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Flu, saline-bag shortage create crisis for U.S. medical supply chain

This year’s bad flu season has shown that the U.S. has bad problems with its medical supply chain, according to an essay in The Washington Post. One is that Hurricane Maria slashed production of IV saline bags.

The writers noted: “There are two ways the ‘just in time’ system can be disrupted: an unexpected surge in demand or a delay in delivery. In this case, both occurred simultaneously. The United States is dealing with an unusually potent strain of the flu, while Hurricane Maria brought production in Puerto Rico  {of the saline bags} to a grinding halt. If only one of the two had occurred, it’s unlikely the United States would have experienced a shortage.”

To read their essay, please hit this link.


Trying to stop clinicians from working while sick


A study published in JAMA Pediatrics says most physicians and nurses report to work when they are sick in spite of the risk  to patients and other personnel. The article says institution-wide approaches are needed to stop the practice.

The article said that many sick clinicians come to work  because they didn’t want to disappoint their patients; other clinicians said they reported to work when ill because they felt that their absence would cause  poor patient care as their co-workers struggled to keep up with the increased workload.

“Institutional culture also contributed to presenteeism,” wrote the authors, led by Audrey L. Tanksley, M.D., “including not wanting to disappoint colleagues, fear of ostracism from colleagues, unsupportive leadership, and coming to work while ill because their colleagues do the same.”

One possible approach to addressing the problem, the authors said, is organization-wide triage policies for ill healthcare workers. Consider that University of Chicago Health System clinicians with upper-respiratory illness symptoms or fever were tested for the influenza virus during a recent flu season. If the tests came back positive, the workers were ordered to stay home for at least seven days. And the authors further suggest applying a “fitness for duty” metric like that used by the airline industry for pilots.


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