Covid Stuff - Unrelated

[NHSleddog]

I don't want to step on any toes in the other thread or go off topic talking about medical care over there. However this does affect us all. Get as unrelated as you want.

Before my posts started getting deleted, I was bringing up the hospitals preparedness and how it wasn't all the governments fault. That and medical care in different places. It seemed related to me however I was informed it was not and asked to start a new thread.

The hospital my wife works at was out of masks 5 weeks ago before the first patient showed up. That is just really really bad management there. The hospital my niece works at is the same. No PPE and no Covid patients. No government entity kept them from stocking their shelves.

I run a small business and need to keep several thousand dollars worth of gear sitting doing nothing just in case it hits the fan. In the scope of my budget it would be like the hospital keeping a million dollars worth of masks handy, a million dollars worth of gloves etc. There is no excuse for it. There are supposed to be "smart" people running the show there - meh, not so much.

Right now the hospital is half empty. There are no electives going on right now. The hypochondriacs are afraid to go near the place. And they have no gloves. It would be funny if it wasn't so serious.

 

[NHSleddog]

Working from home.

Listening to one of the Senators talk last night really drove home how out of touch they really are.

Not everyone CAN work from home. This is obvious for someone working for GM, but it is no less a concern for the pool cleaner or lot attendant. They can't work from home either. Obvious to most.

What ISN'T obvious to most is many people can't work alone at home - period. It takes a certain mentality to be productive when you are at home and I know many people that can't do it. They need the structure and schedule that comes from going in to work.

I started in 2006 and while it suits me in my 24/7 business great, it is also like a slave being tied to the stock.

 

[NHSleddog]

Cleaner.

If you want to break down and start making any bleach based cleaners.

Go to the pool store (or a walmart) and pick up some pool shock. It is about 15% chlorine where the normal chlorox type products are 3-5%.

As a bonus, they are never sold out.

 

[D2Cat]

I don't want to step on any toes in the other thread or go off topic talking about medical care over there. However this does affect us all. Get as unrelated as you want.

Before my posts started getting deleted, I was bringing up the hospitals preparedness and how it wasn't all the governments fault. That and medical care in different places. It seemed related to me however I was informed it was not.

The hospital my wife works at was out of masks 5 weeks ago before the first patient showed up. That is just really really bad management there. The hospital my niece works at is the same. No PPE and no Covid patients. No government entity kept them from stocking their shelves.

I run a small business and need to keep several thousand dollars worth of gear sitting doing nothing just in case it hits the fan. In the scope of my budget it would be like the hospital keeping a million dollars worth of masks handy, a million dollars worth of gloves etc. There is no excuse for it. There are supposed to be "smart" people running the show there - meh, not so much.

Right now the hospital is half empty. There are no electives going on right now. The hypochondriacs are afraid to go near the place. And they have no gloves. It would be funny if it wasn't so serious.

The real problem with lack of inventory is laws that tax inventory.

I have a friend who owns an auto salvage yard. A few years ago I was looking for an item and at that time he was crushing cars. When I asked him what determined which ones got crushed he told me about being taxed for his "inventory". It seems crazy to me, but that is how JIT (just in time) delivery was developed. One company makes the product as another company needs it. No inventory available to be taxed.

Also, no inventory for pandemics (or any unpredictable need)!

Maybe our government will learn from this experience to change tax law.

 

[NHSleddog]

The real problem with lack of inventory is laws that tax inventory.

I have a friend who owns an auto salvage yard. A few years ago I was looking for an item and at that time he was crushing cars. When I asked him what determined which ones got crushed he told me about being taxed for his "inventory". It seems crazy to me, but that is how JIT (just in time) delivery was developed. One company makes the product as another company needs it. No inventory available to be taxed.

Also, no inventory for pandemics (or any unpredictable need)!

Maybe our government will learn from this experience to change tax law.

I totally agree. While that is true and screwed up in some ways it is another example of how unrelated things affect the Virus and response. Tax Code - lol.

You are right about inventory, however it is the cost of doing business. I have to inventory every server and switch that I have sitting as hot spares and I pay on them. It is the cost of doing business.

They have a new 3.5 million dollar cat scan machine and not $20.00 worth of gloves. That is bad management.

 

[Magicman]

It is very easy to judge last year's or even last month's decisions based on today's knowledge. Monday morning quarterbacks are always 100% correct.

 

[NHSleddog]

It is very easy to judge last year's or even last month's decisions based on today's knowledge. Monday morning quarterbacks are always 100% correct.

Sure, but that comes off a lot more as an excuse than some kind of reason.

