While managing inventory of patients is a key requirement of healthcare facilities, managing distributed equipment inventory doesn’t fall far behind. Having the wrong equipment, too little equipment, contaminated equipment, or equipment in the wrong spot can mean problems for patients. On the other hand, holding more equipment than you actually need is very costly.
Fortunately, managing equipment inventory and distribution is not a new problem. Many industries have addressed and optimized inventory systems and developed methods to pursue continuous improvements. Let’s consider some of the distributed equipment needs in medical facilities and discuss best practices that might apply.
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What is distributed healthcare equipment and where is it distributed?
A hospital might spend a million or more on an MRI machine, CT scanner, or other installed piece of equipment that will last for a decade or longer. This specialized, expensive equipment generally has a managed schedule for operation, cleaning, and maintenance to ensure effective utilization.
At the same time, the hospital likely has even more money invested in the distributed equipment that is used throughout the facility. In fact, GE Healthcare estimates that 95 percent of a hospital’s clinical asset base is made up of these mobile devices, such as ventilators, patient monitoring units, and telemetry.
In a modern hospital, a typical patient bed is surrounded by 13 devices, so the typical hospital likely has over 1,000 pieces of this distributed equipment. That means a lot of operation, cleaning, maintenance, and storage to manage for effective utilization. Think of the MRI schedule and multiply by 1,000. That may seem daunting, but prioritization can help. Medical researchers have created models to define what equipment to include in inventory management based on function, risks, and maintenance requirements.
A snapshot of this equipment within a facility will show many devices in patient rooms, but others in central and department storage closets and hallways. Some may even be in private cubbyholes, pirated away be well-meaning staff members who don’t want to play musical chairs with equipment, ending up without a working device when they have an urgent need.
First, determine what you have
Unless the facility already has a superior equipment management system, it’s likely that only a small part of the total inventory is being managed. So the first step—after establishing a multidisciplinary improvement team, of course—is to find out what equipment you have. In addition to the equipment itself, inventory of consumables, spare parts and other related items must be included.
Create a manual data-gathering log or use an electronic system. Ideally, you will collect information including type of device, serial number, date placed in service, most recent maintenance, next required maintenance, and designated storage location. The World Health Organization offers a recommended data template. Not all of this content will be available for all devices. However, as long as each device is given a unique identifier for the facility, it is a good start. Without unique identifiers, counting equipment is a bit like herding cats.
To avoid undercounting or double counting, it’s important to physically walk the halls to identify and count equipment in place rather than accept the recollections of busy staff members. Be sure to include operating rooms, emergency department, maintenance areas, closets, drawers, and other off-the-beaten-path locations when gathering the data.
Then, determine what to do with it
In parallel to the identification and physical count, the team can make observations of how the equipment is typically used. This follows a standard work methodology of watching—or even videotaping, complying with all privacy rules—how, where, when and how long different staff members use each type of equipment and associated supplies.
This study and the aggregate results can provide excellent answers to important questions, such as:
- Is there enough equipment across the facility for peak needs?
- Is equipment located near its point of use?
- How much variability exists between staff members in equipment usage?
- What does a “best practice” utilization model look like?
- What, if any, equipment needs to be retired and replaced?
The team can then use Lean and other methods to make improvements. A 5s approach can help define where equipment should be stored, often resulting in frequently used items nominally within arm’s reach of the user and less frequently used or more expensive items in a more controlled central location. Visual methods can help staff members tag devices for maintenance or cleaning before they are in critical need. Load leveling across peak periods and even between shifts can help to reduce need for purchasing extra equipment.
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Storage, communication, and system maintenance
Whatever system is devised will require effort to implement and maintain. Storage locations can quickly become catchall areas for broken or contaminated items or equipment that harried staff members don’t have time to properly put away. Establish storage locations using the Lean tenet, “A place for everything, everything in its place,” to make it easy to see where pieces of equipment belong and know when they are not where they need to be. Technology allows facilities to scan equipment barcodes just as they do patient wristbands to establish identity and track movement around the hospital.
Communication about the new system, establishment of personal accountabilities (e.g. Who does cleaning? Who restocks supplies?), and creation of an accountable management role within each department will help to create a sustainable system. Interconnectivity and service level agreements between healthcare staff, maintenance crews, purchasing, and other functions makes interfaces operate smoothly, avoiding the “I thought you were doing it” syndrome.
Once the new system is in place, the team will shift to sustaining mode. Gather feedback from users to measure overall satisfaction and determine what kinks need to be worked out. Conduct annual inventory counts or cycle counts to verify compliance. With a smoothly operating distributed equipment inventory management system, you will have the right equipment at the right place at the right time to help you serve your patients. Get started with your free interactive assessment from EON today.
