This, too, will make you stronger

Posted by

Luann Culbreth, MBA, RT, CRA, FAHRA

By Luann Culbreth, MBA, RT, CRA, FAHRA; AHRA Regulatory Affairs Committee Vice-Chair

Supply chain disruptions.  A phrase we’ve all come to know and use.  Micro chips, baby formula, PPE, appliances, diesel, raw materials, and now iodinated contrast.

At the end of 2021 optimism was rampant about a new year, 2022!  Yet, again it seems we are living in “2020 too.”  The Omicron surge & variants, China lockdowns and Russia/Ukraine War have imposed significant challenges on global supply chain.  Trade war tariffs are ongoing, and inflation is the highest in it has been in twenty years as seen in things such as gasoline, housing and food prices.

We have learned how dependent we are on imports and of the extreme shipping container costs.  According to Bloomberg.com the $2,000 average rate for a container pre-pandemic escalated to over $20,000 per container in 2021.  Although rates have started to come down the fuel surcharges will likely send them back up again.  Meanwhile hundreds of ships wait in ports with no place and no one to transport their cargo, and shipping warehouses are closing. 

Labor shortages have not only impacted supply chain operations but also the delivery of patient care.  Healthcare professionals are getting long overdue recognition for being heroes yet many are leaving patient care settings for their own physical, mental and emotional wellbeing. 

Many experts believe we will likely not see any real near term relief due to so many factors with supply disruptions for the next several months.  If so, can you imagine what will we look like in 2024?

We/You as leaders will be stronger.  Think about all you have learned in the last couple of years, it’s hard to articulate it all.  You have managed through an unknown pandemic taking one day at a time, sometimes one hour at a time, to lead in a chronic crisis.  You have sacrificed things of importance and things taken for granted.  As you have navigated uncharted waters you learned to lead yourself and others in all ever changing tides.  Your teams have recognized, respected and appreciated your leadership.  They trust your guidance as we continue to handle whatever comes next and need you to remain strong. 

Until recently has anyone really thought about where contrast media comes from?  We do now.  Your understanding and ability to articulate the current situation will help your staff, physicians, leadership and patients recognize the burden facilities are faced with due to supply chain disruptions.  Your shared knowledge will assure them you are staying informed and the importance of their help in managing scarce resources.

During a recent webinar provided by the American Hospital Association, GE Healthcare leadership shared that 80% of Omnipaque manufactured for the United States is produced in Shanghai, China.  Unfortunately the recent China imposed lockdowns due to Covid-19 surges in many high risk areas such as Shanghai brought manufacturing to a standstill.  And Shanghai is one of the busiest ports in the world.  Omnipaque is also manufactured in Cork, Ireland, yet that location is not of the size and scale to assume all of the contrast production needs.  However GE is optimistic supply for the US market will return to normal late Q3/early Q4 this year.

The supply chain disruptions to one supplier also affect the others.  Bracco Diagnostics produces Isovue in Europe.  They traverse the same global disruptions and demand for radiographic contrast media has strained their ability to supply customers at full capacity.  Just like we saw with toilet paper and PPE, hoarding of contrast media is now a thing.  Those of us who have been around awhile have seen contrast shortages before.  We’ve seen interventional radiologists get the MRI gadolinium contrast (it’s got electrons in it) and use for critical cases.  They are now doing that again.

As operational leaders who have strong clinical acumen and management talents, this current disruption has a spotlight on you and your ability to lead effectively.  You are not in this alone and have a strong AHRA family as intellectual resources and comrades.  Communication skills, budget variance analysis, information management, human resource considerations are your innate gifts.  Show them off, let your healthcare teams recognize you are strong and that this, too, will make you stronger.

Let’s go rejuvenate in Phoenix!


Luann Culbreth is the Director of Clinical Operations at HealthTrust in Nashville, TN. She can be reached at Luann.Culbreth@Healthtrustpg.com, and will be presenting at AHRA 2022 in Phoenix, July 10-13.

Please visit AHRA Advocacy for more information on regulatory issues, legislation, AUC, and more!

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