I.2 Materials Handling Technologies for Hospitals

Jeff BarberSr. Applications Engineer

Swisslog

Denver, Colorado

Materials Handling Technologies for Hospitals

Demographic Trends in Healthcare

According to a 2004 Report of Social Security Trustees: – In 1950, there were 16 workers to support every 1

beneficiary of Social Security.– Today, there are only 3.3 workers supporting every Social

Security beneficiary.– And, by the time our youngest workers turn 65, there will be

only 2 workers supporting each beneficiary.

According to a report prepared by CMS:– spending for personal health care per senior citizen was

almost 400 percent greater than for those under 65.

– According to this study, over 1/3 of these senior's healthcare spending is on hospital care.

Issues Driving Healthcare

Improve Turnaround Time (TAT)Reduce operating costsEnhance patient-focused careDecrease inventoriesDecrease in-patient staysImprove service quality Consolidate support servicesConsistent quality careIncrease patient/staff safetyIncrease productivity / reduce laborReduce dependence on elevators24/7 operationIncrease space utilizationIncrease flexibility to expand facilityReduce injury to staff & facility

2005 version

Automation is the application of computer-based system to improve productivity and quality of performance.

Definitions

Automated Transport System (ATS): A computer controlled system for automatically moving materials between two or more locations.

Automated Storage & Retrieval System (ASRS): A system for automatically storing and retrieving loads from defined storage locations under computer control.

Material Handling is the movement, storage, control & protection of materials, goods and products throughout the process of manufacturingmanufacturing, distribution, consumption & disposal.

  Logistics: The problems and methods of obtaining,obtaining, transporting,transporting,

distributing, maintaining and replacingreplacing material andand personnelpersonnel.

 

2005 version

Systems for automatically storing and retrieving loads from defined storage locations under computer control.

Automated Storage & Retrieval System (ASRS)

BENEFITS:

High Cube utilization reclaiming up to 75% of floor space by using overhead space and increasing storage density

Materials are presented to the picker reducing risk of operator injuries, including repetitive motion syndrome & eliminating up to 2/3 of an operator's wasted walk and search time

Materials are stored and protected securely inside the storage units

Decreased inventory levels possible through centralized storage & control

ASRS – Vertical CarouselLinked shelves rotate vertically on oval track. Bins hold “small” materials

Up to 35 fpm

10,000 to 25,000 pound capacity

10 to 35 feet tall

Option: Pick to Light

Environmental control (clean, refrigerated or frozen)

Facility Requirements– Power (3Ø & 1Ø)– Space

ASRS - Horizontal Carousel

Linked bins rotate horizontally on oval track - Shelves hold “small to medium” size materials.

Up to 90 fpm

300 to 2,500 pound bin capacity

6-12 foot high

Option: Pick to Light

Option: Auto Extractors

Facility Requirements– Power (3Ø & 1Ø)– Space

Facility Requirements– Power (3Ø & 1Ø)– Space (higher the better)– Floor loading on grade

S/R Machine travels horizontally on floor rail w/ a vertical moving extractor to store & retrieve payloads from rack structure on both sides of aisle.

200 to 500 fpm

50 to 10,000 pound loads

10 to 100 foot high

Environmental control (clean, refrigerated or frozen)

ASRS – Crane In Aisle

ASRS – Box Picker Fast controlled-access storage (small crane in aisle) for meds & supplies in bins. Secure or limited access to 1 bin at a time.

Bins 14”L x 7”W x 3.3” H

687 bins in 75 sq ft.

Store/Pick to 200 / hr.

High capacity drawers

Interface to IT system for access & inventory control

Facility Requirements– Power (3Ø)– Location space

Packaging DispensingStorage

From Bulk Stock

To Patient

To Bar-Coded Unit Dose

To Storage

ASRS / Automated Drug Management (ADMS)

Increases Patient Safety On demand & daily schedule Integrates with CPOE Facilitates bedside verification Complies w/ FDA Unit-

Dose Bar Codes

Facility Requirements– Power (3Ø & 1Ø) – Compressed Air

Automated Transport System (ATS)

Systems that transport unit-load payloads horizontally and/or vertically between two or a multitude of station locations.

