Telelift GmbH, Frauenstrasse 28, Maisach, Germany,

Transcription

1 Findings for a safe, hygienic and ecological transportation throughput of materials (1Kg) with Telelift Electric Track Vehicle (ETV) systems in hospitals By Winfried Oberstadt, Global Marketing Director Telelift GmbH, Frauenstrasse 28, Maisach, Germany, July 6 th, 215 Summary: The survey was made in five European and East Asia hospitals. All hospitals have between 57 and 1. inpatient beds and all provide full services. Evaluation was focused on transport safety, hygiene, monitoring and environmental impact (smart and eco) during the entire transportation (measured by throughput) by electric track vehicle (ETV) systems. The main transportation by electric track vehicle (ETV) systems were evaluated with pneumatic tube systems (PTS), conveyor belt and manual transportation with portering service. The findings of the above survey, provided a better understanding of products application and key performance that can be perceived and understood accurately. PTS (pneumatic tube system) ETV system (electric track vehicle) Porter service Abstract: From year 2, ETV system was not the main stream of materials transport in European and Asia hospitals due insufficient ETV manufacturers offering similar alternative after closure of RALFS Germany in In view of the above after 2, consultants planned a combination of pneumatic tube systems (PTS) and manual transport by porter service and maybe supplemented by automated transport system (AGV) PTS became the popular choice of application was overly perceived because of the payload (avg. 1 Kg) and volume (3. dm³) as compared to ETV payload (1-15Kg) and volume (3-35 dm³). In reality the throughput of PTS is around 1-15% supported by another 85-9% by manual portering service to fulfill hospital logistical demand. However in China market, they realized the importance of efficacy/productivity and throughput is critical due to huge patients load. As a result, they invested in about >1 large ETV systems regionally 1 annually. Furthermore, hospital logistics requires monitored, hygienic and stable processes. In such demand the ideal situation will be automation in order to achieve reliable and predictable process. On the other hand, the healthcare market is highly cost conscious and has to reduce operational costs where possible. Savings on energy usage, optimization of processes, quantity purchases and even letting go of routine jobs like porters and typists etc. is the goal. 1 Telelift UniCar reference list Oberstadt, July Results throughput automation quality in hospitals V1-

2 Survey: The questionnaires were sent to 12 hospitals from which 5 answered fully or partially. There are 2 possible reasons: Participants may not really know/understand about logistic processes in their hospital for those who had responded and also those who have not. The questions were organized into 6 groups: 1. Hospital (types & size) 2. Logistics (current methods) 3. How much & type of goods to be transported 4. Staff needed 5. Hygiene and disinfection 6. Advantage/disadvantage of existing solution Additionally, hospitals with existing ETV have been requested to present a normal working day s transport history file. The data was matched and the historical records were evaluated in order to analyze what kinds of material are usually transported by ETV in which quantity from where to where and at what time of the day. These data then has been compared with a usual working day s transport of a PTS system 2, an AGV system 3 and manual transport by porters. Results of findings: Pneumatic tube systems (PTS) convey an average of one transport per hospital bed per day. Transported goods are predominantly samples (>85%), some drugs (single dose) and some blood samples (possibility of hemolysis and inaccurate results for LDH and for ASAT), all sent in individually and separately. Initial investment costs (CAPEX) are lower than ETV systems, but only 1-15% of goods can be transported, product life time is shorter and higher operational costs. Transports / day Some hospitals operate automated guided vehicle (AGV) systems which carry standardized container trolleys for storage and transport. Goods transported are waste, linen, meals and suppliers deliveries. The investment costs are much higher than ETV systems but product life time and operational costs are comparable. Transports / day PTS deliveries in a European hospital Samples Drugs (single doses) Blood probes Others AGV deliveries in a European hospital Waste Meals Linen Central storage ETV systems carry all goods up to 1 Kg in a hospital. Empty deliveries have not been considered in the transport statistics. The transported goods are: 2, 3 Data by Quirepace UK 4 76 PTS deliveries/day in a 7 bed hospital in Europe AGV deliveries/day in a 7 bed hospital in Europe Oberstadt, July Results throughput automation quality in hospitals V1-

3 1. Samples (single) 2. Samples (bulk) 3. Blood probes 4. Sterile supplies 5. Pharmaceuticals (unit dose) 6. Pharmaceuticals (bulk) 7. Internal postal mails 8. External postal mails 9. Documents, prescriptions, attestations 1. Vaccines 11. Blood preservations 12. Intravenous drips 13. Radionuclides ETV deliveries in Nuremberghospital ETV deliveries in an Asian hospital 6 5 European hospitals usually deliver much more patients documentations as compared to Asian hospital due to different requirements of storage and archiving. Another German hospital has been analyzed and shows very similar results of transport analysis. The figures may differ in total but the transportation tasks correlation was matching ETV deliveries in Stuttgart hospital ETV deliveries/day in a 9 bed hospital in Asia ETV deliveries/day in a 1. bed hospital in Germany ETV deliveries/day in a 78 bed Hospital in Stuttgart Oberstadt, July Results throughput automation quality in hospitals V1-

