Supply Chain Shortages Impact Patient Care and Provider Workflows

Supply chain shortages are compromising patient care and increasing administrative burden in every sector of healthcare, an ECRI survey revealed.

The survey reflected responses from 200 healthcare workers, including pharmacists, pharmacy technicians, physicians, procurement specialists, and nurses. ECRI and the Institute for Safe Medication Practices (ISMP) gathered responses in July 2023.

Six in ten respondents said that more than 20 drugs, single-use supplies, or durable medical equipment were involved in shortages during the six months before the survey. Nearly three-quarters of respondents said these shortages have impacted care quality in surgery and anesthetics.

The shortages are also affecting emergency care (64 percent), pain management (52 percent), cardiology (45 percent), hematology and oncology (44 percent), infection diseases (39 percent), and obstetrics and gynecology (37 percent).

Most healthcare workers reported that supply chain shortages have compromised patient care. Nearly half (49 percent) of respondents said patient treatments had been delayed. For example, a lack of supplies needed for procedures has led providers to reschedule, postpone, or cancel surgical cases. In addition, a shortage of medical equipment spare parts has delayed equipment repair, requiring patients to be transferred to other facilities.

Almost a third of respondents reported they could not provide patients with the recommended drug or treatment for their condition due to shortages, with 21 percent saying this resulted in patients receiving a less effective drug.

Supply chain shortages have also led to errors, with 24 percent of respondents reporting they were aware of at least one medical or medication error related to a drug, supply, or device shortage in the six months before the survey.

One error stemming from the lidocaine multidose vial shortage included a single-dose lidocaine vial being procured but inadvertently utilized as a multidose vial.

Healthcare workers have attempted to address supply shortages in various ways. The majority (90 percent) of respondents reported adding backup inventory for critically important drugs, supplies, or equipment for those in short supply; changing periodic automatic replacement levels; or purchasing a more expensive product from the vendor.

Meanwhile, 86 percent of respondents reported rationing or restricting drugs, supplies, or equipment in short supply. Over four in ten said they have used short-supplied drugs or equipment beyond its use date or have reused a single-use device.

Communication with staff has also been key during supply shortages. Many respondents (84 percent) said they have provided resources to educate clinical staff about safe dosing of alternative drugs or properly utilizing alternative supplies and equipment, while 92 percent of workers regularly inform medical staff about products in short supply.

Additionally, respondents have established meetings with central supply and materials management staff (82 percent) and pharmacy staff (77 percent).

As healthcare workers grapple with financial challenges and staffing shortages, supply chain problems add to their administrative burden. Educating staff, stocking alternative products, and working with secondary market vendors take up significant time that could be spent on more valuable tasks, the survey noted.

Addressing supply chain shortages could improve patient care, reduce medical errors, and improve workflows for healthcare staff in all sectors.