An Interview with Amanda Chawla, CSCO, Stanford Health
Today I had a fantastic interview with Amanda Chawla, as part of our new Supply Chain Leadership series within the Supply Chain Resource Cooperative at NC State. Her comments provided some important insights for our students, especially on the subject of change management.
Amanda described the healthcare supply chain’s objective is about serving the “healing hands” that care for our patients. I had never heard that term used to describe physicians, clinicians, nurses etc – but it is spot on. To support this objective, Amanda’s team is seeking to change the way they operate –all the traditional aspects of the Supply Chain. The aim is to be leading edge, re-think, and re-design the operations. “We have to transform and envision the future today with no boundaries which requires an understanding of the needs of all of our constituents including the patient. Our mission is to deliver premium value to the healing hands with all the rights – right item/service, at the right time, at the right place, transforming tomorrow’s health care supply chain today”. Everything form the way we contract, manage supplier relations, to the logistics and distribution to our system and analytics infrastructure is on the table.”
One of the most important challenges in healthcare supply chains is “Utilization” – the level of sustainability applied to waste. Utilization and consumption rate are synonymous; utilization is the value of medical supplies used relative to waste (i.e. throwing way, opening but not using as intended, obsolescence, etc.). We know there is waste in healthcare, but it is extremely difficult to measure. For example, in the operating room, consider a “kit” of various bandages, scalpels, supplies, etc. that is required for surgery. If only a few items are used from the kit, the rest are typically thrown away; and wasted. This waste may end up in landfills, and only rarely is recycled. These kits can have utilization rates of 40-70% – meaning that 60-30% of the products being purchased and placed in a kit may not actually be used, and for a variety of infection control/safety reasons, may be thrown away. Surgeon/physician practice may vary, the patients’ needs may vary on the amount of medical supplies used in a kit; and that kit can contain lifesaving key critical supplies. This plays a role into sustainability. When thinking about what products are being used, hospitals evaluate disposable vs. re-usable products and the product selection can have an impact from a sustainability lens. These two simple examples represent complex intricacies of a supply chain. Stanford not only addresses these types of challenges like many hospitals; but focuses heavily on innovation, teaching, and research. Physicians and other clinical team members partner closely with the supply chain.
Amanda began her career in psychiatry, then worked in clinical trials, ran hospital operations overseeing clinical and non-clinical departments, and eventually wound up in supply chain. She has stayed in this area and has been at Stanford for 7+ years. One of the reasons she loves the field so much is that it involves both strategic and operational elements.
Amanda notes that when it comes to change management as part of her job, “I LOVE CHANGE for the right reasons – we evolve!” “my team is always ready dive “. Change management and leadership centers around relationships, understanding, listening, communicating, and connecting. Healthcare and supply chain is about people – and the magic is aligning processes and procedures with tools in a people business.
“It is truly a unique position to be both strategic and operational – and have the opportunity to work with every department across the Stanford Medicine system. Supply Chain is the life blood and the life line of the organization. My love for supply chain involves the ability to disrupt and elevate how we provide care, have greater intelligence, working with people at the center, and having a mindset of making the impossible possible. Supply Chain must get out of the hunting and gathering business; we support the financial viability of an organization – it is anything and everything that is purchased in an organization – service or product. Serving as the non-labor resource expense leader, my work is centered towards support and bringing the science and art together.”
Amanda notes that “The way I’ve done that – is through “internal branding!” What I mean by internal branding is getting people aligned with the WHY for change, and connecting with my team first and bringing forward alignment as one voice across all levels so when we connect with our stakeholders – it’s one voice. I use a concept of “informal dyads”. An informal dyad is somebody you have identified as a key stakeholder that you are directly connected with – you meet with them often, with purpose, understand their needs, and communicate your work and align on the why and what. Understanding those stakeholders to build a relationship is key to change management. Secondly, you must be transparent. When aiming at a dartboard, everyone of course wants to hit the bullseye. But a lot of times, you miss and get it on the outer rim. My view is that for certain types of changes it is good to go from a 10 to a 7, and maybe down the road, get to a 5 and then a 2. Small changes will enable long term changes. Others may require you to hit the bullseye more directly; more often than not it’s gradual, but very small changes can become irreversible and completely locked with no ability to adjust.”
One accomplishment that Amanda is proud of is the project to determine “critical items” for Stanford’s supply chain resilience program. This was part of industry leading work that I worked on with Amanda to help advance the healthcare supply chain industry on it’s thinking of resiliency as part of the SMI Supply Chain Resiliency Maturity Model, and the Critical Product Attributes Model.
Amanda noted that in a hospital, it is difficult to identify which products are more critical – because everything is critical! In healthcare, there are many levels of criticality such as a “never” event, “serious adverse” event, “adverse” event, “near miss”, etc. Using the same approach from a clinical standpoint, Amanda, Alan Mavis her co-chair at SMI, many other supply chain executives, and the rest of the Stanford team have taken that concept and applied it to supply chains. “We decided to take that adverse event framework and apply it to healthcare products. For example, we developed a temperature gauge – hot-medium-cold – to define each product. From there, have taken the concept to the next level to create a model in which products can be mapped – clinical impact (Y axis) and supply disruption (X axis) represents the level of risk. This type of work guides healthcare supply chain in their prioritization of disrupted products but more importantly provides insights to mitigation and resiliency planning at the product sku or category level.”
Amanda provided the following advice, “Connect with people in a real way – have a meaningful conversation. Be intentional about what you want to do. Be involved in the associations, the literature, understand what is going on in the industry and be active in it. If you are looking at a career transition or moving across into another function, get involved in the industry. Talk to people, be genuinely curious, ask questions to seek understanding and adopt a continuous learning mindset.”
“When I look to hire people, what I care about is your ability to work with others and communicate. You can be a great analyst but if you can’t get buy in and fail to connect and communicate effectively – you are not effective at all. EQ is very important; I look for people skills and aptitude. We can teach you the technical skills, and translate what you know into healthcare – but the EQ skills is something that you own. Can you be an informal influencer (not talking about social media), and can you partner and represent Stanford with our suppliers, the Stanford brand and the needs of our stakeholders and patients?”
Amanda’s insights are completely aligned with my own, and the critical elements around stakeholder engagement that is such a strong part of the MBA 541 class.