Integrated Logistics in Hospitals

Keyur ShahNarayanan Palani

Inventory Products and Non-inventory Products

• Two major management methods are applied by hospitals. Inventory Products:• Certain products are managed and stored in the hospital’s

stores (or pharmacy) before being distributed to specific departments

Non-inventory Products:• Other items are ordered directly by specific departments

from the purchasing department, which oversees the purchases as needed and delivers them upon receipt to the departments. These are generally not stored in the institution’s stores.

INTEGRATED LOGISTICS

• Inventory flow– Physical Distribution– Manufacturing Support– Procurement

• Information flow– Planning and Coordination Flows– Operational Flows

Integrated Logistics Flow

Planning and Coordination Flows

Physical Distribution Flow

Physical Distribution Performance Cycles

Key factors

• Increased digital interaction and communication

• Increased availability-Always fast access• Efficient and secure communication access• Always up to date patient information- focus

on the patient

Integrated Logistics Benchmarking-Three Steps

1. Hospital logistics process2. Analytical model3. Data collection approach

Hospital Logistics Process• Stock ordering and management:

1. Identify Needs2. Create, Process and Track orders3. Review stores and pharmacy management parameters

• Order Receipt1. Take receipt of and check items2. Transfer and stock items in stores or the pharmacy3. Authorize payments to suppliers

• Stock Replenishment1. Order items from stores of the pharmacy2. Collect items from stores or the pharmacy3. Transport items to patient care units4. Store items in patients care units5. Review patient care unit management parameters

Analytical Model

• The analysis hones in on two types of performance measures — efficiency and quality.

• Since labor accounts for about 60% of a hospital’s costs, the primary element affecting cost calculations is the time spent by personnel in carrying out various logistical activities.

• A second element, technology maintenance expenses, was also considered to build a more thorough picture of the situation.

• The quality of the logistics process was also considered in the measurements of hospital performance.

Service Quality Performance Measures

Data CollectionPhase1:• The data collection combined case studies of five hospitals, which provided an in-depth

study of a limited number of sites, and questionnaires, which delivered the advantage of reaching a large number of respondents at a reasonable cost.

• This hybrid method thus identifies the practices deployed by institutions and determines their performance level.

Phase2:• A second data collection phase specific to the most promising practices will therefore be

needed to identify the impacts of implementing these practices. • This phase will be conducted on a much more limited scale, since only the most promising

hospitals will be visited.• In the current context, where health institutions must carefully manage public funds, where

public accountability is becoming more and more pressing, and where governments are trying to motivate hospitals by rewarding high performing ones and penalizing those that are not performing as well, improving the logistics process through the implementation of best practices has become a must. Identifying best practices by benchmarking the hospital logistics process can help hospital managers find cures for the ailing health sector.

Traditional Approach

Functionality Integration

Integrated Logistics at Internal Hospital Administration(Middleware Enabled)

Integrated Logistics Implementation at Health Institutions

Integrated Logistics between Pharmacy, Stores and Hospital Departments

Healthcare Logistics - Facility MovingCase Study

• Transportation Management - Communication and coordination with each health care material vendor for optimal transportation passage to site.

• Capital Equipment Accounting and Identification - Beltmann ensures that all POs within the program are received and delivered in perfect order.

• Inventory Management Services - Beltmann leverages an ideal blend of asset and non-asset based facilities and specialized transportation equipment to securely manage the inbound receiving, inventory, and material inspection process.

• Sequenced Site Deliveries - Beltmann's fulfillment professionals facilitate the timely delivery of all program equipment - either direct to site or via the local warehouse in the most cost effective manner available.

Implementations• Medical Equipment Installation Services - Beltmann provides qualified, in-house staff

who assemble and install many types of health care equipment. Examples include:– Shelving (both static and mobile)– Crash cart assembly– Otoscopes, ophthalmoscopes, BP units– Whiteboards, bulletin boards– Glove box dispensers, sharps containers– Artwork and signage– Case goods– Bed assembly

• Technology - Beltmann provides project milestone visibility to each and every PO we manage through Beltmann's proprietary technology - TotalTrak.

