Enhancing resilience and sustainable healthcare supply chains: integrating circular economy and dynamic barrier management

The healthcare industry heavily relies on supply chain resilience to ensure the continuous supply of medical products, equipment, and services. At the same time, awareness of sustainability in the healthcare sector is starting to emerge, as stakeholders recognize the significant impact of medical waste and the increasing pollution caused by the industry. Adopting circular economy (CE) principles can reduce environmental impact while improving supply chain performance. However, achieving both resilience and sustainability is faced with challenges such as logistics disruptions, global pandemics, and product shortages. Unpredictable events further expose vulnerabilities in this dynamic and evolving healthcare sector. The primary objective of this research is to enhance the resilience of healthcare supply chains by promoting CE strategies and implementing Dynamic Barrier Management (DBM) in planning systems. This manuscript analyses key barriers to healthcare supply chain efficiency, with a focus on preventing critical product shortages and assessing their impact on sustainability, resilience, and public health. Using the Bayesian Network (BN) model within the DBM methodology, it establishes causal relationships through discrete distribution with Boolean variables, addressing critical factors such as sustainable sourcing, demand forecasting, and supplier and logistics performance in dynamic scenarios. It focuses on Mean-Time-To-Arrival (MTTA) failure as a key driver of critical product shortages. The findings indicate that under current conditions (baseline scenario), a critical shortage increases the probability of rare shortages from 41.9% to 66.3%, representing a 25% increase over the baseline. The study applies backward propagation analysis, with the most significant scenario 2 — focusing on optimizing sourcing and operations by improving supplier performance, logistics, and quality standards. In addition, the integration of CE principles improves high impact sustainability from 38.6% to 52.2%, an improvement of almost 14%, while resilience improves by 16.7% and public health impact by 17.3%. Key performance indicators also show significant improvements over the baseline, including a 12.5% increase in reliability, a 38.8% increase in responsiveness and flexibility, and a 15.3% improvement in asset utilization. This study examines how dynamic risk management can prevent critical product shortages while improving the resilience and sustainability of healthcare supply chains. By integrating DBM into supply chain planning, healthcare organizations can better anticipate disruptions, optimize resource allocation, and strengthen overall resilience. This research benefits healthcare supply chain stakeholders by providing insights for strategic planning in the transition to a circular economy. In addition, this study contributes to the existing body of knowledge by offering a novel approach to improving the resilience and sustainability of healthcare supply chains by addressing the challenges of integrating dynamic barrier management with circular economy strategies. The research provides a comprehensive assessment of barriers and risks and offers practical solutions for stakeholders to improve supply chain operations and align with circular economy goals.