Logistics - St. Olavs Hospital

Logistics - St. Olavs Hospital Summer 2007 Bjørn Bakken Logistics manager, Helsebygg Midt-Norge

Logistics? Challenges - Center structure several small hospitals External logistics; location supply center? Goods terminals in each center? The store structure? Transport solutions? Organization operation internal suppliers? IT-system? We need some principles for planning, building and operation logistics functions!

Based on: 6 logistics principles, flow of goods Operating costs Investments Organization Quality and safety Capacity and flexibility Tecnical challenge phase 1 and 2, and phase 1+

6 logistics principles, flow of goods 1. Transport. Automatic transportsystem. Automatic Guided Vehicle (AGV) Tube System Automatic Waste System 2. Supply. One common goods terminal, and maximum 2 store level. 3. Information. Use of IT-system for logistics processes (ordering, purchasing, stockholding) 4. Production. Locate production units in the same area 5. Module. General sizes of module units for transport and store 6. Organization. Jobs according to supply and flow of goods are not perform by health care people, if its not a medical reason.

Supply One common goods terminal, and maximum 2 store level. Supply Centre Inn-transport Varemottak Lager Plukking/ ekspedisjon Clinical Centre Produksjon/ service Oppstilling distribusjon Distribusjon til sentrene Lossing/ oppstilling Lokalt lager Lokalt forbrukssted Ut-transport Oppstilling ut -transport Behandling av retur Mottak retur Returtransport fra sentrene Lasting/ oppstilling

Production Locate production units in the same area Fig 3 Samlokalisering av sentral produksjon Felles funksjoner Ekstern terminal - mottak sentrallager Produksjonsenhet 1 Produksjonsenhet 2 Kulvert terminal - Oppstilling intern transport Varer inn og ut Produksjonsenhet n Varer inn og ut

Supply and production; Plan Supply Centre, U1

Information Use of IT-system for logistics processes (ordering,purchasing, stockholding) Enterprise Resource Planning System (ERP)...

IT-system used for different product group Linen Drugs Consumergoods Food Sterilgoods DB SW DB SW DB SW DB SW DB SW IT INFRASTRUCTURE DB SW DB SW DB SW DB SW Cleaning service Technical service building Technical service equipment Transport

Modul Equipment for transport and store are based on a general size 40 x 60 cm of the module unit. Multiply bigger og divided smaller

Organization Jobs according to supply and flow of goods are not perform by health care people. Exception: Medical reason.

GENERAL CENTRE Main logistics

generelt senter 4, 5, og evt. 6. etasje: Sengeområder, evt. kontor. 3. etasje: Teknisk mellometasje over teknikkrevende medisinske funksjoner hovedgate mindre gate paviljongen mindre gate 2. etasje: Tverrgående bruforbindelse, operasjon, og radiologi, oppvåkningsplasser. 1.etasje: Poliklinikker,dagområder, kantine, senterkjøkken, auditorier, utleieareal Underetasje:Tverrgående kulvertforbindelse, tekniske funksjoner, sengeutstyrslager, garderober og renholdsenhet. E2 E6 E5 E4 vinkelen E3 E2 E1 hovedgate U1 prinsipplan prinsippsnitt

Old bedwards St. Olavs Hospital Store Beds

generelt senter PRINSIPP SENGEOMRÅDE hovedadkomst - etasje kommunikasjon, vertikal - horisontal forsyning,forbruksvarer ekspedisjon, arbeidstasjoner m/skrivepl. ensengsrom m/bad, tun med 6-8 rom støtterom felles for flere tun/sengeområde; UB rom, pause, skrive, kontor, medisin, undervisn, møte,gruppe, pas. bibl.,samtale, vente, skylle, utstyr,kjøkken/spis, fysio.,teknisk grad av tilgjengelighet til fellefunksjoner i sengeområdet, indikator for plassering grad av overvåking/ nærhetsbehov til akutte støttefunksjoner mulig direkteheis til/for akutte støttefunksjoner

Stock in the ward Consumergoods, linen Tube System Station

Automatic transportsystem AGV Pneumatic Tube Automatic Waste System Collection

AGV-transport Consumergoods Sterilgoods Food (from supply-kitchen to center-kitchen) Linen, cloth Dirty Linen, cloth Drugs Post Hazardous waste Waste sorted (not Automatic Waste Collection)

LAB KVB NEV Demand AGV transports maximum weekday PAS HOT AHL GAS BEV PSY KUN SPC SPC APO TOT LAB (1) 0 0 0 0 0 0 0 0 13 0 0 13 KVB (1) 0 0 0 0 0 0 0 0 24 0 0 24 NEV (1) 0 0 0 0 0 0 0 0 21 0 0 21 HOT 1) 0 0 0 0 0 0 0 0 10 0 0 10 AHL (2) 0 0 0 0 0 0 0 0 24 0 0 24 GAS (2) 0 0 0 0 0 0 0 0 24 0 0 24 BEV (2) 0 0 0 0 0 0 0 0 24 0 0 24 PSY (X) 0 0 0 0 0 0 0 0 19 0 0 19 KUN (2) 0 0 0 0 0 0 0 0 24 0 0 24 SUP (1/2) 16 32 32 10 32 32 32 31 32 5 1 257 SUP (2) 0 0 0 0 0 0 0 0 0 6 0 6 APO (1/2) 0 1 1 0 1 2 1 1 2 0 1 12 TOT 16 33 33 10 33 35 33 32 35 188 6 1 457 Systemdesign prepared for 50 % increase

