Automatic transport of goods in the hospital

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The automatic goods transport (AWT) in the hospital is a sub-discipline of hospital logistics . AWT systems are very powerful systems for the automated transport of a wide variety of goods and materials within a hospital, which on the one hand can carry out thousands of transports per day, on the other hand because of this high transport performance - and the high investment costs associated with the installation - but not in all, but are more likely to be used in medium-sized and large hospitals (e.g. University Clinic Cologne , Düsseldorf , Münster ).

Logistics in the hospital

In Europe, the teaching hospitals known today developed in the 18th century from the previously common poor houses . The best-known example of an early modern hospital is the Charité in Berlin, which was founded in 1710 as the Pest Hospital . Smaller houses offer from 100 beds, large ones up to 1,000 and more; the average in Germany in 2012 was 250 beds per hospital. This means that several hundred patients have to be cared for every day, which results in a wide variety of flows of goods:

The core competence of a hospital is the improvement of the patient's health . In this context, hospital logistics must ensure the availability of all the necessary resources in order to guarantee optimal patient care. At the same time, it should sustainably increase or maintain profitability in the hospital through efficient process design. As in industrial logistics, automated or automatable goods transport can make a significant contribution to this.

The Automated Materials Handling (AWT) in the Hospital Logistics utilizes a variety of designs: Power & Free systems, electrified monorail systems (EMS), Automatic Guided Vehicles (AGV), container handling equipment, freight elevators and pneumatic tube systems . The automated transport of people / patients, organs and beds is not the subject of this consideration.

When material flow within a hospital are essentially the areas of medicine (for example, OP, pharmacy, central sterilization), maintenance (eg ward), Food supply (in this central kitchen), Magazine / warehouse and technology services (such as waste disposal, container storage, container washing system) to call.

Driverless transport vehicle (AGV) with stainless steel roll containers for transport in hospitals

The supply and disposal of these areas is mainly carried out by means of roll containers made of stainless steel in different versions for food, laundry, sterile goods, medicines, stored goods and waste. Timely delivery of the containers to the recipient (bed wards) is particularly important when it comes to food supply. For this purpose, the transport processes must be aligned with the fixed and strictly adhered to schedules and thus have top priority. Compliance with hygiene regulations is also important in order to prevent the so-called spread of germs across ward boundaries.

Transport routes of a few hundred meters to several kilometers are usually found. A few hundred to a few thousand transports per day are handled here. Due to the currently applicable safety regulations, these transport routes are strictly separated from the areas in which patients and visitors of a hospital are located and are usually located in the basement / basement.

Modes of transport

In the following, the logistic processes that are carried out in a hospital are presented. Other types of load carriers such as trolleys, lattice boxes, etc., which are also used in hospital logistics, are also equated with containers.

Food transports serve to deliver meals (food and drinks) to the care stations as well as to pick up the dishes and any leftover food.

The special requirements for food transport result from the strict food law regulations: Keeping food warm for a long time is not permitted due to the loss of quality in terms of aroma , consistency and nutritional value , but also because of the risk of germs multiplying. Organizational measures, such as the delivery of meals according to strict schedules, take effect here. There are two common ways to prepare hot meals:

  • With cook-and-serve, the dishes are usually produced in the central kitchen and stored hot in special containers in warming trolleys (containers). They must then be delivered to the wards immediately.
  • With the cook-and-chill method (English for "cooking and cooling"), the food is only pre-cooked. Then they are strongly cooled down in a shock cooler. In this state, the food can be stored in a cool place for several days. After the patient-friendly portioning on trays, the meals are placed in pre-cooled containers and then transported to the wards. Here the gentle regeneration of the food takes place approx. 30 minutes before the desired distribution time on the station.

Contaminated or used dishes are then transported back to the kitchen in the containers. After emptying and manual or automatic cleaning, the containers are returned to the supply circuit.

Laundry transports serve to deliver clean laundry and collect dirty laundry in containers. Clean and dirty laundry must not come into contact with each other. Clean laundry must be kept free of pathogens and germs during transport or sterile for certain purposes. Laundry transport containers and laundry trolleys must therefore be disinfected if necessary . The containers are made available to the supply circuit again after emptying and any cleaning / disinfection.

OR transports are used, for example, to deliver sterile surgical instruments and materials in containers as well as to collect and transport non-sterile materials back for cleaning and sterilization . The hygiene and cleanliness of the containers and, if necessary, the means of transport, play an important role inOR transports. The delivery of OR containers usually has to take place in a defined order at fixed times according to the OR plans. The return transport usually also takes place according to the surgical plans. After emptying and cleaning / disinfection, the containers are made available to the supply circuit again.

Waste transports are used to transport all types of waste in containers for waste disposal. For waste transport, containers are used that are not used for other transports and are usually transported and stored separately from all other containers. After emptying and any necessary cleaning, the containers are made available to the supply circuit again.

Pharmacy transports are used to deliver goods (e.g. medication , bandages , etc.) from the pharmacy to the wards or to the operating theater areas. The most important aspect of these transports is securing the goods / containers against unauthorized access by unauthorized persons. The hospital pharmacy is an area to which only authorized personnel have access. The container must be securely locked during provision and transport in order to prevent unauthorized access. The transports are usually to be carried out quickly (security / storage / priority). The containers are made available to the supply cycle again after they have been returned.

Storage / magazine transports are used to transport general goods, such as consumables, in containers. This includes, among other things, transports from incoming goods to the warehouse and magazines as well as the delivery of picked goods to the various consumption points ( care stations ).

Transports from / to external are used to transport containers to a central goods issue for external areas and from the central goods receipt to the hospital areas. External areas can be laundry or kitchen , for example .

hygiene

Containers and means of transport are used in areas with different hygienic requirements. Since they themselves transport infectious material or come into contact with infected material, dangerous germs can be spread. The transmission of pathogens through containers and means of transport must be avoided. The transport processes must therefore be planned in such a way that separate transport routes are used in accordance with the given hygienic requirements. This can mean that a ward can only be reached by bypassing another ward (for example, garbage containers may not be transported via the operating theater).

In principle, the same hygiene requirements apply to automated transports as to manual transports. There are therefore at least three different, appropriately labeled types of container used, namely for food and dishes, for other goods and for waste. The type of container must be easily recognizable for the personnel. Containers and possibly transport racks must be able to be disinfected and cleaned at any time. Both chemical and physical processes can be used for disinfection, the effectiveness of which must be proven under operating conditions. As a rule, the means of transport are made of stainless steel and are therefore easy to clean and disinfect.

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