April 24, 2020

How UnityPoint Health built a PPE pipeline for the surge—and the months to come

Daily Briefing

    A global shortage of personal protective equipment (PPE) remains one of the principal barriers to safely caring for patients during the Covid-19 outbreak.

    How are hospitals handling a PPE shortage?

    Short-term scarcities of PPE put health care providers, staff, and patients at risk of infection. Longer-term shortages of PPE—particularly of face shields, masks, and gowns—will likely persist even after the Covid-19 curve flattens, stalling health systems' transitions back to business as usual. With standard supply chains significantly depleted and continuing uncertainty around federal and state governments' abilities to supply additional PPE, health systems must take proactive steps to scale up PPE production.

    We recently spoke to Matt Warrens, Managing Director of Innovation at UnityPoint Health, about the organization's entrepreneurial approach to sourcing PPE and his recommendations for building a sustainable PPE supply chain.

    UnityPoint Health's response to PPE shortages

    UnityPoint Health, headquartered in Des Moines, Iowa, has tackled their PPE shortages head-on by working with in-house production teams, sourcing materials from distributors across the country, and partnering with local manufacturers to produce gowns and shields. In a matter of weeks, they have procured enough single-use face shields and gowns to get them through the short term. Now, they're proactively shifting PPE manufacturing production from single-use to reusable options that can be safely sanitized for multiple wears. This strategy will allow UnityPoint Health to produce a more sustainable supply chain and equip them for the anticipated Covid-19 "microsurges" across the coming months.

    Early lessons from UnityPoint Health’s PPE strategy

    1. Look beyond 'DIY' options and start investing in scalable partnerships with local manufacturers

    Right now, many health care leaders are operating in crisis mode when it comes to PPE—they're solely focused on getting the supplies their staff need on a day-to-day basis. And while that’s understandable, it’s not a sustainable approach. Supply change shortages will be an issue that continues to limit organizations’ ability to get “back to normal” for some time after the Covid-19 surge.

    "We don't know exactly when this crisis will end, and in partnership with local and state authorities we’re evaluating what a return to full operations might look like," Warrens said. "We know that requires a number of critical pieces to be aligned with recommendations from CMS and the CDC. Most of all, we must make sure we have enough PPE to protect patients and team members alike on a long-term basis—because safety is always our top priority."

    For UnityPoint Health, building a scalable PPE pipeline meant thinking about PPE procurement in terms of months, not weeks.  They shifted from short-term, temporary solutions, such as 3D-printed masks or face shields made from local materials in their in-house innovation lab, to partnerships with commercial producers that can turn out high quantities of face shields and gowns for the next several months. To ensure quality and safety standards are met, their clinical and infection prevention experts team test the PPE products.

    "With the example of face shields, we started with an idea and then looked to scale it quickly for production purposes," explained Rose Hedges, who leads medical technology and learning initiatives at the innovation lab, as well as dedicated nursing and research efforts at the organization’s Cedar Rapids hospital. Hedges also teamed up with fellow clinicians to design "The Olson," a specific sewing pattern and prototype for fabric face masks intended to help support the fight against Covid-19.

    That's not all UnityPoint Health has done. Because typical supply chains are depleted, the team had to think beyond the usual suspects when sourcing potential producers for PPE. When UnityPoint Health faced a shortage of high-end seamstresses in their area who could produce the quantities of reusable gowns they needed, they reached out to other commercial producers with sewing expertise, like agricultural machinery manufacturers who use sewing equipment to stitch the fabric on tractor seats.

    2. Pick up the phone—and be persistent with potential partners

    Warrens' team has had to be relentless when sourcing PPE and looking for commercial manufacturers. Often, that meant calling dozens of businesses and contacts before finding one that had the resources they need. The process also necessitates a robust partnership with supply chain and clinical leadership.

    As Warrens describes, "There are typically six degrees of separation between you and the PPE you need. You might call 20 people and find the supplies you need on the 20th call. But that's the amazing thing about our people—we keep pushing forward to find a solution so we can show up for the team members and patients who need us most."

    In a crisis shortage of PPE, cold calls and a simple Google search have proved effective means to source substantial quantities of face shields, disposable masks, and gowns for UnityPoint Health's team.

    When searching for potential manufacturing partners, consider your expansive network—and be willing to do some sleuthing to find the supplies you need. More often than not, people are willing and ready to pitch in to help where they can.

    Interested in how other organizations are approaching PPE shortages? Access our running list of ideas here.

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