Layout AGV MIL ABD PSY PAS (pasient hotel) NEV (neurology center) APO (MTFS) HLC BEV KVB (mother/child center) SPC (supply center) phase 1 phase 2 LAB (laboratory center)

AGV Sending station Station type "F" Transponder for container identification Transponder reader (if applicable) approx. 1.2 m

AGV Receiving station concrete ceiling suspended ceiling Receiving stations do not require any positioning device. The arrival of a container is detected with an ultrasonic sensor (ceiling mounted)

AGV sending/receiving station LAB-center

AGV safty

Transport items: Blood samples Blood plasma Tissue samples Drugs Tube System

Layout PTS-system Kunnskap Gastro Bevegelse Nevro Pasient hotell Akutt Hjerte- Lunge Kvinne/ Barn Apotek Lab Supply Centre

Tube System in the ward PRINSIPPSKISSE SENGEFLØY KLINISK SENTER Alternativ 2: Rørpoststasjon i hvert sengetun APOTEK/BLODBANK BLOD/ BLODPRODUKTER MEDISINER CYTOSTATIKA IV ERNÆRING EKSPEDISJON SENGETUN SENGETUN SENGETUN VOGNTRANSPORT MEDISINER PRØVER MEDISINROM TEGNFORKLARING: Manuell transport Rørpost LABORATORIESENTER

Demand PTS transports, capacity Productgroup Daily Peak hour Samples Blood 440 72 123 20 Drugs 357 75 Systemdesign prepared for 50 % increase

Demand PTS transporttimes, capacity Productgroup Normal transport Priority transport Samples Blood Drugs 10 min 75 % of transports 10 min 70 % of transports 10 min 88 % of transports 2,5 min 25 % of transports 2,5 min 30 % of transports 5 min 12 % of transports Changes demand transporttimes: About 90% within 5 minutes About 10% within 8 minutes

Simulation* Average transmission time: 2 min 45 sec Longest transmission time: 7 min 25 sec System efficiency: 91, 3% * 1174 transports a day (50% increase included)

Automatic Waste System Fractions: Ordinery waste Paper Plastic Confidential paper Better hygiene Better working environment for employes Less smell Long lifetime, 30 years Payback, 15 years

Periode 3 Waste-shafts phase 1

Shaft and sorter

Throw waste in the ward

Sorting waste

Reserv (Rest eller plast) E/E avfall Järn/metall Grovavfall Waste Terminal Halvautomatisk Manuell hantering Envac system Transportvogn Vridbar på/avlastning Wellpapp Glas / metall Rest Konfidensiellt papir Rest Plast Papir

Waste Terminal

Container outdoor

Cook-chill Food - Logistics Supply kitchen supply center Cook-chill, transport chilled food to center kitchen Center kitchen and canteen centers Prepare food to pasients for each meal Transport in containers in trolleys to wards Eathing place for pasients in beed areas (one for 2-3 beed clusters) Serving each pasient, in the eating place, or in the singel room.

Sterilization goods - Logistics Sterilization central supply center Washing, packing and sterilization Main store in the hospital for sterilization goods Wards, surgary/operating area in centers with limited store capacity Frequently order the demand Frequently delivered with AGV, prepared for use, not stored in the local stock After use, return by AGV to sterilization central Limited local store in wards store for security and emergency

System for staff clothes Cabinet Staff clothes RFID-tag Includs aerial to reed RFID-tag

PROL IANT 8000 ESC DLT SD SD Structure of the system Web Service IKT Nettverk Kundeapplikasjon DB SW DB SW Kuvøsen Kvinne/Barn Senter Økonomisystem Internet Personalsystem 1 4 Gyn Opr. Nordfløy Nevrosenter Nordfløy Laboratoriesenter Nordfløy 1 2 1.18 1..23 1.20 Barn Herre Sørvestfløy Nevrokir.Opr. Sørfløy Sørfløy 1 3 Føden Herre 1.10 Sørøstfløy 1 3 Øye Opr. 1 9 ØNH.Opr. 1.16 Apotek 1 1.10 1 3 1 2 1 2

Pick up og deliever staff clothes System registrate stockholding before and after a person unlock and lock the wardrobe. Changes in stockholding registrate, and invoice the ward department the person are associated.

Drug Logistics plan for future Patient Journal Electronic prescription Delta: Receive prescriptions Stockholding management local hospital stocks Ordering management pharmasy Message Pharmasy controll Unit dose solution Automatic or Manual store Production (cytostatics ++) Transports PTS-system AGV Preserve on wards Patient Journal Bedside scanning

2014 Thank you!