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Stanford Health Services has automated supply services for fast turnaround and recapture of lost charges. Satellite stock rooms on the units keep day-to-day supplies, which are ordered by procedure to eliminate unnecessary supplies. The four-year-old program has more than paid for itself, saving the system almost $15 million in labor and inventory costs.
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It's a battle of wits in the war to gain storage space. Plus, storage systems fax poll: your chance to tell manufacturers about what you need in storage equipment.
Three large hospital-based stockless inventory systems are described. First, the method of stockless inventory is described in some detail and differentiated from the just-in-time (JIT) method of inventory management. Second, three hospital case studies involving successful stockless systems are summarized and evaluated. Finally, some important implications for the implementation of stockless inventory systems are summarized for hospital management.
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BACKGROUND: The pneumatic tube system (PTS) has been implicated in inducing haemolysis. It is not known whether certain sample types are more susceptible to haemolysis than others. We assessed the level of haemolysis in commonly used sample types in the clinical biochemistry department when transported through the PTS. METHOD: Blood was collected in pairs for different sample types and sent to the laboratory via the pneumatic tube or delivered by a porter. Haemolysis indices were measured spectrophotometrically and compared for each pair of sample type. RESULTS: Our results suggest that plain serum samples are more susceptible to haemolysis than the other sample types when sent through our PTS (P <0.0001). Compared with serum with gel samples, plain serum samples are more prone to haemolysis (P <0.001). This suggests that gel may confer some protection against haemolysis. CONCLUSION: Different hospitals will have varying system configurations and use different sample types. We recommend that each hospital investigate their own system to assess whether haemolysis is a recurring problem in any of the sample types transported.
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In anticipation of the temporary relocation of Surgical Pathology some distance from the operating rooms, a "pneumatic" tube system was installed to transport fresh tissue from surgery to pathology at the Hospital of the University of Pennsylvania. The point-to-point 4-inch internal diameter system is actually of the blower or "pea-shooter" type. Side-opening carriers were preferred, and electronic sensors were installed for monitoring and safety. At the pathology end of the system, a complete panel of electrical controls exist that are capable of initiating the blower at either end, enabling full control. For possible future retrieval of stuck carriers, several points of mechanical entry were desired and constructed. The transit time over 886 feet varies with the weight of the specimen but averages 25-35 seconds. Thus far, after 32 months and 12,652 transits, no specimens have been lost or damaged. During the first few months, two specimens became stuck for reasons relating to human error but were easily retrieved. This system, in conjunction with operating room telephone intercoms, has become fully accepted and trusted by surgeons and pathologists.
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As CFOs assume responsibility for the materials management function because of the potential to maximize cash flow, achieve economies of scale, decrease costs, and streamline operations, they look for guidelines to evaluate performance. Conducting a systems operations audit can aid in assessing that performance. CFOs can determine whether materials management processes are working "smarter, nor harder."
CONTEXT: Many remote hospitals keep small on-site stocks of red blood cell (RBC) units for emergency use and to support patient care programs. In Canada, the blood supplier does not accept returned units into inventory. Discard rates can, therefore, be high. OBJECTIVE: To transport near-outdate RBC units to a high-usage hospital site, which would reduce overall discard rates, thereby increasing overall stock levels available in the blood system. DESIGN: A blood transportation system was developed and validated. The validation was presented to a high-usage site that agreed to accept near-outdate RBC units transported by this system. Stocks at the remote hospitals were optimized without increasing system-wide discard rates. The redistribution program was implemented in 4 remote sites in northern Alberta, Canada. The final disposition of each transported unit was tracked. Data from the first 2 years were analyzed. RESULTS: Between April 1, 2003, and March 31, 2005, 106 RBC units were successfully transported to and transfused at the high-usage site. The majority of the units were group O. None of the transfused units were involved in any reported transfusion reactions. The success rate of the transportation system varied among the sites (59%-78% successfully transported and transfused). Changes to the transport system were implemented as problems were discovered. The use of a temperature monitor in each shipment allowed for concurrent revalidation after each change. CONCLUSIONS: Redistribution systems can be an effective way to reduce RBC unit discard rates. Even simple transportation systems have many factors affecting the RBC unit temperature. Novel temperature stabilizing materials may make future transportation of RBC units more reliable.
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This article describes a typical Gordon Friesen-design institution in which the facility design and systems design complement one another to make an efficiently run hospital. The basic concepts of the hospital are to keep the nurse with the patient and to maintain a steady supply flow by centralizing responsibility for materials. Problems that occur in pharmacies of facilities designed by Friesen usually are related to logistics. The design of the institution make delivery of medication and communication with staff nurses more difficult. Pharmacy programs such as unit dose and intravenous admixtures, excellent examples of products in "patient-ready units," complement the other supply delivery systems that are typical of a Friesen-design institution. Good written and verbal communications between nursing staff and pharmacy can bring about a smoothly flowing pharmacy service that blends with the overall concept.