# Defective PPE Received and Distributed



## mathepac (3 Apr 2020)

FROM RTE: https://www.rte.ie/news/2020/0403/1128300-ppe-covid-19-ireland/

No QC at point of receipt or no accurate specs on orders? Dail printer all over again? No comment yet from HSE or Ministers or than sycophantic response to suppliers.


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## seamus m (3 Apr 2020)

mathepac said:


> FROM RTE: https://www.rte.ie/news/2020/0403/1128300-ppe-covid-19-ireland/
> 
> No QC at point of receipt or no accurate specs on orders? Dail printer all over again? No comment yet from HSE or Ministers or than sycophantic response to suppliers.


Speaking to senior healthcare worker again (yesterday very disheartened with gear) today she's not as despondent a lot of gear although not up to standard they are used to she describes as functional.Up to yesterday they had been completely out for few days and says they are glad of it as it's all they can get


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## john luc (4 Apr 2020)

when this was commented on at the news bulletin a side comment about how many countries are trying to get all that's available and so a consignment destined for France was grappled by the USA instead


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## Watcher (4 Apr 2020)

referring to this?
*US swoop sees 3M masks allegedly diverted from Berlin*
German official denounces ‘modern piracy’ but company says it has ‘no evidence’ of seizure





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## llgon (4 Apr 2020)

I'm sure the HSE could have been much more specific in what they wanted and sent a team over to China to do QC checks before confirming the order. And the result, we would now have very little PPE in the country.

As Michael Ryan WHO said:

"The problem in society we have at the moment is that everyone is afraid of making a mistake. Everyone is afraid of the consequence of error.

But the greatest error is not to move. The greatest error is to be paralysed by the fear of failure.

Perfection is the enemy of the good when it comes to emergency management

Speed trumps perfection."


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## money_man (4 Apr 2020)

llgon said:


> I'm sure the HSE could have been much more specific in what they wanted and sent a team over to China to do QC checks before confirming the order. And the result, we would now have very little PPE in the country.
> 
> As Michael Ryan WHO said:
> 
> ...



That quote really sums up my thoughts on this to be honest. You're not going to get it 100% right but you're going to get it right enough that you keep moving forward and you deal with issues as they arise. 

The HSE have managed to secure the equivalent of 13 years worth of PPE in a matter of weeks, during a global shortage. If they need to work with the supplier so that part of that order needs to be replaced so be it. It sounds like a big win to me.


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## seamus m (4 Apr 2020)

To be fair it's probably a little bit more than a part of it .A part of it is completely unusable I presume it's the short sleeved garments .There were no respiratory masks just plain covers basically and the overall  quality was way behind what our frontline is used to. A lot of the issue is they won't say it straight up.


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## mathepac (4 Apr 2020)

money_man said:


> That quote really sums up my thoughts on this to be honest. You're not going to get it 100% right but you're going to get it right enough that you keep moving forward and you deal with issues as they arise.


Everything has a context and in the HSE we have an organisation that has been out of control since Mary Harney set it up, has never met budget targets, has a history of secrecy and lying, has killed its clients and left other seriously ill and damaged but refuses time and again to admit wrong and closes ranks when wrong-doing and incompetence is highlighted - no-one gets fired.

We don't know how much of the €208m order for PPE is useless/defective and we don't know the full consequences of such defects. 



money_man said:


> The HSE have managed to secure the equivalent of 13 years worth of PPE in a matter of weeks, during a global shortage. If they need to work with the supplier so that part of that order needs to be replaced so be it. It sounds like a big win to me.


I'd hate to think what a loss looked like. "Let's be seen to do something, anything, sure it'll be grand."


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## money_man (4 Apr 2020)

mathepac said:


> Everything has a context and in the HSE we have an organisation that has been out of control since Mary Harney set it up, has never met budget targets, has a history of secrecy and lying, has killed its clients and left other seriously ill and damaged but refuses time and again to admit wrong and closes ranks when wrong-doing and incompetence is highlighted - no-one gets fired.
> 
> We don't know how much of the €208m order for PPE is useless/defective and we don't know the full consequences of such defects.
> 
> I'd hate to think what a loss looked like. "Let's be seen to do something, anything, sure it'll be grand."



