The adage, "doing more with less" is far from new in healthcare. Today’s hospitals continue to face workforce and resource shortages, and despite those challenges, departments are forced to manage more patients, caseloads, instrumentation, and physician requests than ever before.

If that weren’t bad enough, healthcare organizations are also doing more with less in regard to storage. Much less, in fact. In many cases, doors are being permanently closed on storage rooms, closets and warehouses to make room for revenue-generating areas, such as labs, diagnostic centers and surgical suites.

"The number one storage and supply organization challenge facing healthcare is the lack of physical space. The rooms and supply areas simply aren’t big enough or there aren’t enough of them to hold everything a facility needs," noted Nick Klusty, vice president, US. West region, LogiQuip LLC, Battle Creek, MI.

Space limitations don’t appear to discriminate, either. Although older healthcare facilities may be particularly storage-challenged because they are often forced to maximize revenue-generating square footage in an effort to stay competitive, newer hospitals aren’t exactly exempt from storage woes.

"We’re seeing a lot of storage challenges with new facilities as well. Although storage is important, it’s often an afterthought in new construction and renovation plans because most of the focus is placed on more patient beds and patient care areas," said Taylor Gilbreath, a storage expert with Omaha, NE-based Midwest Storage Solutions Inc. Midwest Storage Solutions is a contractor for Spacesaver Corp.

Those trends are having a direct and negative impact on supply organization and utilization. After all, the more patient procedure rooms are created, the more supplies will be needed to keep them up and running.

So where will all those supplies be stashed? It’s a valid question that’s being asked with growing frequency. And oftentimes, those in charge of supplies are finding that their employers have few reasonable answers to the ever-increasing storage conundrum. Not surprisingly, central supply and sterile processing areas face some of the greatest storage shortcomings. Although the departments serve as a core supplier of sterile supplies for surgical services, the emergency department and critical care nursing areas, CS’ storage needs are often at the bottom of a hospital’s list of priorities.

"Central Supply and sterile processing are often the departments that lose space to other uses," said Lisa Van Deusen, marketing coordinator for IRSG, a comprehensive shelving and storage solutions provider based in Woodinville, WA.

The ED and pharmacy, with their fast-moving, constantly revolving supplies, and the O.R., with its increasingly limited floor space, also tend to be short of storage space. Of course, space is at a premium in virtually every department in the healthcare organization, so every inch of space that can be utilized more effectively should be a top priority, Van Deusen pointed out.

"Keeping supplies easily accessible without using more space, as well as allowing for mobility to a specific area of use, are very important factors."

Stacking up the options

If space constraints weren’t challenging enough, many facilities are stuck in the draconian mindset that storage solutions are limited to basic wire racks and shelving units.

Gilbreath said it’s not uncommon to find every type of supply, regardless of size or inventory par levels, being stowed on wire racks. Then, whatever won’t fit on those racks often finds an unsuitable resting spot on the floor – or crammed in any available nook and cranny. Although wire storage solutions do have their place, he said they aren’t a good choice for certain supplies, such as small packages, tapes, tubing and gauzes. Wire racks can also serve as serious dust collectors.

Although many facilities try to solve these problems by storing items in bins, vendors stressed that relying too heavily on them can take a substantial bite out of already limited space.

"The key is to eliminate wasted cubic space within any particular shelving unit. On a typical wire shelving unit, for example, there are about 15 inches of space – up and down — between the shelves, and the shelves are typically 24 inches deep, front to back," explained Klusty. "If they are storing supplies on that shelf in a plastic bin that is 14 inches deep and eight inches high, they are wasting ten inches behind the bin and seven inches above it."

Other common problems include using storage units that don’t make the most of available vertical space and relying on different storage solutions that don’t work well with one another and don’t allow for cohesive, standardized supply storage. The outcome, vendors agreed, can resemble a disorganized garage where items are stowed on different sized shelves, in boxes on the floor and perhaps in drawers or behind closed doors of narrow cabinets. Even worse, difficult to store items, such as catheters, which come in long, slim packages, can easily be tipped over and tumble onto the floor if they aren’t stored properly.

