Heroes of Procurement

At the outset of the coronavirus pandemic, hospitals began taking in exponentially larger numbers of patients, and the availability of beds was rapidly running low. Scarcity of hospital beds is a prominent issue for both developed and developing nations, but during the Covid crisis, it has been particularly problematic for countries with small healthcare budgets or those that are less financially stable, such as Ghana and Ethiopia.

Over the past few months, countries with lower capacities of hospital beds have experienced higher risks when treating coronavirus patients, with the US and Italy reportedly the most severely lacking, at 2.8 hospital beds per 1,000 people (US) and 3.2 per 1,000 (Italy). Bed shortages can undermine patient quality of care, leading to increased delays, hospital infections and worsening A&E performance, with reports in developing countries of people being refused admittance altogether. In light of this, four manufacturers joined forces to procure emergency hospital beds for those in greatest need, using local supply chains.

Contents Fast Tracking Production Sourcing High-Demand Products Setting Up Global Supplies Competing for Materials

 Local Medical Supply Chains

US medical supply company Stryker South Pacific partnered with Australian firms AH Beard, AmTek Australia, Fallshaw Wheels & Castors, and Varley Group to create the Emergency Relief Bed partnership, and within one week they mobilised an operation to start supplying hospital beds. These units have been delivered to US hospitals and makeshift triage centres, as well as Western Australian hospitals, and the partnership has expanded its provisions to other states and regions, including across Europe, the Middle East, Africa and Latin America.

Brad Saar, president of Stryker Medical division, says: “People are at the heart of what we do, and Covid-19 hasn’t changed that. It has amplified our mission of making healthcare better. We’re focused on meeting the supply needs of our customers so they can focus on taking care of patients right now.”

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 Fast-Tracking Production

On 20 March, Dean Birkmeier, director of advanced operations at Stryker Medical division, realised action needed to be taken. “Hospitals urgently needed beds, and our existing products were designed to be customised, requiring time hospitals just didn’t have,” he says. “I wanted to figure out how to design a new bed using readily available materials and processes that would allow the team to move at a speed never before attempted.”

Birkmeier worked with Stryker Medical division’s leadership team to redeploy a group of over 120 individuals from across the medical, instruments and joint replacement divisions to design and build a “low-cost, limited-release emergency response bed”, with a 10cm-thick foam mattress made by manufacturer AH Beard. The other local manufacturers, including AmTek Australia, Fallshaw Wheels & Castors, and Varley Group, assisted with designing and producing the frame, wheels and fabric. Together the firms established a new supply chain for regional manufacturing in order to meet the global demand.

AH Beard says: “The Emergency Relief Bed was first released by US medical supply company Stryker, to aid the high demand for patient beds in hospitals, pop-up care facilities and makeshift centres, like those in New York’s Central Park.

“Through this project, we will help manufacture over 1,000 additional emergency Australian-made beds per week to boost our nation’s health response, while also supporting neighbouring countries in their Covid-19 response efforts.”

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 Sourcing High-Demand Products

As the US team began sourcing materials to make the beds, they discovered that procuring steel was the most difficult challenge due to the significant quantity required and that the economical impacts of Covid-19 had created an adverse environment for the commodity. Stryker comments: “The project required enough steel to stretch from New York to Dallas. Calling every steel mill and service centre in the US and Canada, the team eventually secured the material. And just two days after the bed design was finalised, the shipments began arriving.”

In only seven days, the collaborative team had created the first supply of beds, which would play a critical part in the overall management of patients and frontline efforts, “ranging from hospital emergency departments and in-patient units to triage and pop-up sites of care”. All operations, from manufacturing to regulatory filings, were specifically coordinated to ensure the project could meet such a reduced timeframe.

Saar says: “Creating a limited-release bed that will help emergency responders and caregivers move and position patients efficiently is a small contribution in the shadows of their amazing work.”

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Image: ©Stryker

 Setting Up Global Supplies

A day after the US team launched the project, a global team of 86 was established from across six countries to manufacture and deliver the emergency beds on a worldwide scale, headquartered at Stryker’s Kayseri facility in Turkey, and at the Tuttlingen facility in Germany. A plant manager and director of operations from Stryker’s Endoscopy business unit offered the plant in Tuttlingen, Germany, as a base to assemble the beds.

Stryker emphasises that the project target required the new team to “condense an approximately two-year project timeline into 10 days”. The firm says: “The team understood that the response to the Covid-19 crisis would be a marathon, not a sprint. Countries at various stages and waves of the virus would need to be prepared not only for what was happening now, but also for the future.

“The project quickly gained traction as Global Quality and Operations, Sourcing, Stryker Medical International (SMI), Research and Development, Operations, Regulatory, Quality, and the Tuttlingen Plant teams looked beyond their decentralised business units, divisions, titles and geographies to truly live the Stryker mission as one entity working towards a common goal of helping our customers on the front lines.”

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 Competing for Materials

The global operational team turned the CE marked Emergency Relief Bed around in a very short time to meet the demand on the health services during the peak of the pandemic. At the start of May, 1,000 beds were dispatched from the Tuttlingen facility to a hospital in Qatar. The bed has entered the market in 21 countries, increasing vital resources and assisting the frontline efforts in healthcare facilities in some of the most vulnerable regions.

One of the main challenges was sourcing the raw materials during a period when many countries were not exporting, and suppliers were limited as they had to temporarily shut down during quarantines, or until Covid-19 safety and health measures were implemented. While working across a wide supply chain, Italy and Turkey were identified as common sources of steel bolts in Europe. However, Italy was proving especially difficult due to strict lockdown measures. Therefore, the sourcing team turned to a group of trusted Turkish suppliers with which they had pre-existing relationships to procure the steel bolts.

Stryker says: “The regulatory, quality, research and development, and operations teams in Turkey, Germany and the Netherlands partnered with colleagues in Kalamazoo, Michigan, to prototype, test, iterate and ensure compliance with all CE mark requirements while expediting every step of the process.”

Mathieu Badard, vice president at Stryker’s Medical division, EMEA, concludes: "We are living in unprecedented times. Hospitals around EMEA are facing capacity challenges. We had to find a way to support them and prove that our mission is more than just words. We are pleased to now offer this limited-release bed in a majority of EMEA countries to help our customers so they can stay focused on saving lives."

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