4 University hospitals generally have a different assignment. In these hospitals, higher research requirements reduce the standard transports like laboratory probes or sterile goods which are the usual transportation jobs in a municipal hospital. ETV deliveries in Wuerzburg University Hospital The high quantity of Others transports in all ETV charts show that these hospitals operate a significant number of other transports apart from the main goods like pharmaceuticals, IV-bottles, documents, blood probes, samples, etc. The materials transported up to 1Kg in a hospital can be graduated to the following modes of transport: 1. Samples (single) 2. Drugs (unit dose) 3. Blood probes 4. Internal postal mail 5. External postal mail 6. Prescriptions, attestations 7. Samples (bulk) 8. Pharmaceuticals (bulk) 9. Blood preservations 1. Vaccines 11. Intravenous drips 12. Radionuclides 13. Sterile supplies 14. Waste 15. Linen 16. Meals 17. Suppliers deliveries PTS Manual transport ETV AGV From the above table ETV can perform 13 out of 17 tasks as compared to 2 key tasks. The throughput of an ETV system is very high and measureable in this case. Since the ETV has a higher payload (1Kg) and smother ride (.6m/sec or 36 meters/min) as compared to faster PTS (1Kg), the layout planning goal is to have high throughput with ETV in accordance to specified location demand and needs in close proximity made know to the Architect and Consultant Waste, linen and meals are usually transported in covered containers, so that hygiene demands are less significant. For these goods, manual transports or AGV transports are good enough ETV deliveries/day in a 57 bed University hospital in Germany Oberstadt, July Results throughput automation quality in hospitals V1-

5 Energy saving: Energy consumption between ETV and PTS is calculated as follows: Asian hospital with 9 inpatient beds 1 : ETV system voltage: U = 24V ETV vehicle current drain: I = 3A Average transport time: t = 5 min. ETV transports per day: n = 1.1 E = Energy consumption / day: U * I * t 6 * 1. E = 6.6 KWh (ETV) European hospital with 7 inpatient beds 11 : Blower quantity: n 1 = 6 Blower demand: P = 5.5 KW Duration of transport: t = 45 sec. Transports / day: n 2 = 76 Size factor between hospitals: 1.3 E = Energy consumption / day: P * t * n 2 * E = 63 KWh (PTS) PTS consumes nearly 1 times the energy than ETV systems. Portering costs: Manual transports have to use porter services to deliver all materials which are not transported automatically. Potential risks of manual transport are questionable hygienic circumstances, tardy handover, damaging of goods, thefts and unsupervised routes of transport. In addition, manual deliveries often have been outsourced. This makes controlling of actual costs complex. With the results and delivery statistic of PTS, ETV systems from European and Asian hospitals, the realistic comparison to portering service costs can be only based on assumptions. So the figures only give estimation about the analysis and no hard results. The assumptions are as follows: 1. 8% of manual deliveries of goods <1Kg in hospitals are performed 2 ways deliveries. The average distance of this transportation mode is 5 meters between 2 stations. 2. Direct on time deliveries are used where 2 ways trips are too tardy. 2% of manual deliveries of goods <1Kg in hospital is direct transport. The average distance of single direct transport is 25m. 3. The average speed is.3 m/s which include stopping, waiting times at lifts and handover duration. 4. The supposed average total hourly rate of porter service in a European hospital is 15 /hour. 5. Costs have been calculated for three European hospitals. In view of the above assumptions, the amortization of an ETV system against cost of manual transports of goods <1Kg in hospitals can be demonstrated as follows 12 : Municipal hospital Nuremberg Municipal hospital Stuttgart University hospital Wurzburg Amortization after x years An ETV system usually runs 25-3 years. With optimal use, after 4 years the payback (ROI) is achieved. After the breakeven all future deliveries are only considered as cost savings or earnings ETV transports/day à 5 min. in a 9 bed hospital in Asia PTS transports/day in a 7 bed hospital in Europe 12 Forecasted investment costs plus annual maintenance costs minus saved annual porter costs Oberstadt, July Results throughput automation quality in hospitals V1-

6 Due to the possible blood hemolysis resulting in data shift at LDH and ASAT with PTS, the stability of blood constituents can no longer be guaranteed and can cause significant errors in case of examination of blood probe dissection 13. Finally, with PTS a water condensation inside the main transporting plastic tubes or any blood leakage in plastic carriers/capsule cannot be prevented. That s why PTS (pneumatic tube systems) may have the risk of MRSA spreading affecting the delivered materials and persons in the hospital. The following diagram shows the differences for LDH analysis for probes transported by PTS. 14 Conclusion: An Automated Intelligent Delivery (AID) technology which document-tracking, hygienic, safe with predictable performance should be the gold standard for any new or existing hospital to seriously consider apart from long term throughput benefit, cost savings and environmental impact (energy) consideration. Below, our recommendations to have the Gold Standard in Automated Intelligent Delivery (AID) technology: 1. Hospital departments with high deliveries traffic e.g. laboratory, operation theatres, intensive care units and emergency rooms must be located near to each other. 2. A small service shaft (1.2 x 1.2 meter) for reaching from ground to highest floor should be considered as part of the architectural planning. 3. The Automated Intelligent Delivery (AID) must be able to updated and extended with the growing hospital needs in next 3 years with easy integration. 4. Eco planning in water and power consumption is a must due to higher annual demand and carbon footprint. 5. No compromise in Hygiene, Safety, Monitoring and Reliability (every time and all the time) for such an AID (Automated Intelligent Delivery) technology. 6. An electric track vehicle (ETV) installation is the key to the Automated Intelligent Delivery (AID) technology. Compiled by Winfried Oberstadt, March - July , 14 Oberstadt, July Results throughput automation quality in hospitals V1-