Since January, hospitals nationwide have been dealing with a saline solution shortage. Scott Crandall, senior director of medical purchasing at Novation, offers some insight into causes of the shortage and what healthcare providers can do to ease the strain of limited supplies.
Note: Answers were edited for length and clarity.
Question: What are some of the causes of the shortage?
Scott Crandall: The manufacturing capacity is maxed out. There's no ability to make more saline solution unless more capacity is added. The industry is making as much as they can right now, and it's not quite meeting the needs of the hospitals. Also, the U.S. Food and Drug Administration has required a higher level of quality inspection, so that has slowed down production. Flu season was higher than expected. It's a confluence of all those things. Baxter shut down one of their plants for maintenance in December for a couple of weeks. There are only four companies, three domestically, that make the product.. If one supplier shuts down, it impacts the whole market.
Q: What does the saline solution shortage mean for hospitals?
SC: They're having to alter their clinical protocols to make their supplies go farther. One example is telling patients to drink more water, oral hydration, as opposed to hydration through an IV bag. They're also using different sizes of saline bags. One thousand milliliter saline is really in short supply. Hospitals have gone to 500 milliliter and 250 milliliter bags, and it's becoming a strain on those sizes as well. In the past, they'd request a 1000 milliliter bag on a larger percentage of the patients. They're all getting saline from alternative sources if they can, which is becoming less possible. Ultimately, they're having to work inside their facility to monitor their supply and understand what they can use.
Q: Are there alternatives hospitals and supply chain managers can use?
SC: First thing they need to do is really understand who's ordering these supplies. If the pharmacy and the materials managers put orders in, they don't always talk to each other. All the pharmacies and materials managers on all the campuses should communicate so they can understand what is being ordered. The biggest thing we can do is make sure [clinicians] understand the clinical protocol alternatives and the best way to manage through it. Be collaborative in your institution and be educated on what your alternatives are.
Q: Is there an estimated timeline for when the shortage will lessen?
SC: When this first started in January, suppliers were telling us the shortage would be over in the next couple of months. At the end of March, the message was that this could go on for quite some time, perhaps through the end of the year, at the very least. Nobody wants to put a date on when the supply is going to be better. Ultimately, there's not a lot of new supply that's going to come onto the market in the next year. The big concern is if there is any other big disruption like a tornado or other natural disaster. With a tight supply, small disruptions or hiccups will have a dramatic impact.
More Articles on the Saline Shortage:
Saline Shortage Update: Baxter to Distribute IV Fluid From Spain
6 Strategies to Conserve IV Solution
FDA Importing Saline From Norway to Ease Shortage