As the mobile workforce and skeleton of inventory management operations facility-wide, carts and storage systems have seen their share of design improvements over the years, ranging from minor tweaks to full-blown overhauls in functionality, organization, shape and utility.
Healthcare Purchasing News has explored and detailed progressive developments in carts and storage system capabilities for the last 40 years, and as HPN celebrates its 40th anniversary this year, it opted to peer back on where carts and storage systems have been, where they’re at now and where they’re headed in the future.
So HPN reached out to the leading manufacturers of carts and storage systems serving the healthcare industry to ask them what has stood out over the last four decades and has withstood the test of time?
Seven companies shared their impressions and insights about overall product trends — including the most intriguing advancements and innovations — during the last four decades, how they addressed those trends through their own product lines and then how they’re steering toward the future based on perceived customer and market demands.
Backward glances forward
Michael Couch, Marketing Manager, Medical Casework, Seating & Care Exchange Products, Midmark Corp., Dayton, OH, pointed to technology’s application to a changing footprint in a healthcare facility as a key barometer.
“The biggest change in the medical space is the use and implementation of technology in the medical workflow,” Couch said. “Technology has changed the layout in the room and the products in the room, as well as how we store items in the medical space. Forty years ago, the outpatient space was primarily independent and would store as much in the space as possible to maximize their limited buying power. Now with the normalization of just-in-time shipping, and the high likelihood that the same practice is part of a large health system, the need for massive amounts of storage has been decreased significantly.
“Today, it is not about better storage,” he added. “It is about having the right storage to enhance your workflow.”
Flexibility and portability also played a key role in footprint and workflow issues, according to Amy Flynn, OR/CS Market Manager, Hänel Storage Systems, Pittsburgh.
“Storage solutions have evolved to the point that individual carts and workstations are not needed as often, and can be used to transfer supplies from point to point, rather than as a static storage location,” Flynn said. “Vertical storage carousels provide much more storage within a higher density and a smaller footprint.”
Perhaps one of the more noteworthy progressive developments in carts and storage systems over the last four decades involves the emergence of affixed or embedded automation and computer technology, first as a theft deterrent for medications and later supplies, then as a usage monitor and also an auditing/tracking system.
“The most significant initial advancement for medication management was when personal computing technology was integrated into dispensing cabinets and carts, providing secure storage and record keeping capabilities to medications stored in patient care areas,” indicated Jason Strohm, Vice President and General Manager Worldwide, Dispensing and Preparation Technologies, BD, Franklin Lakes, NJ. “This technology was first developed for controlled substances around 30 years ago.” BD markets the Pyxis-branded technology, which it acquired through its acquisition of Cardinal Health-spinoff CareFusion back in 2009.
“Nurses were the original champions of this new technology since it precluded the need for time consuming manual record keeping of narcotics as well as minimizing drug diversion,” Strohm continued. “ As use of these systems spread, state regulatory agencies integrated this technology into their requirements for controlled substances.”
As hospital and pharmacy information systems expanded, these automated dispensing cabinets (ADC) interfaced with them, too, according to Strohm. “This technology increased medication safety by limiting nurse medication access to just medication orders approved by pharmacy, while continuing to provide labor efficiencies for nurses,” he said. “The positive ROI allowed hospitals to justify their investments while also increasing overall medication safety. The cart and storage hardware enabled by software was ideal for single-site hospitals.”
With hospitals and other healthcare facilities consolidating operations as part of integrated delivery networks and accountable care organizations amid healthcare reform measures, ADCs enabled enterprise-wide medication management practices and procedures, Strohm said. “New enterprise functionality and centralized medication management capabilities to support IDNs was introduced in the market place in 2013,” he added, “enabling practice standardization, increased efficiency, control and lower cost for managing medication. “
For carts, Dustin Patterson, Director of Operations, LogiQuip LLC, Galesburg, MI, agreed that automation and computers represented the more recent developments and improvements. In fact, connectivity and information technology has impacted cart design and functionality at an “exponential rate,” he observed.
“Utilization of electronic controls, integration with hospital Wi-Fi systems and proximity card readers are all more commonly used providing greater control of and more secure access to carts,” he said.
Storage systems have benefited from similar enhancements, Patterson noted.
“Some storage systems — enclosed or open — have incorporated some form of RFID, barcode reader or computer data entry to manage inventory items,” he said. “While the ROI has been questionable in some applications, it has had some success in adoption in areas where expensive and critical inventory items are stored.”
