Storage solutions pack big punch in little space

No one ever has enough space, and in hospitals that goes double. That’s where creativity, careful planning and flexibility come into play. Healthcare storage companies today offer a multitude of options beyond simple shelves and bins – clever solutions that can ultimately save much more than space, including time, money, and as any nurse can attest to, more than a few headaches.

When it comes to optimizing precious space, high density storage solutions are becoming increasingly adept at tucking away supplies in nooks and crannies, while at the same time making it easier for workers to locate needed items. Suddenly finding stock is a lot less like looking for a needle in a haystack.

Moveable aisle systems

One company that offers high density storage solutions is Spacesaver, with its moveable-aisle mobile systems that eliminates space between multiple aisles. The benefits of a high density mobile system include added efficiency and inventory control by positioning more supplies near the point of use. Spacesaver claims that their smaller footprint has the capability of increasing storage capacity by as much as 100 percent over standard storage systems. The Spacesaver systems are available in manual, mechanical assist systems that work on a chain drive; electric powered; and programmable options depending on the facility’s budget or automation requirements. The system includes rails that are recessed into the floor that avoid the risk of tripping over exposed tracks.

Spacesaver has been providing healthcare storage solutions since 1972, and has developed a network of contractors across the country who are experts in the systems, and will work with you from the planning and design stages.

One such contractor is E. Coleman Goodwin of the Walter H. Hopkins Company in Atlanta, who oversaw an installation at Kennestone Hospital in Marietta, GA. The hospital had expanded their Surgical Services department adding a new self-contained wing. Goodwin installed twin mechanical assist mobile systems for Kennestone in the wing’s central core in order to house all surgical supplies and instruments in one location, outside of the O.R. The facility’s surgical services supply coordinator, Kate Shandley, says this helps to open up the O.R. and gives them the added benefit of preventing cross contamination of sterile supplies.

Another Spacesaver installation, at Medical College of Pennsylvania, a member of the Tenet group purchasing organization, involved remodeling the operating room (OR) suite and incorporating a Spacesaver mobile storage system in the sterile supply room to free up space for operating room expansions. It was able to centralize all sterile supplies — which had formerly been scattered throughout the procedure rooms — in one storeroom in the OR corridor.

Lisa Czyzewski, OR director explained that by consolidating the sterile supply inventory, she’s been able to reduce the amount of sterile supply inventory and meet the hospital’s operational streamlining goals. "It was difficult to maintain a cost-effective level of supply inventory when we had supplies scattered," she said. "With everything in one place, we have been able to cut inventory." The change also made it easier for the sterile processing technicians to get case carts assembled. They complete their sterile processing of instruments the night before a procedure and bring it into the OR area on a case cart where they add their sterile supplies. Whereas before they had to go to three floors and multiple rooms to find the items needed. Now they are faster and more accurate — and no time is wasted if a supply is urgently needed during a procedure.

Top-track moveable aisles

Another variation of the moveable aisle concept can be found in InterMetro’s Super Erecta Top-Track System. Mobile storage units on casters are positioned between stationary units, with a single aisle. Users move the units along the top-mounted railing system to create an aisle where needed between any two units. Metro says this system increases storage capacity by 25% without increasing floor space.

The systems require no drilling or bolting into the floor. And with the overhead track, there’s little chance for dirt and debris accumulation; plus the system allows easy access between units with a utility cart.

Warehousing meets healthcare

Many companies are adopting philosophies borrowed from warehousing. Automated storage and retrieval systems technology that has been used for years in warehousing operations are surfacing in automated   supply storage systems for healthcare.

Swisslog, which also delivers medication storage solutions, has introduced its BoxPicker Automated Supply Management System. The BoxPickerCS stores and dispenses items in individual storage bins. The basic system would consist of three storage modules and one operator station. The operator fills a bin with supplies and via a robotic crane that moves vertically and horizontally within the system, BoxPickerCS automatically stores it on racking inside a secure enclosure. All transactions start and finish through a controlled-access drawer. Information concerning bin contents is entered at the work station on the keyboard or using the barcode scanner. A drawer then releases, and presents a storage bin for loading. The operator fills the bin, closes the drawer and the system stores the bin on the racking. Automatic storage and retrieval proceeds inside the unit while the operator is loading and unloading bins.

According to Andy Youtz, Director, Automated Drug Management Systems, Swisslog, the robotic technology of the automated crane is a tried and true technology borrowed from warehousing.

