IWK Health Centre building.
The IWK Health Centre in July, 2021. Photo: Yvette d’Entremont

While a North America-wide shortage of epidural catheter kits used in labour and delivery is on the IWK Health Centre’s radar, pregnant people are being advised there’s no reason to panic here.

Two weeks ago the Saskatchewan Health Authority issued a media release advising families expecting a baby to “review pain management options with their care providers” due to the North-America wide supply-chain shortage of the kits.

Used to provide epidural analgesia during labour and epidural anesthesia for cesarean sections, epidural catheter kits are also used for other surgeries and for post-surgery pain management.

“We know where our supplies sit at the IWK and we’re comfortable for the upcoming months. We’re going to be continuing to work with our vendors to ensure that that continues,” Matthew Campbell, executive lead for planning and performance at the IWK Health Centre, said in an interview.

“The epidural issue for us is not a tomorrow, this week, next week (issue). We’re talking about what do we need to be doing today to ensure that a few months from now, we’re still in a healthy, safe position for the health centre.”

Campbell said they’re also working closely with the Reproductive Care Program of Nova Scotia to better understand supply levels elsewhere in the province so they can create a joint communication with Nova Scotia Health (NSH).

‘Not immune to the global supply chain shortages’

The pandemic hasn’t been without its challenges for hospitals, and definitely not when it comes to supply chain issues.

Whether it’s travel restrictions and transport trucks being stuck at the border or the disruption caused by the “freedom” convoy in Ottawa earlier this year, Campbell said they have complex systems in place to ensure they have appropriate supplies on hand when needed.

“We’re not immune to the global supply chain shortages that have been experienced across all sectors over the past number of years,” Campbell said.

“We do have various issues causing disruptions in our supplies with our vendors. They’re ongoing, and really no end in sight to where we’re living in a perfect world again, so we have to manage through that accordingly with the top priority being the quality and safety of the care and service that we provide to our patients and families.”

Despite ongoing global supply chain issues, Campbell said that over the course of the last two years, on average fewer than 3% of the 1,300 items managed through the hospital’s distribution centre are running short at any given time.

“Those items can vary day to day, week to week, depending on what’s happening in the broader supply chain system,” Campbell explained.

In the pandemic’s early days when PPE was at a premium, close tabs were kept on glove and face mask sizes that were hard to find. Campbell said that shortage served to heighten the level of concern around specific groups of items, and as a result the IWK Health Centre implemented new reporting and monitoring processes.

“We were actively managing that hour by hour, day by day, with line of sight, all the way up to our executive team about what was happening and what we needed to do to ensure that we had the supplies we needed to provide safe care,” he said.

‘An increase in the urgency’

The IWK Health Centre has also introduced new frameworks and guides for its strategic sourcing and buying teams to ensure they focus on items that might be cause for concern in the coming days or weeks. They also keep a “scorecard” updated on a six-week rolling average about the number of items at risk of running short.

“Given the nature of the supplies and the limited number of vendors that produce the supplies, we’re always going to experience crunches and shortages at any given time,” Campbell said.

“I don’t have the historical data at my fingertips to do a direct comparison, but over the last almost two years, I would suggest that we have seen an increase in the urgency regarding these types of concerns.”

‘Creative in a safe, quality care way’

In a recent tweet, one former patient praised the IWK Health Centre’s staff for their creativity in the face of shortages.

A tweet from a mother about the "bizarre" supply chain shortage at the IWK. The tweet says "gloves, bottles and other important and necessary medical things. The IWK team had to be creative when they should just hae the supplies they need. Is anyone talking about this?

Although Campbell couldn’t speak specifically to everything that might have been happening, he said they were running short on a sensor and waiting for a rushed delivery of additional supplies.

“To the tweet, there are times where we may need to be creative, but creative in a safe, quality care way,” he said.

When they do identify a product shortage or potential shortage, Campbell said an urgent meeting is held with clinical, management, administrative, and supply chain/procurement operations teams. Together they’ll come up with appropriate and safe substitutes.

In addition, Campbell said when and if required they reach out to other hospitals in the province and across the country, and will work with different vendors as needed.

“My overarching message would be we have a very robust supply chain framework,” Campbell said.

“We have excellent vendors that we have longstanding partnerships with, and we are not at a point in time where there is cause for concern for the community and patients and families that we serve.”

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Yvette d’Entremont is a bilingual (English/French) journalist and editor who enjoys covering health, science, research, and education.

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