may not routinely work together — except to collaborate on infrequent, unplanned, and high-stakes emergency events.

That’s the inspiration behind our Resuscitation Perspectives series, where we interview different members of Code Blue teams to better understand their role and impact in resuscitation response. And while our interviewees preferred to remain anonymous for privacy, we know their insights will resonate and inform readers across all Code Blue roles — from nurses and physicians to patients and families.

Resuscitation role spotlight: Materials management

On the subject of teamwork, the clinicians on the Code Blue team are often (rightfully) heralded as the heroes of in-hospital cardiac arrest. But it’s also true that the most effective resuscitation response starts well before a code is even called. It starts with the careful stocking of crash carts, a task that — at many hospitals — is often the shared responsibility of staff in Materials Management and Pharmacy.

That’s why we kicked off our interview series by speaking with an Assistant Vice President of Supply Chain Operations. Below, we talk about why “having the right things in the right place at the right time” takes on a new meaning in emergency response, the importance of educating supply chain staff on Code Blues, and where resuscitation response is headed in the future.

Current role

What is your current role, and how are you involved with resuscitation/emergency response?

I’m the Assistant Vice President of Supply Chain Operations for a large health system. I also sit on the resuscitation committee at the flagship hospital of our system.

How do the unique responsibilities of your role impact your perspective on emergency response?

One of the biggest concepts in the supply chain world is having the right things in the right place at the right time. But there’s another level of understanding and education that goes into this for emergency response scenarios, and in restocking and replenishing the crash carts specifically.

I have to make sure my staff understand that this is a Code Blue event, and there’s a higher level of expectation when it comes to making sure items are where they need to be. The clinician is not going to have time to validate that we put the supply in the right spot; it just needs to be there.

For frontline supply chain staff, it might be their first job and they might not know much about being a first responder. So for them, seeing mock codes or real events — getting that experience and actually seeing what goes on during a code — is crucial. Clinicians are whipping open the drawers and grabbing stuff. The weight of resuscitation response falls on them, right? So on the supply chain side, we need to get this right and make sure the carts are stocked correctly to support them.

Impact on emergency response

What are two of the most important changes that you have driven, or been a part of, that improved resuscitation response?

The first was educating materials management staff and having them come to mock codes. That changed the level of standardization with the crash carts. Before, it was a bit like the wild west: a handful of this and a handful of that in each cart. But once staff saw the events in action, they understood the importance of their role and how they stocked those carts. So that’s the first part — education and setting expectations: “Yes, this laryngoscope handle needs to be in the airway box, not with the medications — and here’s why.”

The second was implementing a compact, self-contained airway roll modeled off of EMS boxes. With the original airway box, staff were having trouble locating items during events, even though the items were technically there. There was this “aha moment” when a colleague went to a crash cart and pulled out the airway box, and stuff was just falling out of it. That’s what helps drive change, being able to bring something like that to the group — no matter how bad it is — and saying, “OK, this is where we need to put in some effort.” We standardized the airway roll and implemented it throughout all crash carts, and it improved workflow and staff satisfaction drastically.

Do you see your role as having an impact on improving patients’ survival?

I would say that our failures are going to have the opposite effect. So yes, anytime we can prevent a delay, standardize a process, and work with clinicians to have supplies in the right place at the right time — then we’re going to make a positive impact.

Reflecting on the past — and looking to the future — of resuscitation response

What is some advice you would give your younger self that you didn’t know then, but know now?

I would tell myself to get clinical involvement to gain a better understanding of how the supplies are used. And maybe develop a program for supply chain staff to partner with clinical teams to get that knowledge.

The information that I’ve learned from respiratory therapy managers, nurses, the IV team, central line staff, doctors, the people who are the coaches has been so valuable. They would sit there and answer the basic questions from me for a half hour so that I understood how, exactly, a central line works. That’s something I always share with my staff: If you don’t know, go find the person who uses this item and ask them.

How do you see resuscitation response changing in the future?

I don’t work on the clinical side of resuscitation, but I think it’s important for someone like me to know that it could take clinical staff 27 clicks to document something, and that’s just crazy! Better technology and apps for documentation could change so much. For example, we’re measuring time to epinephrine administration. We can’t rely on the documentation that is timestamped by the old-school clock on the wall — the one that’s run with a battery, which might or might not be changed. When it comes to some of the technology we use in healthcare, it’s like we’re in the Stone Age.