Supply chain management staff members break the bulk for internal distribution to end user locations. Check.

With sighs of resignation, they then move the inventory clusters to a variety of clinical storerooms and closets, ready to shoehorn as much as they can into the jam-packed areas. Check.

But it doesn’t have to be this way.

Simply put, organizing supplies and equipment within a facility’s confines remains a hallmark of effective supply chain management. But limited space, coupled with supply and equipment hoarding, present a recipe for cluttered minefields of products, absent a burst of organizational creativity.

So how can healthcare facilities redesign and improve inventory locations using new products and systems in the market today, as well as simple ingenuity? To prevent stockouts, error-prone inventory levels, expired supplies and a basic inability to locate needed products, what strategies make the most sense for organizing and storing supplies and equipment within a facility for more effective supply chain management? Those strategies may involve exploring recent and near-future developments in storage system applications and capabilities that will contribute to performance improvement, in addition to smart planning.

Healthcare Purchasing News caught up with several executives from storage system manufacturers to get their input and insights on the processes and products that can make a difference.

If you’re looking for a universal storage-system-in-a-box to solve common problems a la the consumer market, you’ll be searching a long time.

But that doesn’t mean simple solutions aren’t available.

"There seem to be lots of high-tech solutions being talked about with [radiofrequency identification], ‘smart cabinets,’ etc.," said Patricia List, executive vice president, Medical Design Systems, Lenexa, KS. "Some of those solutions of the future will no doubt work well in some environments; some won’t. There is no one solution to medical storage. There are too many variables – including personnel compliance, numbers of procedures, PAR levels. Cost is always a big factor, and many facilities just can’t justify spending hundreds of thousands to replace storage systems.

IRSG’s High Density Overhead Storage

"We believe there is a real need to just simply design storage for each department in clean, closed units that are well organized, so the available space is fully utilized. Most customers are surprised to find how much space was actually being wasted and is freed up after we reorganize their storage."

Nick Klusty, vice president, Western region, Logiquip LLC, Galesburg, MI, emphasized the desired payback for supporting more advanced inventory management processes, such as just-in-time management with low-unit-of-measure items.

"We see hospitals going in two directions," Klusty said. "Since non-chargeable, low-cost items are growing in percentage in any given supply area, some facilities are not seeing the ROI for high-ticket inventory management systems. Many facilities are going back to simple inventory management procedures. With this they still need the capacity in the storage areas. This is getting more important because in order for a facility to move more towards just-in-time inventory practices they need increased capacity on the nursing units. Central supply areas are becoming smaller and smaller as more facilities increase the percentage of items that skip that area and go right from the truck to the nursing units."

Klusty also expressed some hesitation, if not trepidation, about RFID as an option.

"RFID is still being discussed for inventory tracking and management," he noted. "However, many material management supplies for nursing units are low dollar and don’t justify the cost of the technology. We are still waiting to see where this technology is headed in regards to these supply items."When it comes to using technology to increase efficiencies and decrease costs, however, integration between existing and new technologies is the critical factor, according to Scott Bostick, vice president and general manager, Pyxis Supply Technologies, Cardinal Health Inc. "Vendors will be expected to provide integration with existing information systems to extend the hospital’s clinical information infrastructure," he noted. "Automation of processes that currently require manual data entry allows clinicians more time to focus on patient care and reducing error rates."

InnerSpace System 100

But Bostick also predicted that storage system vendors increasingly will shift away from simply selling product and toward selling "solutions" where they work with customers "to optimize material management practices and minimize overall costs to the hospitals," he said. "Over time it is expected that the development in storage systems will become less about the physical hardware but rather the services and the overall partnerships that manufacturers can provide their customers." 

Efficiency in the supply chain shouldn’t be dismissed, Joe Dattilo, president, PAR Excellence Systems Inc., Cincinnati, emphasized. "Patient care is improved whenever the supply chain can be made more efficient," he added, such as when "human error is removed from the replenishment identification process."

InnerSpace (Grand Rapids, MI) recently introduced the System 100 which uses embedded RFID technology and biometric security access to reliably and accurately track and account for high cost clinical supplies in real time without the need for manual processes. System 100 can assist hospitals in maximizing charge capture by ensuring user compliance and accountability. Because it interfaces with hospitals’ business systems it helps streamline processes and reduce errors.

Omnicell Inc. (Mountain View, CA) introduced its OptiFlex SS 9.0 supply chain management system earlier this year. A complete preference card-driven system that tracks supplies, special items and other aspects of surgical service cases, the OptiFlex SS 9.0 system delivers important new features in an integrated solution that includes management of both secure cabinets and open shelves. Surgical services managers and nurses now have the ability to efficiently handle supplies in multiple operating departments across hospital environments and provide an increased level of secure storage for IV solutions.