The system allows 24/7 unattended access to supplies; plus the security of controlled access to authorized operators only. Software that tracks inventory and operator access interfaces directly with hospital information systems. The systems, which are custom configurable in 4’ long modules for easy add-on ability incorporate up to 687 bins in less than 75 sq.ft.

The company says it allows up to five bins to be
accessed per minute. To allow for multiple workers, additional operator stations can be added on the same or opposite side of BoxPickerCS. Swisslog proposes that, located along a wall with operator stations on opposite sides, BoxPickerCS could enable loading inside CS and retrieval access outside CS; with retrieval being the same process in reverse.

For hospitals that want additional levels of automated supply delivery, Swisslog offers its AGV systems, which are used to deliver supplies throughout healthcare facilities. The AGVs are known generically in warehousing/distribution as an ASRS, automated storage and retrieval system.

Interchangeable parts

Other companies offer products designed with interchangeable parts in mind, to make the healthcare worker’s job in getting supplies from storage to the patient easier.

Mark Roberts with Herman Miller says "One of our strengths is our breadth of line and the ability to interchange components. One of our labor saving features is a drawer that integrates with all the clinical product lines we offer."

He describes an easy-to-clean, durable drawer that is held in place by a C-Frame that can easily be removed without tools. This allows the drawers to fit into both mobile and stationary applications including Herman Millers’ carts, workstations, wire carts, wall mounted storage units and casework cabinets. The drawers can also be hung from a work table.

Herman Miller offers its own version of a moveable aisles product which Roberts says offers numerous components to accommodate specific materials, allowing storage of small items and large items on the same vertical plane. Components adjust in one inch increments to eliminate unused space.

Dedicated healthcare storage

Sometimes a facility needs the input of a dedicated healthcare storage company. One such company is Innerspace/Datel, which was founded twenty years ago by a cath lab nurse who saw the need for organized storage systems specifically made for healthcare. The company’s entire focus is healthcare storage and inventory management.

Notes Shannon Bennett of Innerspace, "Often times, departments are equipped with off-the-shelf casework that does not take into account the specialized storage needs in the clinical environment. By building in versatility, you allow a department to change their cabinets or cart configurations as their needs change. With modular storage solutions, we can accomplish the goal of storing a lot of inventory in a small space."

Bennett says Innerspace’s modular systems also incorporate the same bins and drawers as its mobile cart solutions. "Stock rotation is simplified when your procedure carts accept the same storage components as the cabinets in your supply room."

InnerSpace has also begun to offer its spaceTRAX™ inventory management solution. The web based software package allows the facility to manage inventory items using the existing bar code information already printed on the packages. The system provides advance notices of product expirations and automatic reorder notifications and alerts.

Carousel technology

Another option for healthcare facility storage involves automated carousel systems. Remstar International (Westbrook, ME) offers wire shelving carousel systems that allow high density storage through its rotating shelves.

A single picker operates the workstation at the end of a four-carousel cluster. Supplies are brought to the picker, rather than the picker walking to the supplies. The software-driven carousels stay several picks ahead of the operator, automatically turning via the shortest path to pre-position and present the correct carriers for picking. Pick Light Towers tell the worker which shelf on which carrier to pick from, and the quantity.

Remstar recently completed an installation for Children’s & Woman’s Health Center of British Columbia (C&W), Vancouver, and Richmond General Hospital, Richmond B.C. The two facilities agreed to unify their separate medical supply warehousing activities under a central warehouse run by the Logistics Operations Department at C&W. This allowed the facilities to consolidate inventory, increase their bulk buying power and reduce overall storage space and manpower. Richmond General Hospital was able to eliminate its on-site warehouse.

                                       Herman Miller

Remstar installed a horizontal carousel system in the 12,000 square foot warehouse space. The carousels store some 70% of SKUs handled by the warehouse — mostly smaller medical and surgical materials such as bandages, needles, gauze, laboratory devices, catheters, masks, respiratory devices, etc., arrayed in totes and cartons. Prior to the consolidation and automation, C&W picked entirely manually from shelves and racks via paper pick lists. Says Melinda Mui, Melinda Mui, Director of Logistics Operations at C&W, says, "I estimate that continuing with just shelf and rack storage, had room been available, would have required about 50% more floor space," Mui said. "The carousels are inherently more space efficient because aisles are unnecessary. Further, more of the overhead cube was utilized by specifying 9 and 10 foot high carriers."

