Embedding innovation in healthcare environments

Automated logistics systems are a key characteristic of the twenty-first century digital hospital. There are a number of such systems in use around the world, and a key component of each is the use of robotic delivery vehicles. These systems have the potential to optimise material and human resource flows. Like factory production lines, these systems are designed to optimise throughput and reliability. As this analogy suggests, they’re also highly effective when it comes to reducing labour requirements.

For the most part, we’ve seen this technology adopted in Europe and – to a lesser extent in Asia and the USA. Australia has been much slower to adopt this technology. This, however, is set to change in the next five to six years, with at least eight new tertiary hospitals commissioned. A number of these facilities, such as Royal North Shore Hospital in Sydney, have already committed to introducing this technology.

The benefits of an automated logistics system are well documented, with some systems reporting a return on investment (ROI) in the order of two to three years depending upon the scale of the solution. The recurrent long-term benefits of automated logistic systems can be significant. Aside from the ROI impact, the range of benefits includes the efficient transportation of goods and equipment; a reduction in damage to the built environment as well as a reduction in occupational workplace injuries.

Planning for such technologies goes well beyond the development of a cost benefit analysis.

Traditionally, when planning new healthcare facilities, the focus has been on meeting future health care demands. Future service demand is modelled taking into account factors such as growth in demand for services above current supply. Once demand is projected across the planning horizon, this requirement is then translated into health planning units such as beds, consult rooms and the like.  The focus at this stage of the planning is largely focused on clinical services rather than back-of-house services such as logistics.

Once an automated logistics system is adopted it inevitably has a profound impact on the way traditional back-of-house services are delivered across the entire hospital. Given this, we can no longer afford to start planning for support services and logistics flows during the design phase. Instead, detailed planning should be undertaken as early as possible to ensure end-to-end solutions are achieved. In the absence of early detailed planning, design teams will struggle to integrate the solutions and maximise efficiency.

A number of support services will benefit from an integrated logistic solution. When talking of logistics we often think about the movement of supplies or goods. These may be clinical supplies, consumable items, equipment or even food. On the flip side, hospitals produce large volumes of waste that must also be moved through and ultimately out of a facility in an efficient manner. Throughout Europe, hospitals such as Orbis Medical Centre in the Netherlands utilise this technology to provide end-to-end solutions for catering, pharmacy, linen, waste and materials management.

The timely movement of goods and supplies throughout a hospital is paramount to supporting clinical care.

In today’s environment of reduced stock holdings and just-in-time ordering, effective delivery systems are pivotal. Frequently we find that in a just-in-time environment there’s a corresponding requirement for more frequent delivery of supplies. While reduced stock holding may lessen storage requirements and inventory costs, the hidden cost of this will often be the labour costs associated with the provision of more frequent deliveries. Robotic vehicular delivery systems (commonly referred to as automated guided vehicles or AGVs) can reduce the labour requirements and can operate around the clock.

Traditionally, the movement of waste through healthcare environments is time consuming. Efforts to stream waste have also contributed to the overall workload. Logistic solutions for waste management range from traditional manually handled methods, through to vacuum waste solutions and robotic transport. It’s fair to say however that no single magic solution to this issue exists, as some waste streams have specific handling requirements. The same assumption can be applied to other service streams, such as pharmacy services. 

Given this, it’s vital that logistic solutions for services such as waste management be developed early in the planning stages to ensure technology integration. Factors such as point-of -use waste collection, decanting waste from smaller containers into larger bins and regulatory requirements for contaminated and harmful waste streams will all have an impact on the final solution. In this context one thing is certain: where new technologies are adopted, there will be a resultant impact upon the delivery of the service. This impact will require the reengineering of work practices and the associated workforce.

Automated logistic solutions have specific technology and facility requirements. While the technological requirements such as IT infrastructure change over time as systems improve, one thing remains constant: namely, that

adequate space be provided at the right locations within a facility in order for the systems to be functional.

In particular, circulation space and handover points must be sized appropriately. In order to determine this requirement, operational models similar to models of care for clinical services should be developed as early as possible.

The investment in automated logistics technology is significant. To ensure successful implementation of the technology, the following key aspects should be taken into account:

  • Commence planning for support services as early as possible
  • Define the scope of the logistics solution in the planning stage
  • Recognise circulation pathways for logistics are of significant importance
  • Ensure adequate space is provided to innovate the systems
  • Commit to the development of new models of service delivery
  • Strive for end-to-end solutions for each service stream
  • Engage with external suppliers to achieve end-to-end solutions

Thinc Health is currently working with a number of government clients to plan and implement world leading logistic technologies in Australian healthcare facilities. As technical advisors we provide independent advice to achieve the best possible outcomes for our clients, particularly when it comes to groundbreaking technology.