Standardizing Access Mechanisms to Prevent Medical Equipment Supply Chain Disruption
At the onset of the COVID-19 pandemic, manufacturers of critical care medical equipment were faced with a demand far greater than they had ever prepared for, especially for ventilators and other life-support equipment.
The impact was global, broad-based and impacted their ability to meet demand in two critical ways. First, massive increases in demand forced major reworking of manufacturing schedules and processes, just as COVID-related restrictions forced many plants and engineering staffs to either shut down or strictly limit the number of personnel working in facilities.
The restrictions also forced manufacturers and equipment assemblers to modify production floors, erect barriers and implement social distancing and protective equipment practices to keep the virus from spreading within their plants.
Second, the sudden shutdown of “just-in-time” global supply chains, built around highly predictable demand scenarios for a whole range of common components like mobile devices, electronic components , touchscreens and secure locking mechanisms, prevented many medical device manufacturers from completing orders, due to temporary loss of global components supplies.
While the COVID-19 pandemic was unprecedented, it has presented medical device manufacturers with an opportunity to examine their approach to equipment design, manufacturing and component supply chains. The vulnerabilities in this complex system of suppliers for various parts points to the need to adopt a more secure approach to medical equipment design and manufacturing.
The industry can draw lessons from other manufacturing segments, such as automotive, that use standardization as a key foundation for their system design and manufacturing philosophy. This strategy allows vital mechanisms to be standardized across multiple platforms to create a streamlined manufacturing process from design to procurement.
For many commonly used mechanisms — latches and locking mechanisms, hinges and touchscreen monitor mounting devices — standardization across multiple models and configurations can enhance supply chain security and help ensure that urgently needed medical device equipment such as respirators can be delivered when they’re needed the most.
Disruption of medical equipment demand
The sudden changes in demand for medical equipment driven by COVID-19 were uneven and highly disruptive in a number of ways. The most obvious demand increases were for ventilators and other breathing assistance devices. However, the pandemic also ramped up demand for other types of mobile medical equipment, particularly mobile nursing stations and medical carts carrying supplies and medications.
As hospital wards, medical centers and even large-scale public facilities like convention centers were converted into COVID-19 intensive care wards, other equipment was needed. For example, there was a sudden increase in demand for air purification and mobile/portable air handling equipment, of all sizes and capacities, to support temporary tent structures. There were even shortages of shipping containers to securely move all this equipment.
In addition, because so much of the medical establishment had to focus on treating the pandemic patients, demand for nonessential medical equipment, such as portable MRI machines, colonoscopy equipment and dental surgery systems flatlined as elective treatments were postponed or suspended.
As with any unprecedented and sudden shift in demand for goods, this strain waterfalled throughout the supply chain as component suppliers rushed to increase production and delivery of vital components. On the procurement side, manufacturers had to coordinate across dozens of vendors to ensure the expedited delivery of components.
This disruption was compounded by major global restrictions on air travel, including air freight, to help prevent the spread of the virus. In response, many suppliers shifted to ocean transport, forcing increases in costs as well as changes in lead times from components suppliers, from four to six weeks to fourteen to sixteen weeks.
It also led to shortages of raw materials such as steel and high-quality plastics. And components widely used in many mechanisms and typically produced in high volumes in one part of the world — cast aluminum parts made in the Asia Pacific region, for example — became difficult and expensive to obtain.
So even the simplest of products, such as compression latches for securely closing shipping containers or air handling equipment, or springs and other components needed to manufacture adjustable monitor mounts for mobile nursing stations, became difficult for some mechanism manufacturers to supply — delaying the completion and delivery of vitally needed medical equipment.
Standardization offers supply disruption solutions
Implementing standardization for many mechanisms on medical equipment begins with smart decisions and planning at the design stage. Many medical equipment manufacturers sell their equipment into different markets; since there can be significant competition for products like ventilators and mobile nursing stations, manufacturers will invest time and resources to custom-design their equipment to have distinctive features and appeal to enhance the end user experience.
It is possible for industrial designers to achieve market-specific, competitive designs while implementing a standardization approach for key elements and mechanisms. Leading suppliers of these types of mechanisms often have well-established component portfolios that designers can “mine” to create the solutions they need.
A good example is monitor mounts for touchscreens on mobile medical equipment such as ventilators, carts and nursing stations. These typically use mounts that are easily adjustable but have enough resistance so they don’t shift when personnel use the touchscreen. Some are mounted directly onto the mobile equipment frame, while others may be on extended swing-arms for greater flexibility.
Medical device manufacturers could custom-design these mechanisms from the ground up with specific, virtually one-of-a-kind tooling for all the components. The risk is that supply chain disruptions can prevent all the needed components from coming together and being assembled into a finished mechanism.
Suppliers with large monitor mount portfolios can prevent this scenario from arising, while still supporting the manufacturer’s goals of creating a distinct and competitive design for their equipment. Working with the manufacturer’s industrial designers, they can pull from their existing portfolios of standard mounts to provide the functional “skeleton” of the device, with the exterior housing being customized.
Economies of scale and supply chain security
There are several key advantages to working with established mechanism suppliers when medical equipment manufacturers move to a more standardized approach for supplying their needs.
Leading suppliers of standard mechanisms like hinges, latches, locking devices and monitor mounts typically produce hundreds of thousands — even millions — of parts every year for a variety of industries and applications.
That has enabled them to fine-tune their portfolios to serve a broad range of needs and equipment types — a depth of product portfolio that also provides economies of scale, since the standard mechanisms being manufactured at much higher rates for multiple customers drive down the cost per unit, versus custom-manufacturing smaller production runs.
By building from an established portfolio, the medical device manufacturer can be more confident that the mechanism supplier has sufficient production capacity to adapt to any sudden surges in demand for components. This is especially true for companies with a global/local manufacturing footprint.
For example, Southco is a leading global supplier of access mechanisms and positioning technology widely used in medical equipment applications. The company has multiple production plants in key locations across the globe. The company’s global manufacturing platform can respond to changing situations without imperiling customer orders, lead times or product quality — no matter where the production is done.
This quality control is crucial to successful standardization, through highly uniform manufacturing and quality processes, no matter what region or facility is performing the work. Each plant has the same equipment, the same tooling, the same plant layouts and production flows and the same procedures, whether they are located in the US, Europe, India or China.
This global/local approach can be extremely valuable to medical device manufacturers seeking to compete in multiple global markets. It also provides the critical supply chain security that is a key benefit of standardization — especially when major disruptive events like COVID-19 occur.
If a North American ventilator manufacturer has a strong relationship with a global mechanism supplier, and the supply chain flow from Europe or China is disrupted, the ventilator manufacturer will still be able to meet the surging demand for their products as long as their mechanism supplier can provide the same monitor mounts from their local production base.
The best way for medical device manufacturers to take full advantage of standardization is by establishing early working relationships with mechanism suppliers as the design of new or updated medical equipment is begun.
Early engagement with leading mechanism suppliers with large product portfolios and engineering staffs will enable the supplier to fully understand the functional and design requirements for positioning, access and security equipment on the new system. They can then assess what existing, standard products they have in their portfolio that can be most easily and cost-effectively adapted to meet the new mechanism’s requirements.
It can also ensure that, once production commences, if there are any dramatic, disruptive events like COVID-19 that causes a dramatic surge in demand of medical equipment, the right devices can be supplied with as little disruption as possible, to meet critical healthcare needs.
