Hospital logistics: three action steps to future success

Behind every hospital are sophisticated and complex logistics that must run like clockwork to keep things going. But how good are the processes when it comes to managing patient care and hospital staff? There are many weak links that can be avoided. Comprehensive digitization and efficient, targeted healthcare workforce management are required to set up hospital logistics for future success.

In this MEDICA-tradefair.com interview, Prof. Henner Gimpel talks about the "Hospital 4.0" project, describes the status quo of hospital logistics and explains what this might look like in the future.

Prof. Gimpel, what was the objective of the "Hospital 4.0" project?

Prof. Henner Gimpel: We took a closer look at hospital logistics to identify ways to make processes leaner and more efficient with digital technologies. The goal was to remove inefficiencies and waste and optimize flow to improve all quality dimensions of care delivery.

We teamed up with the University Hospital Augsburg and the Bayreuth Medical Center (German: Klinikum Bayreuth) and got detailed information on processes in these facilities. Together with the University of Applied Sciences Ingolstadt and POLAVIS, a Berlin-based developer of information technology solutions for hospitals, we have drawn up possible solutions.

How would you rate the current state of hospital logistics?

Gimpel: We must look at this from different perspectives. When it comes to the conditions and surrounding influences of work, I would give logistics in most of the facilities I know a poor rating. This pertains to structural designs and the IT systems, but also refers to many work procedures.

That being said, when it comes to the hospital team members themselves, I am always impressed with the knowledge, excellent work, and commitment they give to their hospital to keep things going despite working conditions that need improvement.

Have you identified specific weak links in hospital processes?  

Gimpel: We reviewed two specific processes. The first one pertains to material logistics, that being all aspects starting with the arrival of the delivering carrier at the loading ramp, all the way to the use of the material at the patient's bedside. The second process is bed management: How are hospital beds transported through the facility and then cleaned? How are they returned to where they came from?

Some hospital warehouses process material requisitions without requirement prioritization in the order in which they are received. When it comes to urgent requests, the process moves faster if a nurse personally visits the warehouse to pick up the material. All told, the nursing staff is generally too involved in logistics processes, which includes inventory control at the wards, or the creation of material requisition forms. These are tasks that could also be handled by a care assistant, which would enable the nursing staff to spend less time with logistics tasks and more time with patients.

There is also a lack of transparency: most hospitals today do not have a clear view into their on-hand inventory. The central warehouse actually has a good record, but often classifies inventories that was brought to wards as "consumed" even though the material can still be used for quite some time. If there is a product recall, no one knows where parts of a batch are located.

What is your process improvement proposal?

Gimpel: Hospitals should take three action steps. First, materials, beds, and equipment must be clearly identifiable with machine-readable codes such as QR codes, RFID chips, or Bluetooth beacons. Second, these objects must be easy to locate and track. This means you must know about the inventory in each cabinet. The third step is to assess the object’s condition. This includes the expiration date of medical consumables, for example. Meanwhile, hospital beds must be assessed based on their cleanliness, impurity, or infection-associated factors.

Apart from the use of digital technologies, how can healthcare workforce management be optimized?

Gimpel: As I mentioned earlier, nursing and medical staff should only have limited involvement in logistics processes, thus allowing them to focus on their primary role of delivering patient-centered healthcare.

We also need specialists that handle logistics tasks. To improve employee efficiency, the staff should not manage processes that require unnecessary steps or take on tasks that software could handle.

You and your colleagues plan to publish the project findings in a book that outlines the ideal hospital logistics of the future. What does your future 2030 logistics scenario look like?

Gimpel: The logistics of individual hospitals will be more IT-assisted than ever before. The Internet of Things will have a major impact, prompting us to use digital technologies to identify, track, and assess the conditions of both the hospital's infrastructure and the individual objects. Data analytics and AI applications will likewise play a greater role in process optimization and effective healthcare workforce management. A 2030 deadline is already a big step for many hospitals.

In reality, we should look even further down the road and ask ourselves today: Does it make sense for hospitals to have their own logistics system? Of course, this also depends on the hospital size, but it likely makes more sense for smaller hospitals to merge into larger systems, which are subsequently managed by a central service department. This would make processes more efficient, and they would benefit from scale effects. Hospitals could then get back to focusing on their core business strengths.