Charting course of carts, storage over four decades

Even though equipment and technology as seemingly “simple” as carts and storage systems may be taken for granted by healthcare organizations used to having them in circulation and operation, design and functionality improvements will continue, manufacturer executives told Healthcare Purchasing News.

In short, expect to find subtle and not-so-subtle differences between your father’s cart and storage system and your son’s.

Paul Smith, President and CEO, FIRST Healthcare Products Inc., Sanborn, NY, indicated that his company is investing in research and development focused on “critical ergonomic, data security, infection control, and asset tracking issues for mobility products. There are new developments in RFID, locking systems, digital integration and device mounting technology available that we will be showing in new product launches through 2017. We are offering new features that will make tablets and small-form factors easier to use at the point of care, better leveraging the explosion of new applications coming online to help improve quality.”

Michael Couch, Marketing Manager, Medical Casework, Seating & Care Exchange Products, Midmark Corp., Dayton, OH, highlighted the patient-caregiver interaction as an increasing focal point for healthcare providers, which is where he expects improvements to emerge.

“Equipment that helps providers focus on the patient, rather than staring at a computer screen, searching through a drawer for supplies or struggling with a technical glitch, will continue to help improve the point-of-care experience for both patients and their caregivers,” Couch said.

“Storage solutions like casework that are designed for the medical environment first will also factor into the patient-caregiver experience,” he continued. “The right solutions are flexible and do not leave monuments when locations move or switch focus. They provide quick and visual access to necessary equipment, but also help promote a clean environment for all patients. We expect to see increased emphasis on the role of items in the built environment, like casework, in infection prevention in coming years.”

Jason Strohm, Vice President and General Manager Worldwide, Dispensing and Preparation Technologies, BD, Franklin Lakes, NJ, acknowledged that automated dispensing cabinets “continue to have areas of weakness” even as they’ve delivered advancements to healthcare. But he feels technology such as radiofrequency identification (RFID), mobility and IT integration offer several solutions.

“Allowing every dose of medication to be checked on refilling into the cabinet, rather than bar-code scanning of a sample — which is done today — results in a system that performs more thorough checks to prevent miss-filling,” he said. “Mobile technology will also play a role in future systems, allowing medications to be located closer to patient rooms, saving nursing steps and getting medications to patients more quickly. Lastly, tighter integration between health information systems and cabinet functionality will simplify workflows for nurses administering medications to patients.”

Look for machine-to-machine Internet-of-Things technology to play a larger role, according to Dustin Patterson, Director of Operations, LogiQuip LLC, Galesburg, MI.

“Generally, static inventory storage will become more space efficient and operationalized providing more process capabilities, such as Lean inventory management,” he said.

The “next big thing” already is here, teased Jon Winer, CEO, Tollos, Owings Mills, MD, but very few are using it right now. One word: Motorization.

“IKEA is now beginning to motorize all of its carts world wide—those that employees use and those for shoppers,” Winer said. “So we would think that healthcare organizations will sooner or later start buying mechanized carts versus what are some very ancient, often heavy, platform carts. Even the ‘light’ linen carts when fully loaded can weigh over 600 pounds and need to be pulled, so that creates tremendous stresses, as does pushing a 750 to 1,200-pound bed all day.

“Once organizations take advantage of this development patient care will be improved tremendously,” Winer predicted. Because fewer healthcare professionals will suffer injury, they’ll be able to remain at work, delivering a higher quality of care, he explained. “Patient care will also be improved with use of [motorized] carts and storage systems [that] will decrease wait time for certain items to be taken from and delivered to patients.”

Automation, computers and material improvements may dominate continued changes in the years ahead, but look for a distinct emphasis on the clinical, particularly as it involves infection control and prevention, according to Amy Flynn, OR/CS Market Manager, Hänel Storage Systems, Pittsburgh.

“The next big development in storage systems that improves performance should be a more stringent adherence to infection control protocol, in particular to the three-touch rule when it comes to hospital staff handling wraps, containers and other items,” Flynn urged. “This means that sterile supplies can be physically handled no more than three times during their useful lifecycle or risk contamination. The first touch comes after sterilization when the items are placed into storage. The second touch comes when the wrapped items are placed into a case cart prior to use, and the third touch comes when it is used in the operating room. However, there is often no way of enforcing this rule, and items can be touched, moved or carried a number of times while they are in storage, which exposes the sterilized supplies to possible contamination. In many cases, there is no way to determine whether there are truly three touches, or as many as 20.”

Flynn added that inside a Hänel Rotomat, items remain sterile from the very first touch until they are needed in the OR, protected from “all kinds of contamination.”

Craig Orlove, Senior Product Manager, Healthcare, InterMetro Industries Corp., Wilkes-Barre, PA, kept it simple.

“[We’re going to] continue to create carts and storage processes designed to further ease the physical burden on nursing through better ergonomics and workflow analysis,” he said. “[This will] help to streamline the patient care process with our systems, so nursing can spend more time focusing on the patient and their needs. [We’ll] provide application-specific solutions to more completely address the user needs [and] provide the ability to truly custom-design a solution specific to the user needs.”