Your Captain Speaking: About That `Just in Time`

Walking through the supply room with the supply clerk looking at the list we needed for restock, I couldn’t help but think, The cupboard is pretty bare. I could see frustration in the supply clerk’s face and body language as he apologized for some of the shortages. We were missing some things we needed.

“Samantha, what do you hear about the supply situation?”

“It’s hard to chase down what, how many, and when we can expect deliveries. We just don’t know, to be honest.”

It’s a challenge we’re all dealing with, not just in EMS but our lives as well. There’s a supply concept called “just in time” that big companies, small companies, and even families have used often and successfully. Here’s an example: Before the COVID-19 pandemic, we didn’t worry about running out of toilet paper. When we were getting low, we’d stop by a store and pick some up. We were working on just-in-time supply-side control.

There are amazing examples of effective just-in-time management. It helps prevent expiration and waste. Why not just have a big supply of stock items? It is amazing how, when items are put onto a shelf and left undisturbed, those items will spontaneously break, go out of date, get forgotten, or simply disappear. Having a large stock of items is not only costly but inefficient.

Toyota developed a just-in-time process where auto parts were never delivered to a warehouse but rather brought directly to the assembly area. The efficiency was stunning, and it worked. The keys were effective communication, dependability, and timing.

The EMS Supply Chain

COVID-19 threw the EMS supply chain into disarray. We’ve never had such unprecedented and unpredicted shortages. Before the pandemic, as stock levels got down, a service would just order more, and in a few days it would arrive.

When the pandemic is over, do we go back to the way things were? That ship has sailed. We have to change and adapt. Obviously, it will take some time to restock critical items such as PPE. The country as a whole was caught short on many things. There will be a predicable desire to overstock so as to not be caught short again. But maintaining a high stock supply is expensive and can take money from important aspects such as salaries, repairs, and new equipment.

A solution? It’s right in front of us in other areas of our life: While EMS should not in the business of self-manufacturing PPE, there is an opportunity within the supply chain to focus and improve the responsiveness of supplies. Typically, an organization places an order with its contracted supplier and only then asks, “How long before we can expect delivery?” Then it lives with the answer, often regretfully. Often no one even asks—they just wait.

Ask yourself, when you go on the Internet to search for a product, does it show you the expected date of delivery? Of course it does! It also shows whether the item is available. Apply this same concept to the EMS supply chain: Factor delivery dates into purchase decisions. We need to change and adapt.

Not everything in the supply room needs to be checked daily, but key items should be tracked. Step up your logistics oversight. If a supply source is not willing to provide availability and delivery information, start looking for another source. Market forces will force changes in service. You might be a small organization without a lot of individual clout, but many groups working together are strong.

In the military it takes a focus not only on tactics but on logistics to win the battle. EMS is in just such a battle.

Dick Blanchet (ret)., BS, MBA, worked as a paramedic for Abbott EMS in St. Louis, Mo., and Illinois for more than 22 years. He was also a captain with Atlas Air for 22 years and an Air Force pilot for 22 years.

Samantha Greene has been a paramedic, field training officer, and operations supervisor for Abbott EMS of Illinois for the last 10 years and a lieutenant for the Madison, Ill., Fire Department for the last five.