Typical complaints that might show you need to design a new location or redesign your current location or even your practices are:

• Too many expired goods. Do you have proper stock rotation or are your stock levels set correctly?

• Dirty or yellowed goods could mean you have problems with your HVAC system or that you might have windows that don’t have UV protective film on them.

• Backorders to your end customers. This could mean you have problems with your stock levels, or your current location or system doesn’t allow you the ability to know your lead times, safety stock, expiration dates, etc.

• Crushed goods can be an indicator that your goods aren’t stored properly.

• Miss-picks. This, more than anything else, tells you have problems with your processes, your layout, your systems, or your people. Most months we pick over 750,000 items, but will only have 0-5 miss-picks for the entire month.

"Where’s my stuff?"

• One of the biggest challenges in a warehouse that is not well performing is that employees looking to pick an item will not find it, even though the records indicate you have the item. It may be out of stock or it may have been misplaced somewhere else in the warehouse.

• This occurs in clinical care areas as well. Misplaced or missing supplies can impact the efficiency of care delivery as clinical staff look for supplies. They may have to go to a secondary or more remote storage area to find the item which may result in a delay in a treatment delivery for the patient.

Hoarding

• If clinical staff members do not trust that the right products will be in the right place at the right time, they will make sure that product is available to them when they need it — by hiding it! A few challenges that can arise from this are inaccurate inventory valuations, the liability of using an expired product, or the risk of using a recalled product.

Messy storage areas

• In a warehouse, the shipping or dock area may be a mess, with pallets and boxes in various stages of shipping. Because of the mess it is difficult to determine the best, next task. This may result in any number of negative impacts on performance including some packages being worked and reworked a number of times, lost or misplaced stock or even items being shipped to the wrong place.

Backed up receiving docks

• There may be times of every day when this area is so busy it’s not funny. So many warning signs can crop up, such as: Delivery trucks queueing up and waiting for their time to be offloaded; pallets everywhere, waiting to be received and stock to be made available; or items sitting in the dock area for hours, or perhaps days, waiting to be received, and may be for orders waiting to be fulfilled. We have also observed staff coming to check the status of products and retrieving them from this area without proper receiving functions.  

• Stockouts: A system running well should experience no more than 1-2 percent stockouts. However, because of manufacturer backorders and product recalls, there’s no way to entirely eliminate every stockout. Using a Kanban system that can make smart recommendations about replenishment levels can reduce stockouts.

• Expiring products: It’s easier said than done, but hospitals must get expiring products off the shelves and into use before the expiration date. Waste happens because the supply staff isn’t rotating stock or due to slower moving items in inventory.

• Over-ordering/Returns: Sending back items because someone has over-ordered usually occurs due to unit of measure (UOM) inaccuracies. A supply tech thinks he or she is ordering a box but gets a case, and now has to return the items not needed. The warehouse will frequently use a different UOM than the supply techs managing storerooms on the floors; how items are ordered, how they’re stocked and how they’re issued are nearly always different. And once items are returned, there’s a risk of error as it’s far too easy to restock the items in the wrong location.

• Low fill rate: Low fill rates are evident when inventory targets and PARs haven’t been updated, when poor performing vendors are selected and when there is a lack of collaboration through the facility.

• Growing SKU count and on-hand dollars: Growing SKU counts and total on-hand dollars is evidence of a lack of discipline. Hospital supply chains have limited recourses and must thing critically about how to execute those resources. An effective review process seeks opportunities for standardizations and the elimination of low volume items.

• Complaints when finding product: If a storeroom doesn’t have a slotting strategy, proper signage can significantly help create efficiency for both materials management and clinical teams.

• From the central supply room, to the Sterile Processing Department to the OR, inventory tracking is a challenge but critical.  Imagine building a case cart only to find a ripped sterile wrap once you’re in the OR and now scrambling to replace that tray of instruments. Comprehensive inventory management and storage systems are available to assist with this problem.

• Joint Commission, CMS, or similar [agencies] arrive for an inspection and they find not only surgical trays and soft goods stacked closer than 18 inches from the ceiling, but they also find many outdated/expired items. By using an automated vertical carousel with inventory management software, the surgical trays, soft goods, instruments, implants, and any other sterile items can be stored in a six-sided, enclosed box maximizing the usable floor-to-ceiling height while managing and tracking all inventory transactions and expiration dates. Storerooms, warehouses, sterile processing and even the maintenance department suffer significant man-hours lost to back strains, repetitive hand and arm injuries, not to mention falls and trip hazards. Management in all hospital departments must analyze the work time lost to injuries and develop corrective actions to reduce or eliminate the causes.