COVID’s ordeal by fire for Ochsner Health supply chain chief Régine Villain

Villain established the first vendor-owned personal protective equipment manufacturing plant in the United States for proximity supply.

Ochsner Health System in Louisiana experienced supply shortages in 2020, as did other healthcare organizations. But he started stocking up. Prior to the COVID-19 pandemic, Ochsner’s Regine Villain, SVP of Supply Chain Network and Director of Supply Chain, was paying attention to the news. At the start of 2020, a mysterious disease had an impact on the people of Wuhan, China. A little after, Cardinal Health issued voluntary recalls of medical gowns manufactured in that country. Gowns were part of custom packs, the cornerstone of operating room procedures. This one-two punch affecting Chinese manufacturing and workmanship led Villain to an “aha” realization. She predicted that others in China would fall ill, which, along with manufacturing issues, would impact the production of healthcare supplies.

She told her team to start stocking up, as she anticipated shortages. Villain also sent a system-wide note asking staff members to tell him which services and items were essential, as they may soon be in short supply.

Villain was still relatively new to Ochsner, having joined in February 2019. She had yet to prove herself or be “Ochsnerized,” she says. But she was no stranger to crises, having worked in supply chain at New York-Presbyterian Hospital during 9/11, and she was comfortable with crisis management.

COVID-19 hit New Orleans after the February 2020 Mardi Gras season. “I knew it was time to go. I had to stand up as a leader and make sure my team knew I would be there with them. I wanted the organization to have a sense of comfort. I was guiding them through this as the supply chain lead,” she says.

At the start of the first wave, the health system supply chain started from a position of strength. But she soon realized that the rate of supply consumption far exceeded the levels of accumulation. As the largest nonprofit academic health system in Louisiana and also the largest health system in the southern Gulf, Villain says, this has had a big impact. Villain is responsible for 25 owned and operated hospitals and more than 100 clinics, with 32,000 employees and 4,500 employed and affiliated physicians. The health system treated about 900,000 patients in 2020, she says. Villain is responsible for strategic sourcing, contracting and procurement for these entities, including all physician preference items, purchased services, capital support, procurement facilitation, logistics, the distribution, transportation and storage of these items.

Diversity is key

At the start of the crisis, Villain expanded his network outside the department, forming close relationships with clinicians like infectious disease specialists. This helped her understand their needs, define new policies and adapt the messages of the organization. One example is minimizing the number of family members who can visit a sick person, in part to reduce and preserve PPE.

With so many organizations trying to get PPE from China, “we walked away from China because we knew it was a mess,” she says. The medical systems of New York, Washington and Louisiana were growing at the same time, competing for the same resources. “Ingenuity has become the key to breaking this impasse.”

Photo Credit: Régine Villain is SVP of Supply Chain Network and Supply Chain Manager at Ochsner Health System. Photo courtesy of Ochsner Health System.

Villain’s department began to diversify its supply by finding suppliers in Brazil, Mexico, South Korea, Australia, Germany and Canada. Even though COVID was making its way to those other countries, it wasn’t quite as bad there yet, and every piece of supply helped.

Many of these supplier relationships were the result of personal relationships. “It didn’t matter that Ochsner didn’t have a relationship with the seller,” she says, but her connections did. “It was those connections that made a huge difference and created a differentiating factor.”

Pivot to do things differently

The connections also helped to work with local businesses to create PPE products. Mardi Gras is a huge industry in Louisiana, and the push happened right after the season ended. Factories ended with making Mardi Gras costumes and shifted to making PPE. Local distilleries have proactively approached Ochsner with offers of hand sanitizer. “They weren’t going to do alcohol anytime soon. The main ingredient in hand sanitizer is alcohol. We get it!” she says. The community rallied around the health system to ensure it had what it needed.

Staff also had to reconsider their usual ways of doing things, thinking creatively. This meant switching to reusable rather than disposable items. It also meant implementing conservation measures. Instead of throwing away the gowns after a single use, clinicians used the gowns longer if safety evidence showed it could be done.

“I call it going back to the ‘yabba-dabba-doo’ days, which is what we used to do before we got so fancy,” she says. It’s balancing the basics without compromising safety or effectiveness. This practice continues as supply chain shortages have continued with different products, especially for those who have no alternative, as some medical products have only one primary manufacturer. Shortages of raw materials, such as resin, are forcing clinicians to rethink the way they do things.

Set up a factory

After the second wave of COVID, Villain started talking about creating a resiliency plan that included PPE proximity options. This led to the biggest project Villain has taken on in recent years, and of which she is most proud at Ochsner. The health system has created a co-manufacturing partnership called Safe Source Direct produce PPE in Louisiana. This is the first supplier-owned PPE manufacturing facility in the United States, she says. The partnership includes Trax Development and Vizient, which will eventually make products available to its members.

“It was almost like a mind-blowing exercise because I have to be the supplier, the head of the supply chain, and now the maker in the manufacturing space,” she says. “I am my own customer.”

SafeSource focuses on essential items like gloves, gowns, masks, respirators, caps and shoe covers, “the bread and butter of everything we do in healthcare,” says- she. The gloves are in production and going through an accelerated FDA approval process. They can be sold to non-medical entities without the same requirements until they are approved by the FDA. It plans to source 100% of Ochsner’s glove volume through SafeSource Direct. The facility, located 2.5 hours from New Orleans, in Lafayette, Louisiana, will produce 1 to 2 billion gloves per year.

Ochsner doesn’t make the supplies to save money. “We’re looking at this to create that lifeline of supply assurance, making sure we have resilience in our ability to supply ourselves,” she says. That said, they plan to expand manufacturing capabilities to multiple industries and entities. The partnership seeks to diversify the business to bring the products to others, so that ultimately Ochsner is not the only customer. “The idea that we’re playing a role in helping to stabilize the supply chain availability market is gratifying,” she says.

Much of Villain’s time at Ochsner was spent on COVID. “The supply chain has been in constant fire since 2020, from PPE, wave one, wave two and hurricane [Ida]“, she says. “The supply chain is where everything converges. Everything that everyone needs goes through the supply chain.”

She credits her staff for being motivated and positive, even with the constant pressure. “I know without a doubt that none of the things we were able to do would have happened without the people we work with.”

Deborah Abrams Kaplan is a staff writer for HealthLeaders.

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