• Centralized Reporting - TotalTrak provides a variety of reports and key metric summaries for each project via password-protected web-access. These reports may also be generated and transmitted to Beltmann's clients via a variety of electronic means.

Integrated Logistics through dedicated departments

• Project Management - Beltmann assigns an experienced, in-house project manager to successfully coordinate all project phases through program completion.

• Transition Management - After the new facility is complete, Beltmann tightly manages the move of the existing equipment and staff into the new space.

• Relocation Management - Beltmann's 60 years of experience in professional relocation provides superior, cost effective services for all types of health care moving projects, including:

• Medical Records: packed, moved, unpacked in HIPAA compliance• Laboratory Moves: we know the proper way to decommission, relocate and re-

commission all types of labs without compromising your studies.• Medical Equipment Moves: from incubators to -80's, Beltmann staff can handle the

intricacies of moving high value equipment safely, every time.• Professional Staff New Hires - Beltmann's worldwide relocation network allows

you to move those new hires' labs, office effects and household goods from anywhere in the country or the world with efficiency and precision

Transporting Costly, Complex Medical Equipment-Case Study

Client Challenge• When hospitals or clinics purchase valuable medical equipment, they expect it to arrive

undamaged, on time, and be installed in the facility by trained professionals. Our client asked us to deliver a multi-million dollar diagnostic imaging system produced by one of the world's leading medical equipment manufacturers. Medical install crews were waiting, so our on-time performance was crucial.

Beltmann Approach• Several shipments have taken place since we were initially engaged by this client and

many times the shipments have been expedited, making it our responsibility to react and add additional capacity to our fleet as needed. For this client to-date, 28 drivers have been assigned to the dedicated fleet, with many more trained to serve as reinforcements during peak periods. Each driver is equipped with a lift gate trailer to ensure secure deliveries of equipment to medical facilities without shipping docks. Adding value

Value & Impact• Increased speed to market with equipment 99.65% on time delivery performance Claims

frequency of less than 0.2%

Proper and safe removal of obsolete medical equipment

Client Challenge• A major medical supplier had purchased a new medical system, replacing a unit currently in

place in its facility. To prepare for the new system, the existing unit had to be properly and safely de-installed and removed from the premises prior to delivery of the new unit.

Beltmann Approach• Beltmann’s drivers met the de-installation technicians on site and worked with them to

dissemble and remove the old unit. This approach minimizes disruption to patients and staff within the hospital or clinic. After removing the old unit from the facility, the driver transported it to the designated recycling facility, where it was either scrapped or designated for refurbishment.Beltmann reverse logistics system allows Beltmann's drivers to work in concert with field technicians to have old equipment removed from the hospital or clinic as its being reinstalled.

Value & Impact• Fewer interruptions for hospital or clinic staff• Increased productivity for field technicians• Trained professional personnel ensures safe and expeditious removal

Integrated Logistics at Air force Medical Service

• Medical Logistics Support for Deployed Expeditionary Medical Support (EMED)S/ Air Force Theater Hospital (AFTH)

• War Reserve Materiel (WRM)• Storage Requirements• Annual Inventory Requirements• Automated Information Systems (AIS)• Initial Response Materiel• Sustainment• Sustainment Process• Successful Sustainment Concept• Biomedical Equipment Maintenance

Integrated Logistics Flow at Basic Tent Configuration:

Figure 1:EMEDS Basic Tent Configuration

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Figure 2:EMEDS +10 Bed AFTH Tent Configuration

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Integrated Logistics for EMEDS+25Bed AFTH Tent Configuration:

Figure 3:EMEDS +25 Bed AFTH Tent Configuration

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Notional EMEDS+50 Bed AFTH Configurations:

Notional EMEDS +114 Bed AFTH Configurations:

Thank You