"We understand that many facilities are just doing the best they can with what they have available, but I’m amazed how often I see supply areas with the wrong-size shelving and items just shoved in the middle of the room" said Ed Stewart, healthcare market manager, Spacesaver Corp., Fort Atkinson, WI. "It’s important that they understand their options and consider the positive impact effective storage and supply utilization can have." Because many hospitals have purchased their shelving from catalogs, he said they may not be aware that today’s storage solutions can be uniquely tailored to meet their unique needs.

Customized solutions catch on

Indeed, well-thought-out storage solutions can offer numerous benefits. Improved supply storage and organization results in fewer lost or unused supplies and less time spent hunting for items, which in turn, results in enhanced productivity, speedier patient care delivery, more efficient supply purchasing, and, above all, improved quality.

That’s what Sibley Memorial Hospital, a 344-bed community hospital serving the Washington, DC area, discovered. When the facility underwent renovations that created new, state-of-the-art operating rooms, updated storage mandates – which required that all supplies be entered into an automated, computerized materials management system and kept in one central storage location – came along with the construction. Sibley turned to Inter-Metro Industries Corp., Wilkes-Barre, PA, to bring its storage solutions up to speed.

Although the hospital was already using Metro shelving in its five main storerooms, hallways and throughout the O.R., new shelving systems, such as Metro’s Top Track and Super Adjustable Super Erecta were added to the mix to better meet evolving storage needs. The patented release lever on Super Adjustable Super Erecta allowed the facility to adjust shelves to storage bins fit between them. The shelves could also be pulled out smoothly, eliminating wasted space on the shelving unit. By consolidating the five storerooms into one, Sibley gained control over items that were previously disorganized, and by using Top-Track and moving its freestanding shelves to the middle of the room, the hospital gained storage space, including eight additional shelving units.

"All of our tracks now have an extra wide walkway through them," noted Linda Sisson, Sibley’s surgical services management assistant. "People can push carts in when they’re doing case picking, and they can walk back and forth with their carts very easily." Since using centralized storage for all 11 O.R.s, plus the anesthesia department’s emergency supplies, Sibley has been able to lower usage and storage costs by about 10 percent per month. Because supplies are easily accessible and cardboard boxes have been eliminated, it takes one person less than two hours to inventory the entire O.R., a task that used to take three or four people most of the day to tackle.

The response to LogiQuip’s Par Wall storage system has been equally positive. According to Klusty, the system was developed specifically for clean utility rooms throughout the hospital where inventory control is most important.

"This system forces the facility to organize supplies in ‘lanes,’ or one product per section in the basket," he said, noting that material managers have told LogiQuip that the product has cut the weekly inventory and restocking times in half. "It has also been reported that ‘stock-outs’ in departments where the system is installed have been completely eliminated."

The foundation of LogiQuip’s business was the Par Stor basket system for surgery, which is comprised of 20-inch wide modules that hold the same amount of small supplies as 36- to 48-inch wire shelving units. According to Klusty, this gives a facility the ability to hold the same amount of supplies in roughly half the floor space while being able to design the basket interiors to meet unique storage requirements.

Not surprisingly, high density mobile storage solutions, which free up valuable floor space by eliminating aisles between rows of shelving, are also gaining momentum in the healthcare environment. According to Van Deusen, IRSG’s High-Density Storage is the company’s most popular item because it increases storage space by as much as 40 percent, while still allowing easy access to supplies.

For Nebraska Heart Institute, powered high-density mobile storage was a good fit for its O.R. Sterile Supply and Catheter Lab Central Storage areas. The storage solution effectively doubled the capacity of each storage area and provided quick, safe access to stored items.

In addition to Spacesaver’s high-density mobile storage, the hospital also relied on customized pullout racks to provide hanging catheter storage in both stationary and powered storage systems, customized stationary shelving to house supplies in nursing units and CS, and bar-coded bins for simplified inventory tracking. Adjustable shelves were another must for Nebraska Heart Institute because they made it easier for staff to accommodate boxes of varying sizes – a real advantage considering medical supply vendors often change the size of their boxes without notice.

