News Flash

The Department continues to monitor the situation regarding the International Longshoremen’s Association (ILA) workers strike at US ports (including Boston), which began October 01, 2024. To compound this supply concern, Baxter International's North Cove plant, which manufactures 60% of the domestic supply of IV solutions, producing 1.5 million bags per day has been impacted by Hurricane Helene.  Given the potential of both events to have a significant impact on supply chains, we’re asking Emergency Preparedness and Supply/Logistics staff across all health care systems (hospitals, long-term care facilities, clinics, dialysis, EMS, etc.) to consider strategies and planning to minimize effects on patient care.

ILA Worker’s Strike:

Given the strike and its unknown duration, facilities across the health care system should expect backlogs, higher costs, and ongoing delays in acquiring products such as medical supplies and medications. It is likely that many shipments expected to arrive in impacted East Coast ports will be rerouted to West Coast ports, leading to increased lead times, fuel costs, and cargo prices.  As a reminder, given the impacts to the supply chain, the Department is recommending steps be taken to lessen any impacts on the healthcare system:

1. Engaging with supply, ordering, and pharmacy teams to assess and prioritize inventories.  Identify supplies that may be critical to service models that may be impacted and consider if on hand inventory should be increased.
2. Making a determination regarding what “par” (Periodic Automatic Replenishment) levels could be increased prior to any interruption is recommended. 
   1. ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE)’s Disaster Available Supplies in Hospitals https://dashtool.org/ tool can assist in estimating supplies that may need to be immediately available. DASH recommends average par levels for specific supplies that acute care hospitals may need to have on hand to respond to a disaster in their community for the first 48h until resupplied.
3. Collaborating within your healthcare systems to assess needs and implement situational awareness for addressing shortages and interruptions.  The process for obtaining supplies during a critical shortage should start internally, and then your regional network via the Health and Medical Coordinating Coalitions (HMCC)s. The HMCCs can advance requests to the state to look for the scarce resource statewide, as needed.

Baxter Plant Disruption:

Baxter has reported the timeline for resuming full production is uncertain, and as a result, facilities should plan for potential ongoing shortages. In a press release shared by Baxter, they state “Baxter is communicating with its customers about the actions the company is taking to minimize potential disruptions. These include actively managing inventory and implementing a protective allocation process by product line to help support supply continuity and equitable product distribution. The company will leverage Baxter's global manufacturing network to help mitigate potential supply impact as it continues efforts to fully restore North Cove's manufacturing operations.”

While Baxter continues to coordinate with federal agencies and group purchasing organizations, they have recommended steps for hospitals and other health care entities (where able) to take in managing and conserving current IV fluid inventories.  The topics of Baxter’s Management and Conservation Practices (full text attached) are:

1. Evaluate Inventory
2. Evaluate Clinical Needs
3. Identify Alternative Sources of Solutions and Medications
4. Optimize Fluid Management
5. Assess Pharmacy Operational Strategies
6. Engage Clinical Teams

ASHP Conservation and Management Suggestions:

The American Society of Health-System Pharmacists (ASHP) has published suggestions for management and conservation of IV solutions, which can be found here.

The Department continues to closely monitor both situations and will provide updates as more information becomes available. In the meantime, please ensure that your health care agencies are communicating with supply officers and distributors to confirm the availability of supplies, medications, and IV fluids and explore alternative suppliers if necessary. While we anticipate each situation may lead to a surge in demand, we ask that everyone work together in implementing conservation strategies to prevent further strain on the supply chain.  We would also ask that you proactively communicate with your HMCC to share impacts within your systems and the HMCCs will in turn share these challenges with the Department.   If you are experiencing critical resource shortages, please reach to your HMCCs for any critical requests that cannot be sourced internally, who may then contact the Department for sharing statewide.  Thank you for your cooperation during these challenges, and please reach out with any questions or concerns. If you need assistance from the Department in communicating with your HMCC then please email: DPH-ESF-8@mass.gov.