It is interesting to see how a big institution like UCDHS reacts to a new initiative that doesn’t color inside the traditional lines. I made a presentation to the Sustainability Subcommittee earlier this week called “The Trials and Tribulations of a Sustainability Initiative”, which reviewed one such adventure, best characterized as “one step forward, two steps back”. Come along for the ride, and see how the forces of good can overcome the forces of business as usual.

I was at the CleanMed conference last year, cruising the vendor booths during a break in the action (yes, there is action at a sustainability conference!), and came upon the MedShare International booth. MedShare is a really cool non-profit, based in Atlanta with a satellite in the Bay Area. They solicit donations of surplus medical supplies and equipment from hospitals and other health care entities, collect it all up, have volunteers sort it out, and ship the materials to appropriately vetted hospitals in 3rd World countries. What’s not to like? I chatted with the NorCal director, Chuck Haupt, and we agreed to stay in touch.

I was intrigued. Leigh Clary had told me about her process of collecting surplus supplies in the ED, trying to keep them out of the trash. There were rumors that a resident, Dr. Ha, was doing similar in the OR, working with a non-profit that he knew from his Yale med school days. And I had also heard about surplus supplies finding their way from PHS to the warehouse, where they would be sold or donated to non-profits. It really seemed like we had an opportunity to leverage a relationship with MedShare to formalize a donation program, one which would both divert surplus supplies from the landfill, and provide a great community benefit. Let’s do it!

So off I went, figuring out how to make this happen. I talked to Purchasing about how we could have a business relationship with MedShare, and obtained buy-in from the various folks who were working to divert these surplus supplies from the landfill so they could fulfill a better purpose. Distribution’s Troy Taylor was particularly excited, as many pallets of surplus supplies were sucking up valuable space in the warehouse. Finally, COO Vincent Johnson gave his approval to move ahead with the partnership. Off we go!

One potential roadblock was MedShare’s request of a $200/week donation to support the collection and transportation of our materials. Seemed fair to me, as it’s quite a hike to their warehouse in San Leandro, and much time would be spent by their driver going around to our many locations to collect the materials. I received guidance from a few key people on the donation, and it seemed like I had everything going in the right direction. A kick-off meeting with MedShare and UCDHS was set up, and the collection process was just weeks from commencing. Or so I thought.

Purchasing’s Bill Corbett sent me a note, suggesting that we conduct another review of UCD and UCOP policies relevant to the partnership with MedShare. Upon review, Bill thought I might be pushing the envelope a bit on this, and opined that I should get approval from campus Bargain Barn before I went any further. “Why?”, I asked. “This program saves stuff from the trash. What’s the Bargain Barn have to do with it?” Common sense intervened, and I called the Barn’s Katie Jaramillo to get her blessing for the program. A blessing is not what I received, however. Turns out that the Barn had been selling this stuff, not for much money, but selling it nonetheless, and there was a specific process for donating those materials that could not be sold. Unfortunately, the partnership with MedShare did not fit into this process, and I had to back down.

I postponed the kickoff meeting, and started to consider approaches for working around the Barn’s requirements while still keeping peace with the Barn. I was moping about this quandary for the better part of the week, but then, out of the blue, the phone rings. “Hi, John. It’s Katie Jaramillo, and I have good news for you.” Really? Really. Katie had discussed the situation with Janice King, the UCD Director of Materiel Management, and they decided that the little bit of money they received for the surplus supplies really wasn’t worth the Bargain Barn effort, which effectively reduced the value of the supplies to “de minimus”. De minimus (negligible value) provides the flexibility to engage a non-profit for distribution of the goods. The following day, Janice e-mailed a narrow exemption to policy to me, effectively permitting the partnership with MedShare to move forward. Yay, Katie! Katie was immediately gifted with a box of my chocolate chip/oatmeal cookies for her efforts.

Things were suddenly looking really good, but there was still one obstacle to overcome: that pesky $200/week donation for transportation support, which MedShare requested to be paid a year in advance. The donation was already a bit contentious when the project went off the rails. There are essentially two ways to pay for things: via a check request, or via a purchase requisition. It seemed that the check request folks felt that a purchase requisition was necessary, as that’s the way that donations are now handled on campus, and Purchasing said that a purchase requisition didn’t fit into policy regarding donations. Back and forth, back and forth. I’m sure that Bill Corbett got tired of seeing my pathetic face in his doorway. He tried to help, but felt that current policies tied his hands. Ross O’Brien in A/P did a lot of work on his end to assist, but we all ended up stuck in the middle.

As I noted in my presentation, sometimes policies just aren’t geared to take advantage of new opportunities.

I was discussing this with Bob Waste, who’s in charge of government affairs and community relations, and he had a great idea. His group provides sponsorships to a number of efforts that benefit both the community and the Health System, and it appeared that this “donation” was, in fact, a sponsorship of the MedShare partnership. If we reframed it as such, getting a check request approved should go much more smoothly.

Off I went to rework the agreement with MedShare, and the check request is now in the works. There are still a few loose ends to tie up, as I need to register MedShare with the Bargain Barn as a recognized non-profit, and there will be no shortage of logistics to figure out for the collection process. And, of course, submitting a check request is no guarantee of having a check in hand, but I think that most of those bumps have been smoothed out.

It’s been an interesting ride, and quite the learning process. For one, asking for forgiveness instead of permission probably isn’t the best way to go when wrangling with UC policies, for what appears to be wiggle-room can turn out to be the Vulcan Death Grip. However, some really good people came through to save the day, and I’m hopeful that we’ll be in full partnership with MedShare before the summer solstice arrives. It’ll be great to know that those boxes and boxes of surplus medical supplies will be supporting the efforts of a 3rd World hospital instead of filling up a landfill. Sometimes it all works out, in spite of my best efforts to foul things up.  :)

Check out the MedShare website, and…

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