Our family have always had a couple months of food at least put away. It costs money and time and effort to do it, but knowing there is a 3 week food supply in the chain, to me it just makes sense.

In January they could have put in orders that would have shipped right out. Again, these are supposed to be smart people. We added to stock. No "Monday Morning QBn' there. I call it bad management. Before the issue it was bad, and today it is still bad.

 

[twomany]

Due to the elastic straps for the masks, and just the nature of gloves, both items are time sensitive. "Use by date" etc. The hospital would need to monitor and rotate stock.

Not too hard to do, but is normal consumption didn't match with extreme situation requirements, there could be significant waste.

Not an excuse for preparedness, just a consideration.

 

[NHSleddog]

Due to the elastic straps for the masks, and just the nature of gloves, both items are time sensitive. "Use by date" etc. The hospital would need to monitor and rotate stock.

Not too hard to do, but is normal consumption didn't match with extreme situation requirements, there could be significant waste.

Not an excuse for preparedness, just a consideration.

Yes, but for masks it is several years not weeks or months. They would need to rotate stock but really they should be doing that now right? The gloves vary depending on being latex, nitrile etc. Still should have more than a days worth kicking around.

 

[NHSleddog]

Poor management.

The hospital where my niece works they still have the nurses "floating" between floors and wings. It seems like the height of stupidity to me but I'm no doctor.

Floating is where a nurse shows up and they say, "hey, how about you work on 3 west today instead of 2 east like you usually do". 3 West being the Covid wing. Often times it is in the middle of a shift when they want you to move somewhere else. During a non-pandemic time I can see it as being flexible. During a pandemic it seems really dumb.

This practice will basically guarantee that the first nurse/aid/doctor etc. that gets it will rapidly spread it to the other nurses etc. throughout the hospital.

Does that make sense to anyone here (assuming you guys are not doctors).

 

[ccoon520]

Yes, but for masks it is several years not weeks or months. They would need to rotate stock but really they should be doing that now right? The gloves vary depending on being latex, nitrile etc. Still should have more than a days worth kicking around.

Hospitals are businesses. Like it or not, believe that is the way it should be or not, it is the truth. Businesses do not like to pay taxes because that is a loss of profit. Especially if it is something that is usually readily available. That CAT Scanner has probably at least a 36 week lead time if not a 52 week lead time. If that Scanner goes down that is 8 months of critical equipment down. Do they want to have a spare piece of equipment that costs millions of dollars? Not in the slightest especially since they have to store it somewhere. A lot of the time companies with that kind of spare equipment use a cribbing company that "owns" the machine and stores it in one of their warehouses and the company pays a rate for whatever floor space the equipment takes up and then an additional fee for high cost stuff that will smoke the cribber come tax season. This then allows the business to have a piece of critical equipment basically on hand without having to store it.

Gloves and masks for a hospital are on such a normal use rotation that having a 3 week supply that could expire before they can be rotated in is a straight loss that is not going to be recouped. Because of that the hospitals will not stock them unless probably something happens like a government mandate that hospitals have enough gloves or masks to run the hospital for 10 weeks at 115% capacity or the government puts in an inventory exception for PPE (but this still probably will not solve it because if the stuff expires then it is still a loss).

Companies run lean because their job isn't to be ready for extreme situations their job is to create profit. There's nothing wrong with that model but it just needs to be remembered that hospitals don't fix a broken leg because they care they fix a broken leg to make money.

In short I wouldn't expect a company to change their ways unless they can see it having an ROI that they can then make a profit from or if they are forced to by a governing body.

 

[NHSleddog]

I understand most of those excuses. And if we were in the thick of it, it would almost make sense. However they were crying about stock weeks ago before the first case showed up.

I just talked with my wife at work about dates. PPE does not expire by the day. The little blue masks that are most prevalent in hospitals do not have any expiration on them at all. The gloves they wear also do not have an expiration. The "sterile gloves" that are dated can only be found in the operating room. N95 masks have an average age of 5 years. So the whole we are throwing everything away is a bad argument.

They ARE a business so in January instead of buying a bunch of masks at .50/ea. they waited until now and they are more than 1.00 each minimum. Again BAD management, bad business.

 

[NHSleddog]

The Poker Game

A group of friends and I have been playing poker on Thursday nights for 30 years now. It has historically been one full table.

Since the outbreak, we have started a weekly tournament online and now we have more than 3 tables that start. Friends and family from around the country can join now and it has increased the game. Many have already said they want to continue regardless.

 

[ccoon520]

I understand most of those excuses. And if we were in the thick of it, it would almost make sense. However they were crying about stock weeks ago before the first case showed up.

