SUPPLY CHAIN CHALLENGES. Making Canada Whole": Multi-Jurisdictional Collaboration as a Strategy to Advance Supply Chain Resilience for Canadian Health Systems.

This paper describes a framework that engages diverse leaders and decision-makers across Canada's federal, provincial and territorial jurisdictions to build collaboration that overcomes the silos and competition among jurisdictions during healthcare supply disruptions. The collaboration model proposes to address the challenge of fragmented and competitive approaches among Canadian jurisdictions to source and manage supply shortages, which increases the risk of harm for both patients and the healthcare workforce. Empirical evidence of outcomes and effectiveness of collaborative engagement across jurisdictions is presented to demonstrate the potential for a "Whole Canada" approach to coordinating management of supply disruptions and strategies that mitigating the risk of supply disruptions for patients and health system capacity to deliver care. Simulations were used to pilot the framework, focusing on supply management strategies that reach across Canadian jurisdictions to mitigate risks of supply shortages to ensure that all Canadians have access to safe and sustainable healthcare services.