Journal of healthcare materiel management最新文献

Automated materials handling systems have provided dramatic labor savings and efficiency benefits to healthcare facilities. A growing trend is the use of a new breed of service robots that provide automated materials handling without major modifications to the existing building. The robots navigate through hallways, go through doors and ride elevators using a computerized controller that contains a layout of each floor of the hospital; the robots do not rely on any type of physical track to guide them on their way. The robots are programmed to pick up or deliver supplies to nursing stations or other departments, and determine the best route. Purchase and rental options exist at a substantial savings over human labor.

Those of us in the healthcare industry have done a good job in demonstrating the value of our services in relationship to other activities government might undertake. We have done less well in recognizing the demands of individuals to make decisions about their own lives and the healthcare benefits they want. We continue to believe we know best, even to the point that we distrust the public to make appropriate decisions on their own behalf. A major part of freedom is the opportunity to learn from mistakes. When professionals restrict our freedom to choose, we all lose important rights. As the various bills make their way through Congress, we should look beyond our healthcare blinders and see that the public will reject industry-driven plans with almost the same level of suspicion given to the government and business.

Outpatient surgery will be the driving force in the continued growth of ambulatory care in the 1990s. Providing efficient, high-quality ambulatory surgical services should therefore be a priority among healthcare providers. Arthur Andersen conducted a survey to discover best practices in ambulatory surgical service. General success characteristics of best performers were business-focused relationships with physicians, the use of clinical protocols, patient convenience, cost management, strong leadership, teamwork, streamlined processes and efficient design. Other important factors included scheduling to maximize OR room use; achieving surgical efficiencies through reduced case pack assembly errors and equipment availability; a focus on cost capture rather than charge capture; sound materiel management practices, such as standardization and vendor teaming; and the appropriate use of automated systems. It is important to evaluate whether the best practices are applicable to your environment and what specific changes to your current processes would be necessary to adopt them.

Rochester General Hospital in Rochester, NY, included as part of its total quality management effort the task of revising job descriptions for its sterile processing technicians as a way to decrease turnover and increase job satisfaction, teamwork and quality output. The department's quality team developed "skill banding," a tool that combines skill-based pay with large salary ranges that span job classifications normally covered by several separate salary ranges. They defined the necessary competencies needed to move through five skill bands and worked with the rest of the department to fine-tune the details. The process has only recently been implemented, but department employees are enthusiastic about it.

At the Hospital of Saint Raphael in New Haven, CT, the system for identifying and delivering items requested in between regular deliveries to patient care units was not efficient. The Materials Services Center (MSC) staff was frustrated at having to second-guess the needs of the medical floors, and the nursing staff was irate over the number of errors in the supplies they received. In addition, floors were borrowing supplies from each other, and the charges were being lost in the shuffle. The Materials Services Department solved the problem by developing a catalog and order transaction forms that matched requests with standard item numbers and descriptions. Customer satisfaction is way up and lost charges are way down as a result.

Picture archiving and communication systems (PACS) were introduced in the 1980s as the ultimate solution for managing radiological films, but technical limitations and high costs prevented all but a few well-funded institutions from experimenting with PACS. Today, technology is catching up with the early vision of PACS. Partial-PACS solutions can be applied to specific departmental needs and be part of a planned migration toward filmless radiology. The most prevalent PACS solutions today are teleradiology reading stations that enable a department to deliver images over the telephone lines to on-call radiologists' homes, but other applications are growing rapidly. Benefits include more timely patient treatment, increased productivity, elimination of lost films and reduced costs in labor, film and supplies. Each facility must carefully weigh the objectives for a PACS solution and perform a careful cost/benefit analysis before acquiring a system.

Ethylene oxide mixed with chlorofluorocarbons has been the sterilant of choice for heat- and pressure-sensitive instruments and equipment in most Canadian and U.S. healthcare facilities. A pending July 1, 1994 ban on CFCs in British Columbia propelled the Greater Vancouver Regional Hospital District (GVRHD) to seek out any new available technologies to replace EtO sterilization. AbTox Plazlyte Sterilization System, which employs a proprietary, low-temperature gas plasma in conjunction with vaporized peracetic acid chemistry to provide terminal sterilization of instruments and devices, appeared very promising. A task force was formed at the Richmond Hospital to develop and implement a clinical isolate test protocol of the system. Following the three-month trial, the results showed the system to be effective in sterilizing all clinical isolates and compatible with the materials tested. There has also been improved product throughput. The Richmond Hospital now uses one Plazlyte sterilizer to process all items formerly processed using EtO.