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Materials management--hospital style:
Using technology to keppt he storerooms stocked
Mike Kamel
In a hospital, one might wonder, how do all these medical supplies reach the patient’s bedside?
In the 1960s and 1970s, the process was quite tedious, with nursing staff required to submit handwritten requisitions. Then there was the much-celebrated daily cart exchange system used in the 1980s. This method of supply replenishment is now recognized by many as a cause of inventory duplication and congestion.
Today, the most common method of inventory management in hospitals is the par-level system. It's also referred to as the top-up system of replenishment, and is widely accepted as a modern supply technique.
Par-level is defined as a maximum supply, based on predetermined quotas originating from historical consumption data for a particular area of activity within a defined time period.
Automated retrieval
St. Mary's Hospital Center is located in Montreal. It's a 316-bed acute care community teaching facility, affiliated with McGill University Health Center.
St. Mary's operates the only completely integrated logistics management hierarchical model in Montreal, having all the traditional materials and support services under one umbrella.
From a patient-centered perspective, our philosophy is to alleviate nursing staff from any non-nursing task, such as supply management.
The hospital's main stores area is equipped with an automated storage and retrieval system. Fully computerized, the system's 150 feet of mobile shelving provides 5000 SKUs on three identical, 50-foot long, computer-driven carousels. Conceptually, the idea of the carousel is to bring the stock to the worker, rather than having the workers move to pick the stock off the shelves.
The carousel system processes the daily needs of up to eight patient care units in one retrieval process. The entire system may be operated by one worker. Certainly, carousels have been around for a long time and their use is widespread in the private industry but they are relatively new to publicly financed healthcare systems.
Handheld scanners
The par-level inventory system has a standardized look on all patient care units. It's composed of sturdy plastic bins in multiple sizes, which attach to wall mounted plates in utility rooms.
Each par-level holds an average of 100 SKUs at each of the 25 patient care units. Their open bin design enables quick and easy access to supplies by nursing, as well as support staff.
Each patient care unit has its par-level tracked and replenished three times weekly. The tracking is performed using handheld scanners associated with our mainframe inventory management system. The scanners hold the inventory data of each patient care unit, including all the minimums and maximums of each SKU.
Scanners read the bar code of each SKU and relate the information to the database. The worker indicates the quantity missing in each SKU (the variance between the amount of product on-hand and the maximum quota). The information is downloaded from the scanners into our mainframe, where electronic pick lists are generated directly onto the carousel's software for picking.
The replenishment schedule devised by the materials team at St. Mary's Hospital allows us to replenish the clinical departments in rotation, so that one half of the hospital is replenished on day one and the second half on day two. This scheduling method also permits the hospital’s main stockroom to completely close on weekends.
The carousel system is linked with the hospital's emergency generator system, so supplies will be picked and delivered even in blackout situations.
Although the materials team monitors and remedies abnormal activities on all par levels, such as slow moving or stocked out SKUs, an adjustment feature was built into the system at the onset to keep things flexible and dynamic. This simple feature gives any department the option to request a change to their par level quantities. All change requests are analyzed and addressed by the materials team.
Critical success factors
The critical success factors in establishing a smooth and well-balanced par-level system are: a good understanding of inventory management principles; a well-defined demand analysis model for establishing point of use requirements; strong supplier partnerships for the flexibility required in a unique and dynamic demand environment; and an uninterrupted flow of supply.
So what’s next? Well, we already have the technology to transform point of use consumption into automated requisitions sent to either an internal control source or via Internet transmission directly to suppliers.
While the benefits are obvious, the decision to go to the next level will ultimately hinge on cost-benefit analysis.
Mike Kamel, C.P.M., C.P.P., is director of materials management and support services at St. Mary's Hospital Center in Montreal.
Practitioners interested in submitting an article to In the Field should contact the
editor at lisa.wichmann@pb2b.rogers.com
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