Metro is another player in the high-density mobile storage market. Its HD qwikTrak Storage System can hold up to 2,000 pounds and features mobile shelving units that roll smoothly and easily on low-profile floor tracks. The system also consists of end, intermediate and mobile unit kits that can be easily lengthened, shortened or disassembled and moved as storage is needed.

Facilities that want the benefits of mobile floor track storage systems, but aren’t willing or able to scrap the standard wire shelving they already have in place, will be pleased to know cost-effective options exist. According to InnerSpace Corp.’s Shannon Bennett, by installing wire shelving on floor track systems users can eliminate excess aisles and allow up to 400 percent increased storage capacity by placing units back-to-back or side-to-side on one rolling carriage.

"Many back storerooms are already filled with standard wire shelving systems and the cost or time involved to install a floor system may seem overwhelming," she said. "The key here is to look for a vendor that can retrofit existing wire units onto a floor track system, thereby reducing the need to purchase all new units."

Wall tracks are another viable solution to maximizing available storage space. Metro’s SmartWall Plus storage system, for example, allows users to easily customize their walls with a variety of open and closed storage solutions. Facilities simply lay out their room with wall tracks and then choose the storage options utilizing MetroMax, MetroMax Q and Super Erecta shelves, along with accessory grids and Starsys wall cabinets. All shelves, grids and cabinets can be repositioned to meet evolving storage needs.

Cabinets with modular interiors are also catching on because of their ability to improve linear footage and maximize storage space, while allowing for easy reconfiguration. Bennett explained that a cabinet outfitted with a modular interior can more than double the linear footage of storage space available.

"Modular storage is an ideal solution for clinical departments with smaller supplies and the need for rapid retrieval of these supplies," she said, adding the trays, baskets and shelves should always be labeled to further improve efficiency. InnerSpace can place its open, modular QuickStore solution on its floor track system to combine the benefits of a modular solution with a high-density system.

To stretch the dollar further and allow for even more flexibility, a growing number of storage solution manufacturers are creating interchangeable products that prevent facilities from being stuck with limited configurations. LogiQuip, for example, recently launched its LogiCell enclosed cabinets with interchangeable baskets and totes that allow a facility to take supplies right into and out of any given procedure room. With the interchangeable baskets and totes supplies stored in these components can be moved from shelf to cart to cabinet without moving individual items.

Work with the experts

Because storage requirements are anything but one-size-fits-all, vendors agreed that healthcare organizations can greatly benefit by working with experts who will spend quality time evaluating storage needs – all the way down to how many of each item the department needs to have on hand, and which supplies the user wants on a shelf, in a cabinet or in a drawer — and designing tailor-made solutions that can realistically meet a facility’s storage goals.

As IRSG’s Van Deusen explained, a design may look great on paper, but a lot of factors need to be considered to ensure that the facility’s desired outcome can be achieved. She pointed out that a successful project is the result of understanding, prioritizing and evaluating the specific requirements of a space (i.e., storage quantities, ease of replenishment, custom storage requirements, organizational benefits, and ease of use).

"Additionally, the ideal storage design will incorporate within it the ability to be modified to accommodate future requirements," noted Van Deusen.

Top vendors make it easy for facilities to outline their goals and visualize their redesigned storage areas because they generally offer consultative and design services at no cost. Consultants’ roles are comprehensive. Upon evaluating problem areas, gathering specific inventory and par level information, assessing shortcomings, and identifying current and future goals, designers then go to work incorporating various options into architectural drawings, each tailored to the area’s exact specifications.

"It’s our job to ask all the right questions and help facilities make sense of their unique storage requirements. We need to understand what they are doing now, what is working and what isn’t, and whether the solutions they are interested in are ideally suited to their needs and budget," Gilbreath said. "Storage may not seem high-tech, but there’s no doubt that it requires careful consideration and [effective design]. That’s why it’s a good idea to work with an expert. If you do it right, it’s an investment that can give you a terrific return on investment and last you well into the future." HPN