BENEFITS:

Improve Turnaround Time (TAT) – decrease in-patient stays

Increase productivity / reduce labor

Reduce dependence on elevators

Enhance patient-focused care / Improve service quality

Reduce operating costs

Reduce injury to staff & facility

ATS - Pneumatic Tube System (PTS)

Blowers use vacuum and pressure to propel 4” or 6” Ø carriers through steel tubes & transfer units from one station to another.

On Demand

Speeds up to 1,500 fpm

Small materials to 15 lbs

2 to 100+ stations

New & Existing buildings

Facility Requirements– Power (1Ø & 3Ø)– Stations recessed in walls– Diverters in ceiling or shaft– OH Space for Interzone

Carriers

Transfer Units/Diverters

BlowerStation

Computer ControlTubing

PTS – Components

PTS – Features / Benefits

Increases efficiency & productivity

Traverses long distances –outside, overhead, underground, across multi-building campuses

Enhanced patient care

Multiple departments share costs & benefits

ROI in 18 months (on average)

“Point-of-Care” benefits

Reduces elevator traffic

•Technological Advancements • RFID carrier tracking• Multiple carrier transport • Leak-resistant carriers • High volume, long distance transport

ATS - Track Vehicle System (TVS)

Individually powered cars travel on aluminum tracks and transfer units using 24 volt power rails.

On Demand

Payloads to 50 lbs

Up to 500 cars @120 fpm

Systems from 2 to dozens of stations

New & existing buildings

Facility Requirements– Power (1Ø)– Stations recessed in wall – Diverters in ceiling or shaft

TVS – Features / Benefits

Quiet & secure

Vertical and horizontal movement

Variable size containers

Modular track for flexibility

Pass through fire-rated walls where UL listed fire doors are installed

Reduces elevator traffic

ATS- Selective Vertical Conveyor (SVC)

Fiberglass tote boxes move vertically on cars between floors & horizontally on roller conveyors.

Up to 12 totes/minute

Up to 60 lbs capacity

17”W x 20.5”L x 18” H Tote

From 2 to dozens of stations

Designed into new buildings

Facility Requirements– Power (3Ø and 1Ø)– Vertical Shaft for chain,

cars, drive, take ups & station stack

Station Output

Operator Panel

Tote

Chain

Station Input

Drive

Take Up

Selective Vertical Conveyor

Reduces elevator traffic Reduces traffic in common

areas Promotes security Fast efficient deliveries Reduces manual transport Enhances staff availability Quite, non-disruptive work

environment

SVC – Features / Benefits

ATS – Automatic Guided Vehicle System (AGV)

Battery powered, computer controlled vehicles move carts between service and nursing areas

Bulk loads

Up to 230 fpm

Up to 1,000 lbs capacity

From 2 to 100+ stations

New buildings or replace old OH Rail / AGV systems

Facility Requirements– Power (3Ø and 1Ø)– Egress space in aisles– Elevators w/ holding rooms– Fire door interface

Technological Advances• Contour-following laser guidance• Non-contact laser obstacle detection• Quick charging batteries• Windows-based control system

AGV - Material Flows in the Hospital

PatientFloors

Kitchen Laundry

LoadingDock

Cafeteria CentralSupply

OperatingRooms

Clean Linen

Soiled LinenSoiled Dishes

Patient Food

Trash

Bulk Food

Trash

Bulk SuppliesBulk Food

Sterile SuppliesIn Case Carts

Supplies

AGV System CartsAGV – Material Carts

Clean & soiled LinenPatient Food / Soiled

Dishes

Trash

Bulk Supplies

Sterile Supplies in Case Carts

Central Supplies

Mobile Robots & Self Guided VehicleATS - Mobile Robot Vehicles (MRV) & Self Guided Vehicles (SGV)