The OptiFlex SS preference list system creates a unique bar code for each surgical case based on the physician, the procedure and the patient. Real-time case management allows dynamic adjustment of the supplies issued during the procedure. In addition, the system tracks all required time segments for reporting, data analysis and charging purposes.

Oftentimes, improved processes can be the natural outcome of new products – or at least different ones.

PAR Excellence's PAR Bins

For example, PAR Excellence developed its PAR Bins automated replenishment system that uses weight sensors and automatically sends a replenishment order to materials management whenever the bin/item reaches a reorder level. "No human intervention is required," Dattilo said. "PAR Bins do not require input
or action by the caregivers or the materials staff. Installation is quick and simple. A small plastic sensor module is simply placed between the louver and the bin."

Meanwhile, Logiquip has moved in the opposite direction.

"Our No. 1 focus is to get materials managers away from plastic bins," Klusty said. "Plastic bins can be moved and lost, causing stockouts and difficulty in the assessment part of inventory management. Our products are all open wire, and with our divider system, products have their own dedicated space that does not move. Instead of ‘shoe-horning’ supplies into little plastic bins, with our Par Wall and Par Stor systems they can move dividers to create the perfect amount of space needed for any particular supply. The addition of fine mesh wire baskets allows a facility to eliminate the need for plastic bins altogether."

Klusty stressed the simplicity of the company’s new LH3 hanging label holders. They come in five colors so that "facilities can color code by expiration date, lead time, supply type, making it much quicker to identify fast moving items and keep ahead of potential stockout issues," he added.

LogiQuip Par Wall

Medical Design Systems started promoting its foray into steel earlier this year with its MASS Metal line of powder-coated steel cabinets and carts in addition to its standard melamine models.

The metal products are often preferable for supply storage in the operating room environment, according to List, because they are lighter, which is essential for large carts that are moved a lot. They feature modular interior components that slide in and out on ABS side panels, making them very easy to reconfigure anytime packaging changes, she indicated, and "they can be totally redesigned in a matter of minutes if they need to be repurposed for different supplies or procedures."

Modu-Stor is a unique new high density storage system from San Clemente, CA-based Distribution Systems International Inc. (DSI), designed for use in the OR, Central Supply, Emergency Room and Med Surg Nursing floors. The company maintains it can increase storage space in a given area by 30 percent to 60 percent depending on the products being stored. The flexible system features a variety of open and enclosed configurations and bin sizes. The standard divider systems are unique in that each bin configuration can be customized to the particular end-users requirements.

DSI offers free CAD drawings provided by an in-house engineer in an electronic format for jobs as small as closets, to room renovations to new building construction. DSI representatives provide product assembly and installation when requested. The products are manufactured in Southern California and DSI maintains ample inventory on the product to allow for next day shipment if required. Cabinets are also available with tempered glass doors and key-less entry systems, floor or wall mounted.

The new V-Series line of high density, heavy-duty cabinets, carts and workstations from InnerSpace allow for more storage in less space due to partitioned, full-extension drawers. All items are within easy reach and in full view which translates to fast, effortless retrieval. Movable interlocking steel partitions and dividers are shipped fully assembled and allow drawer compartment sizes to be adjusted to accommodate supplies of varying sizes and shapes. Roll-out shelves are also available for storing instrument trays and other large bulky items.

DSI Modu-Stor

John Waner, now former CEO of IRSG, Woodinville, WA, contended that packaging and assembly remain key selling points.

"One of the frustrations of ordering storage equipment is it arrives unassembled, thus sitting in the warehouse until staff is available to assemble it," said Waner, who retired from the company on October 1. "This, along with incorrect assembly, results in departments continuing to work with their current storage issues and the solution being unavailable and unusable as soon as it arrives. Using a company that offers the option of receiving their shelving units factory-assembled stream lines the reorganization process. With IRSG’s ‘ship assembled’ program, customers can simply unwrap the shelving and put it to use, thus saving time, frustration and expense.

"Seamless integration between systems and one-touch accessibility to information are driving efficiencies and redefining storage system development, according to Bostick. He noted that the Pyxis ProcedureStation easily can be linked to the hospital’s Operating Room Information System (ORIS), enabling "clinicians to chart charge and reorder supplies with just the touch of a button; streamlining inventory, improving workflow and providing clinicians with more time to focus on patient care."

The company’s new hosted intelligence tool, the Supply Performance Dashboard, provides hospitals with more "visibility to supply chain and point of use performance along with the opportunity to quickly identify problem areas and necessary improvements," he added.