She adds that the carousel system throughput improved by as much as 500%. "While our manual pick rate, then and now, is only 35 or 40 lines an hour, the pick rate from the carousel system is 150 to 200 lines an hour," Mui emphasized.

Inventory turns have also improved by more than 40%. "The warehouse’s overall inventory turns have improved from an average of 12 per year to around 17, said Mui. "Although turns are low for such items as forms and stationery, they rise as high as 22 per year for some medical and surgical devices. The Remstar carousel system has helped boost turns because of its automated and paperless picking and replenishment and its direct link to the C&W inventory control host computer."

To speed picking and enhance worker ergonomics, the highest volume supplies are positioned in a golden zone (from knee-to-shoulder height) that minimizes operator stooping and ladder climbing.

Up to 10 orders are simultaneously batch-picked and placed in totes at the cluster’s workstation. Put-lights direct the operator to place the correct quantity of supplies into each tote. When the batch of totes is complete, they are consolidated with the bulk items and transported to a marshalling area for delivery.

The carousel system’s control software is electronically linked to the inventory host system. The host provides both picking and replenishment inventory tracking, maintains the carrier and shelf location numbers, and processes incoming orders from the various healthcare facility clients. The carousel control software prints barcode labels that are affixed to the empty totes by the picker.

Replenishment is also automated — but in the reverse of picking. The carousel Pick Light Towers direct the operator to put away each SKU in turn on the indicated carousel carrier and shelf. While the operator is putting away one SKU, the other carousels are automatically being pre-positioned to allow the operator to work as fast as he can.

"The carousel system is very user-friendly," Mui explained. "Any one of the warehouse workers can be assigned to operate it, and it’s easy to train new pickers because the Pick Light Towers and put-lights make the work so obvious. It’s actually more difficult to train someone to manually pick shelves and racks from paper lists."

Remstar also offers its Shuttle™Vertical Lift Module (VLM) that it says can save up to 75 percent of floor space. The Shuttle VLM is an enclosed system of vertically arranged trays, an ergonomically designed extraction platform and computerized controls. It delivers stored materials to the operator at an ergonomically correct height, about waist level, for removal without bending, squatting or climbing. An optional wheeled cart that docks to the Shuttle VLM’s extraction platform allows heavy trays of items to be easily transported to several workstations.

Storage trays can be compartmentalized with partitions and divider systems for storage of smaller items. Several Shuttle VLMs can be placed side-by-side or back-to-back to form a compact, efficient automated storage and retrieval cluster.

Integrated medication and
supply storage

AmerisourceBergen recently introduced its MedSelect line, which includes an integrated group of automated dispensing cabinets and software systems for pharmaceuticals (MedSelect Rx) and medical supplies (SupplySource). The company’s computerized cabinets are customizable, modular and secure; and are linked to a centralized database network that tracks inventory, usage by both patient and provider and other data. The company says its SupplySource helps to reduce steps in the supply chain that impact labor and inventory costs. The high volume storage of the Supply Tower Module has 26 cubic feet of storage capacity. The system can accommodate a scanner module that utilizes bar code technology.

Wire shelving systems

Conventional wire shelving units include InterMetro’s Super Adjustable shelves that are available in a variety of widths and lengths. According to Dave Salus, Marketing Manager, InterMetro first patented wire shelving in the 1950s, and now has a patented system that allows its shelves to be adjusted at 1-inch intervals with unprecedented ease, and without tools. A corner release lever releases tension that inevitably settles in shelving units as heavy items are placed on them, making it easy to readjust them. The shelves are designed to minimize dust accumulation and allow free circulation of air. Super Adjustable Shelves are also available with built-in Microban® protection.

                                                       Remstar International

Meeting codes

One important factor to keep in mind when installing high-density storage systems, Spacesaver’s Goodwin spoke about the importance of adherence to codes regarding floor loading, accessibility, seismic and fire protection among others. As a contractor, Goodwin is well aware of the restrictions placed on those installing high-density storage systems. He’s had to reinforce flooring at hospitals due to the fact that the high-density storage systems pack so many supplies, and ultimately weight, into a concentrated space. He describes these structural requirements, including seismic protection codes and even ADA compliance in terms of handle placement, as "hot issues" due to liability reasons.

Spacesaver systems were awarded OSHPD (Office of Statewide Health Planning & Development) Pre-Approval by the state of California for meeting the strictest seismic requirements for safety, security and stability under the new seismic code for hospital installations.