The HSE has systemic problems that is undoubtedly true. But yes, we absolutely had to do something and do it quickly or risk having a completely crippled health system (that would be quite a big loss). In a crisis you move fast and deal with issues as they arise and leave your media people deal with the commentators who through various degrees of naiveté and malice expect everything to be solved as cleanly as you might see in a 90 minute action movie.

You're right, we do not know how much of the order is defective. What we do know is only a small fraction has been delivered, not all of it is defective and they are working to ensure the rest of the order is right (I imagine, for example, it will be very easy to just make the rest of the gowns with longer sleeves).

Also worth pointing out there is more than just the HSE involved in this. The IDA had a key role too apparently.


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## llgon (5 Apr 2020)

HSE management sitting proudly in front of their PPE stock at press briefing now


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## money_man (5 Apr 2020)

llgon said:


> HSE management sitting proudly in front of their PPE stock at press briefing now



They are announcing the result of their review of the first couple of flights:

65% good to use
15% not ideal but will be used unless alternative is found
20% unusable


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## llgon (5 Apr 2020)

Prof Cormican said that the 20% won't be used by health care professionals but they can find other use for it e.g. masks with elastic ear loops not recommended for use by HCPs but could be used by patients/ public in risk situations


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## llgon (5 Apr 2020)

Flights that arrived last week represent 10 of 300 flights that are planned over coming months with PPE.  Work being done to ensure future deliveries don't have the 35% of order with issues.


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## johnwilliams (5 Apr 2020)

based on what john luc says about ppe getting diverted no guarantee we may get full order if someone else willing to pay higher price for it


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## mathepac (5 Apr 2020)

What are the chances of the HSE, its process designers or product and service suppliers getting to Six Sigma standards of excellence. For those unfamiliar with it, the widely accepted definition of a Six Sigma process is a process that produces 3.4 Defective Parts (or non-conforming outcomes)  per Million Opportunities or DPMO.

Six Sigma aims to deliver yields of *99.99966% *unlike the latest HSE debacle with the PPE which we are told produced a yield of 65%, no where near good enough for a modern healthcare organisation. Excuses like the HSE and its employees are operating under pressure is not a reason for failure to deliver excellence, it is merely a very poor excuse. Doing routine work in a normal environment is just that, routine, stress free, repetitive, day-to-day operations. Operating to a standard of excellence in a non-routine environment is called managing.

Any chance any of their director of this, manager of that, co-ordinator of something amorphous and meaningless that can't be measured will ever get to sigma seven levels of delivery? Based on their own performance measures using the PPE numbers their DPMO is somewhere between 691,462 and 308,538; Sigma Six would be 3.4 and sigma seven 0.019.


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## seamus m (5 Apr 2020)

Also out of that 65 per cent good to go they will have to retrain for use of most of it.I don't care what anyone says but I know the visors looked like they were out of a lucky bag, flimsy to say least and I didn't see any sign of 3 quarter sleeve gowns are they also in 65 per cent .


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## Purple (6 Apr 2020)

mathepac said:


> Everything has a context and in the HSE we have an organisation that has been out of control since Mary Harney set it up, has never met budget targets, has a history of secrecy and lying, has killed its clients and left other seriously ill and damaged but refuses time and again to admit wrong and closes ranks when wrong-doing and incompetence is highlighted - no-one gets fired.


In fairness the HSE was just a reorganisation of what was there. The culture of lying, waste, incompetence and killing its clients was there in the healthcare sector  long before the HSE was formed.


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## Purple (6 Apr 2020)

mathepac said:


> What are the chances of the HSE, its process designers or product and service suppliers getting to Six Sigma standards of excellence. For those unfamiliar with it, the widely accepted definition of a Six Sigma process is a process that produces 3.4 Defective Parts (or non-conforming outcomes)  per Million Opportunities or DPMO.
> 
> Six Sigma aims to deliver yields of *99.99966% *unlike the latest HSE debacle with the PPE which we are told produced a yield of 65%, no where near good enough for a modern healthcare organisation. Excuses like the HSE and its employees are operating under pressure is not a reason for failure to deliver excellence, it is merely a very poor excuse. Doing routine work in a normal environment is just that, routine, stress free, repetitive, day-to-day operations. Operating to a standard of excellence in a non-routine environment is called managing.
> 
> Any chance any of their director of this, manager of that, co-ordinator of something amorphous and meaningless that can't be measured will ever get to sigma seven levels of delivery? Based on their own performance measures using the PPE numbers their DPMO is somewhere between 691,462 and 308,538; Sigma Six would be 3.4 and sigma seven 0.019.