HOW HOSPITALS USE ATSAutomated System

Pneumatic Tube Systems

(PTS)

Track Vehicle Systems (TVS)

Selective Vertical Conveyor (SVC)

Automated Guided Vehicle Systems (AGV)

Application Light unit load, high-speed transport—

-Pharmacy Meds

-Lab specimens

-Supplies

-Paperwork

Medium-weight unit load, lower-speed transport

- Medical Records & Central Supply

- X-ray film

- Intra-Laboratory Transport

- Bulk pharmaceuticals

Medium-weight unit load, lower-speed transport

- Mail

- Parcels

- Internal

paperwork

- Supplies

Bulk, lower speed transport (on-demand and scheduled)

- Meal trays

- Clean & soiled

laundry

- Central supplies

- Surgical supplies

- Trash

- Bio-hazard waste

ATS – Summary & Comparison

Automated System

Payload Speed Flexibility Expand-ability

Facility Mod Required

Cost

Pneumatic Tube Systems

Light – Up to 10 lbs

1,500 feet per minute

High High Moderate to Low

Moderate

Track Vehicle Systems

Light-Up to 25 pounds

100 feet per minute

Moderate Moderate Moderate Moderate-High

Selective Vertical Conveyor

Moderate-Up to 60 lbs.

12 dispatches at up to 68 feet per minute

Low Low Moderate to High

Moderate

Automated Guided Vehicles

Heavy-UP to 1,000 lbs.

20-230 feet per minute

Moderate Moderate-High

Moderate to Low

Moderate-High

Will ATS / ASRS will benefit you? Questions to Answer……

Do you move or store material on a routine, random or on demand basis?Do you have a need for rapid or bulk transport?Do you have a centralized pharmacy or laboratory?How many departments will want or need to use the automated material handling system?How many transactions will be performed & during what time frame (What is the to/from Matrix)?What are the benefits you want to achieve and how will they contribute to a financial justification?How much storage is required?

What should be in a system specification?

What are the needs of each participating department?What is the traffic matrix & quantity during peak times?What type of post-installation testing will be required?How will you ensure selection of the appropriate system and specification?How will you hold the vendor responsible for meeting qualification? Do system specifications include system requirements, vendor qualification, and other safeguards?Does the vendor have architectural guide specifications in CSI format?What pre-qualifications are necessary?How will your vendor’s responses be evaluated?Will vendors bid to pre-designed layout?Are there any special features required?Who will service the system?

Total SystemCosts

*AccumulatedBenefits

True System Costs

Evaluate True System Cost Pneumatic Tube System Example

Initial Installation

Operating/Downtime

Costs

Maintenance Costs

Total SystemCosts

*Accumulated benefits include Turnaround Time (TAT), improved patient care, reduction of inventories, reduction of errors and labor savings.

Cost of Ownership Pneumatic Tube System Example

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Labor cost

System Cost

Breakeven Point

Total Savings = $4,364,000

Pneumatic Tube Systems usually pay for themselves in less than 2 years

System Costs - $350,000

Labor Costs = 10 FTEs @ $10.35/hr with 5.6% annual inflation

Maintenance Costs = 0.3 FTEs @ $10.45/hr with 5.6% annual inflation

8 CRITICAL MEASUREMENTS

A reputable vendor

A reliable system

An easy-to-use system

A system that handles required traffic

Minimal facility disruption during installation

A cost-justified system

A vendor with superior customer support organization

Health and Safety

Installation Considerations

Submittal packageEquipment detailsPower regulationsAnchorage details Seismic supportsCoring & Fire Stop Methods Plenum Cable, Tie-Rap Cable or ConduitProject scheduleCode issues

Security and storage requirementsContract managementCAD support needsCoordination needsDimensional requirementsUnion labor requirementsWorkplace requirementsStorage requirementsInfection control

Questions Please!

Thank you for your patience & attention!