I just talked with my wife at work about dates. PPE does not expire by the day. The little blue masks that are most prevalent in hospitals do not have any expiration on them at all. The gloves they wear also do not have an expiration. The "sterile gloves" that are dated can only be found in the operating room. N95 masks have an average age of 5 years. So the whole we are throwing everything away is a bad argument.

They ARE a business so in January instead of buying a bunch of masks at .50/ea. they waited until now and they are more than 1.00 each minimum. Again BAD management, bad business.

Ok so you run a business, let's say a tattoo parlor. For that business you need to have your essential equipment: tattoo gun, disposable needles, ink, paper, stencils, plastic gloves, etc.. Since it is a business the idea is that you need to make money so that you can feed your family. So to maximize what your company brings in you have minimum stock of a lot of items. You have spare needles, ink and tattoo guns because those could be long lead time and if you run out you can't run to the big box store and buy tattoo ink. But you run minimum stock on the rest because you can just run to walmart and get disposable gloves and paper and stencil paper no problem. Then in the course of 4 months phone and email infrastructure crashes so you everyone is sending snail mail and paper that was 5 dollars a ream is 15 dollars a ream and nearly impossible to come by.

Now yes the owner should have had more paper in stock because it is just paper and it is cheap but now if you scale it to saying the person has 100 tattoo parlors each extra ream of paper that has to be kept in stock at each location balloons to $500. This scaling compounds, so given enough small things that are minimum stock that usually do not impact you if you run low and need to make a jog over to a Walmart could add up to an additional location, more employees, more training for your employees, better equipment, better inks, an online website that add value to your business that brings in more customers and produce a better product at the same or better price than your competitors. Just in time is so widely adopted because it adds value by reducing running costs on the nickel and dime stuff.

I am sure that hospitals go through a ton of face masks and gloves. But they were readily available items that are relatively easy to produce with short lead times. So they don't stock larges stockpiles of them because running day to day there isn't the justification to have that stockpile that they get taxed on, takes up storage space for other critical items, and do not have a significant value add to the company. Now when this pandemic shows up and spreads in a matter of months and balloons the usage of these items significantly it puts a massive strain on the supply chain of them and does drive up the price. But the hospitals will grumpily pay the extra 50 cents for the next year or two until the market settles back down on them and go back to minimum stock of that equipment because the extra $10,000 they spent during that time saves them $11,000 in the long run or whatever the numbers come out to.

Do I agree with this practice in hospitals? Not at all. Is it poor management? It depends on the viewpoint. If you are a shareholder in the hospital getting an additional profit is seen as a good thing. If you work there and you are constantly scrounging for PPE it isn't. At the end of the day hospitals are allowed to be for profit meaning that their first priority is to the shareholders and their second priority is to their product.

 

[sheepfarmer]

Some institutions have a standing order for supplies contracted out a year at a time based on typical needs. Seems !ike if everyone wanted more g!oves etc all at once, the supplier would be in a bind. A cushion would be nice, but storage space can get tight. I am sure after this people will be rethinking the just in time idea.

 

[NHSleddog]

Ok so you run a business, let's say a tattoo parlor.
.

Unfortunately, that is a terrible analogy. A tattoo artist can not have a "run on customers". In a perfect world he can only do a few a day. An artist can also have a years worth of ink for a few hundred bucks and that is one of his cost of doing business. Same goes for his gloves. If his industry is prone to disaster or supply shortages then it is up to him to plan ahead.

A hospital has and does have a run on customers.

They should at the least have seen the writing on the wall in Jan. Poor management, bad business.

 

[Redlands]

We are not talking about million dollar equipment here. When a cat scan goes down or other lab equipment the hospital will pay top dollar for FAST repairs, often times they have a contract to cover such things. It’s the cost of doing business.

Basic things such as gloves, mask, bandages, can be stored a long time. Bought in bulk it saves money which should offset the inventory taxes or come close to it. Once again it is cost of business.

Hospitals seem to not be willing to keep emergency inventory. I also thing its bad management. Sure they want to make a profit. They also claim to be there to serve the public. What I am seeing is plenty of profit coming in the door, and the public is suffering the results of the poor stocking practices. They are already blaming the various levels of government for the lack of their private business’s poor planning. Easy to point fingers and most people will go along with it.

Services such as electrical lines and communications in times of MASSIVE damage such as from hurricanes pay what they have to and get the people and supplies needed to get the power back on. They do keep inventory and have arrangements for fast resupply when’re the stuff hits the fan. Often times lives depend on it.

Guys working lines are in danger daily, much the same as nurses. When the massive storms hit you see them in buckets in the middle of hard rains, snow, ice, often times risking their life’s with hot lines. Working way to long of long hours all because people want he electricity back on, and often times life’s depends on it.