The issues with the Health Service run far deeper than this issue with PPE. We need to stop talking about the HSE as if it is some organisation that sits on top of the hospitals and that it is the root cause of the problems with the healthcare system. The hospitals and the doctors and nurses and administrators and managers in those hospitals are the HSE. 

This is an unprecedented crisis and people are responding in the best way they can but it is hard to suddenly become very productive and proactive after a lifetime of looking for reasons not to do your job properly. It's hard for a bloated inefficient organisation to suddenly become efficient.
This is like someone who spend 20 years eating badly and getting no exercise trying to suddenly run a marathon. They can be as willing and motivated as they like but they still have to drag their fat ass around the circuit.


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## allaround (6 Apr 2020)

will the 20% unusable be returned?, also its far from ideal having equipment (15%) that really should be in the unusable pile?, healthcare workers deserve better, the HSE press conference coming form a warehouse yesterday was that the unusable equipment in the background?


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## Daveevan34 (6 Apr 2020)

It's there in the public domain. Personal protective equipment is being made at speed in back shed sweat rooms. It's not a secret. Hammer and nails Any amount you need.. thrown in with last months Quality approved. This month will have little protective abilities. This is why healthcare are sick.


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## Purple (6 Apr 2020)

I'm aware of a number of Irish companies who have contacted the HSE with offers of everything from PPE to Respirators and have had no response at all. Some of those same companies are now supplying said equipment to the USA and Italy.

If anybody thinks the Health Service (Hospitals, HSE, Dept. of Health) have the skills and mindset to deal with this properly they are deluding themselves. 

I'm waiting for the usual deflection; blame the politicians, blame lack of resources etc. As long as that happens it'll be a case of rinse and repeat.


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## money_man (6 Apr 2020)

mathepac said:


> What are the chances of the HSE, its process designers or product and service suppliers getting to Six Sigma standards of excellence. For those unfamiliar with it, the widely accepted definition of a Six Sigma process is a process that produces 3.4 Defective Parts (or non-conforming outcomes)  per Million Opportunities or DPMO.
> 
> Six Sigma aims to deliver yields of *99.99966% *unlike the latest HSE debacle with the PPE which we are told produced a yield of 65%, no where near good enough for a modern healthcare organisation. Excuses like the HSE and its employees are operating under pressure is not a reason for failure to deliver excellence, it is merely a very poor excuse. Doing routine work in a normal environment is just that, routine, stress free, repetitive, day-to-day operations. Operating to a standard of excellence in a non-routine environment is called managing.
> 
> Any chance any of their director of this, manager of that, co-ordinator of something amorphous and meaningless that can't be measured will ever get to sigma seven levels of delivery? Based on their own performance measures using the PPE numbers their DPMO is somewhere between 691,462 and 308,538; Sigma Six would be 3.4 and sigma seven 0.019.



Im sorry what? How familiar are you with six sigma exactly? This is a rant dressed up to sound "sciency".

It is exactly routine normal work/production where 6 sigma is applied. Ramping up new production lines and producing new parts and shipping them around the world within a few weeks gives literally no time to implement the process controls and systems that produce things like six sigma production. Not to mention, the production lines were producing to a certain spec, this spec differed to what the HSE wanted, this is not a PPM type of issue...


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## Purple (6 Apr 2020)

I'm a fan of using LEAN in people heavy organisations. Six Sigma works when you are making razor blades or cans of beans or disc drives where it's tens of millions of the same thing in an automated process.
LEAN is a much better set of tools for something like a hospital or the management structure of the HSE.


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## mathepac (6 Apr 2020)

Six Sigma  is in use in healthcare organisations world-wide and indeed in supply-chain process and delivered product quality improvement. Whether that's LEAN Six Sigma or Six Sigma I think is a decent topic for debate


money_man said:


> Im sorry what?


No need to apologise. Although I know it has it's critics in very large organisation and in certain types of operations, the focus on processes and outcomes is relevant here.


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## money_man (6 Apr 2020)

mathepac said:


> Six Sigma  is in use in healthcare organisations world-wide and indeed in supply-chain process and delivered product quality improvement. Whether that's LEAN Six Sigma or Six Sigma I think is a decent topic for debate
> No need to apologise. Although I know it has it's critics in very large organisation and in certain types of operations, the focus on processes and outcomes is relevant here.


