2. What factors or practices contributed to those problems?

Dartmouth–Hitchcock Medical Center (DHMC) is a large medical complex in New Hampshire, with hospitals, a medical school, and over 600 practicing physicians in its many clinics.
DHMC was growing rapidly and was encountering a major problem in the distribution of medical supplies. These supplies used to be ordered by nurses. But nurses are usually in short supply, so having nurses spending valuable time ordering supplies left them less time for their core competency—
patient care. Furthermore, having nurses handling supply orders led to inventory management problems. For example, nurses were busy and did not see inventory management as their primary concern. As a result, they tended to overorder in an effort to save time in managing inventory. At the other extreme, they sometimes waited until the last minute to order supplies, which led to costly rush orders.