The hospitals in my opinion have next to no good excuse. I also suspect a few years from now hospitals will be back to the way it was a year ago. What are the odds of another outbreak........

 

[ccoon520]

Unfortunately, that is a terrible analogy. A tattoo artist can not have a "run on customers". In a perfect world he can only do a few a day. An artist can also have a years worth of ink for a few hundred bucks and that is one of his cost of doing business. Same goes for his gloves. If his industry is prone to disaster or supply shortages then it is up to him to plan ahead.

A hospital has and does have a run on customers.

They should at the least have seen the writing on the wall in Jan. Poor management, bad business.

First the analogy wasn't based on a run on customers. It was to demonstrate that when something that is readily available is usually not cribbed or kept in bulk to maximize space. In something like a hospital they don't make money from storing gloves and masks they make money by throughput of people. The means they want as much patient space as possible and since hospitals are a business they need to maximize space and profits. So keeping a year's worth or even 3 months worth of gloves (even though they are just gloves) takes up a lot of room. Leaving less space for other equipment that could have a longer lead time, and they wouldn't use up expensive cribbing (if they use cribbing) to store gloves because that makes no sense. Instead what they do is rely on a supplier (like grainger or Mcmaster) to manage their inventory and keep the minimum amount on the shelves but still in stock. It is a common thing to have your PPE inventory and or nuts and bolts inventory managed by those companies and a bill sent at the end of the month because then you can free up your inventory personnel to more important things that may not move as much.

Second, I am sure that hospitals are prepared for a run on customers for the span of maybe a week or so but these have been sustained massive loads for almost a month now in the heavily affected areas and the load is just getting greater.

Thirdly in Jan. they should have started buying more? Everything was being downplayed or ignored as late as March 9th by leadership throughout the country. But hospitals are supposed to have more up to date information and move to buy a huge stock of gloves and masks for a pandemic that wouldn't be called one by the WHO until March 11th?

It doesn't help to run around blaming people. All it does is spread disdain and a good bit of misinformation. Am I saying that hospitals are managing everything well? Not at all, I have no idea. But rarely do people make decisions that they believe are a detriment to the place that they work or to the general public on purpose. My argument for them using Just In Time methodology is just from my experience in the industries that I work in and the understanding that everything in a business has a price even the slot on the shelf in a warehouse because that is space that is not producing so it is a cost to leave empty of production.

I by no means believe to know everything but I'd rather give the benefit of the doubt that hospitals weren't choosing to shorthand gloves to hurt people but were instead trying to lower costs or maximize space to improve profit margins (which I strongly believe is the case). Which is why I don't think this action is going to change unless there is government intervention saying if you are going to run a hospital for profit you have to have a minimum of some number of gloves.

 

[NHSleddog]

First the analogy wasn't based on a run on customers. ....

First off, I own a business and employ people for going on 20 years now. I understand business. I also maintain thousands of dollars of gear for "just in case". It is the cost of doing business.

I made plans in Jan and I'm not even a doctor. My wife thought it was going to be an issue in Jan. Regardless, they should already have stock.

Now, because they kept no stock they are providing sub standard care and PAYING through the nose for what supplies they can get. That is bad management and bad business. From the medical OR business side. We are not talking about millions of dollars here. We are talking about tens of thousands in a building with a budget in the tens of millions.

I totally agree on the need to require hospitals to have at least enough stock to make it to the pandemic.

 

[Poohbear]

First off, I own a business and employ people for going on 20 years now. I understand business. I also maintain thousands of dollars of gear for "just in case". It is the cost of doing business.

I made plans in Jan and I'm not even a doctor. My wife thought it was going to be an issue in Jan. Regardless, they should already have stock.

Now, because they kept no stock they are providing sub standard care and PAYING through the nose for what supplies they can get. That is bad management and bad business. From the medical OR business side. We are not talking about millions of dollars here. We are talking about tens of thousands in a building with a budget in the tens of millions.

I totally agree on the need to require hospitals to have at least enough stock to make it to the pandemic.

I have to agree. I owned an AC business for 31 years. I had some " special " tools used maybe once a year if that but when needed I needed . Parts inventory for each truck went from small in the winter to about $10K ea when warm weather started and you still found you still needed other things. I was able to nearly clear out inventory in Dec to avoid Jan 1 inventory tax . Parts houses delivered 5 days a week.
On the being prepared at home with food. A good way to look at keeping a stock especially of " canned goods " is over a period of over a year or more the value increases sometimes as much as 15%. Find me a CD paying that interest.