Its not, as I detailed in my comment. Its, at best, a poor understanding of how it would apply in this case. At worst, its an attempt to spread misinformation


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## Purple (6 Apr 2020)

money_man said:


> Its not, as I detailed in my comment. Its, at best, a poor understanding of how it would apply in this case. At worst, its an attempt to spread misinformation


It is used. Here's a good article on the topic, though I suspect that you are talking about the specifics of the recent shipment of PPE and mathepac is talking about our healthcare industry generally.

If you want to see chaotic and costly healthcare spend a few hours in Naas Hospital A&E. Fawlty Towers is alive and well.


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## money_man (6 Apr 2020)

Purple said:


> It is used. Here's a good article on the topic, though I suspect that you are talking about the specifics of the recent shipment of PPE and mathepac is talking about our healthcare industry generally.
> 
> If you want to see chaotic and costly healthcare spend a few hours in Naas Hospital A&E. Fawlty Towers is alive and well.


Oh ya, lean, six sigma has applications in healthcare undoubtedly. Mathepac was applying things to this order of PPE that make no sense though.


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## Purple (6 Apr 2020)

money_man said:


> Oh ya, lean, six sigma has applications in healthcare undoubtedly. Mathepac was applying things to this order of PPE that make no sense though.


I think he was talking about the Health Service in general. That's certainly what I took from his comments.


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## Purple (6 Apr 2020)

We spend €21 billion a year on healthcare in Ireland, 12% of our GNI. A half decent Six Sigma/LEAN programme would, in my opinion, save thousands of lives and billions of Euro. It may require changes in work practices, less  gravy for doctors and nurses (but especially consultants) and an overall reduction in headcount so there is zero chance of it happening. As long as the public healthcare sector is run primarily for the benefit of those who work in it rather than the public we'll continue to waste billions and people will continue to die needlessly. 
This crisis has given us a glimpse of what is possible but I just can't see anything changing; we'll have the same vested interests cynically playing the same emotive soundbites which will be lapped up by the same twits on RTE and elsewhere and the unspoken rule that we don't question or  criticise "front line wurkers" will be again cast in stone.


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## odyssey06 (7 Apr 2020)

Cork fabric company to alter some of HSE's shipment of personal protective equipment to make it suitable for use...








						Cork fabric company to alter some of HSE's shipment of personal protective equipment to make it suitable for use
					

Much of the equipment which arrived in from China has been deemed unsuitable for use.




					www.thejournal.ie


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## mathepac (7 Apr 2020)

Well done Avalon aircraft leasing who donated the use of an aircraft to bring 40 ventilators, 1m pairs of gloves, goggles and other ICU PPE from Chine. The shipment has all been quality checked at source, in advance of the HSE's poor attempt at procuring similar equipment, excluding ventilators. (RTE News)


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## mathepac (7 Apr 2020)

odyssey06 said:


> Cork fabric company to alter some of HSE's shipment of personal protective equipment to make it suitable for use...


Sterile PPE gets unboxed and worked on in a non-sterile environment, repackaged and unboxed again to be used in a sterile environment. Or will all the unboxing, re-work and repackaging be done in a certified clean-room or sterile environment by people who are free of the virus? Great idea but has anyone thought this through any more carefully than they did the  initial mess-up?


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## Sophrosyne (9 Apr 2020)

Purple said:


> We spend €21 billion a year on healthcare in Ireland, 12% of our GNI. A half decent Six Sigma/LEAN programme would, in my opinion, save thousands of lives and billions of Euro.



How do you know that LEAN/Six Sigma programmes are not implemented in the Irish health service?


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## mathepac (9 Apr 2020)

Outcomes.


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## llgon (13 Apr 2020)

Paul Reid:

Revised specification of masks received and being tested. Order 2 to begin arriving on 17th April. HSE trying to bring forward arrival of Order 3.

Gowns are a significant issue. They will be tight on them in some places. Prioritisation use will be set out.


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## mathepac (13 Apr 2020)

llgon said:


> Gowns are a significant issue. They will be tight on them in some places.


Put the obese staff on diets.


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## Purple (14 Apr 2020)

Sophrosyne said:


> How do you know that LEAN/Six Sigma programmes are not implemented in the Irish health service?


There are LEAN programmes within the health service and some have been very successful but they are local and ad hoc and completely dependent on whether the local Union brethren allow them to happen.


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