Craig Orlove, Senior Product Manager, Healthcare, InterMetro Industries Corp., Wilkes-Barre, PA, simply pointed to “keyless entry and auto-relocking” as functional features healthcare organizations needed on carts.
Owings Mills, MD-based Tollos CEO Jon Winer singles out composition and construction materials as intriguing and notable developmental improvements, spanning the last 40 years.
“Today cart and storage systems can be made up of environmentally-friendly materials like aluminum that are terrifically strong yet lightweight,” Winer said. “Anodized aluminum is a great enhancement that results in carts and other storage systems to be highly durable, scratch-resistant, easy to clean and environmentally safe. Anodizing is an electrochemical process that converts the metal surface into a decorative, durable, corrosion-resistant, anodic oxide finish. The increased use of different kinds of plastic has also made for lighter and easier to push and pull systems that are more durable and easily shaped into features like rounded corners. Certain types of plastic that are available now but weren’t 40 years ago make for better efficient and longer shelf lives of carts and storage systems.”
Patterson specified the availability of “much improved” drawer organizers in carts as providing clinicians with faster and easier access to supplies. Beyond better functionality, “newer carts have an improved architectural design and appeal,” he added. “Cart design and performance needed to reflect increasing patient-centric designs, such as quiet operation and infection prevention.”
Open and enclosed storage system designs have enabled “greater space compression and inventory item organization,” he continued. “This has freed considerable space within hospitals and has removed nursing and other non-supply chain functions from inventory management. “ Through Lean Management practices, storage systems have incorporated Kanban accessories and related products that have “transformed static storage into part of an on-going Lean inventory management process.”
Managing available real estate makes a huge difference in storage areas, emphasized Dick Felger, Vice President, Sales, PAR Excellence Systems Inc., Cincinnati.
“Most hospital storage areas have become more organized with the use of individual bins for each individual item,” Felger told HPN. “The many size options with bins has provided flexibility and eliminated significant ‘dead’ space that was a problem with many shelves and racks. This storage method makes it easier and saves time for a caregiver to locate supplies and much faster for a materials tech to re-stock. Adding technology to this storage method is less complicated. Automation success starts with organization.”
Paul Smith, President and CEO, FIRST Healthcare Products Inc., Sanborn, NY, credits healthcare organizations — providers and suppliers alike — for keeping this equipment apace with market and industry developments.
“Storage carts have benefited over the decades from significant improvements to the cost and performance of plastic, steel and other components,” Smith noted. “Cart suppliers have been able to improve their value proposition steadily by employing new technologies and new materials. Many of these changes are not obvious, but we sweat the small details on components and they translate into important performance improvements for increasingly demanding healthcare applications.”
More than meets the eye
Cart and storage system manufacturer executives descr
ibe product development and improvement during the last four decades as organically transformative.
Hänel’s Flynn pointed up, as in using vertical space as eye-opening. “People across all industries have begun to recognize the need to utilize the space above their heads, and it costs far less to fill that space than it does to create additional space through renovation or new construction,” she said.
For storage systems, LogiQuip’s Patterson echoed “space optimization” along with connectivity.
“Supply chain demands for operational efficiency, accuracy and connectivity will drive this,” he said. “Data analytics will start with enhanced and simplified connectivity at the storage site due to [Internet of Things] technology. Hospitals will look to reduce valuable space used for inventory storage and convert to revenue-generating clinical activities.”
Electronic controls and connectivity have driven cart progression, he continued. “Hospitals and clinicians demand more secure and controlled access to patient treatment carts with information provided that controls this,” he added.
InterMetro’s Orlove specified modularity as a key advancement. “Modular application-specific solutions have allowed the cart and storage systems to become a more important and integral part of the patient care process,” he said.
BD’s Strohm emphasized four terms — “computerized, secure, safer and efficient” as definitive. Tollos’ Winer added “mechanized, ergonomic and customizable” to the mix, along with material evolution with strong, lighter materials such as aluminum and plastic joining heavier materials such as steel and wood. Midmark’s Couch offered the fashionable, “function without sacrificing aesthetic.”
Healthcare organizations demand “extreme durability, high mobility, small footprints, increasingly specific applications and low costs,” indicated FIRST Healthcare’s Smith. “Like other healthcare suppliers, cart manufacturers have sought out and employed new materials, such as stronger plastics with antimicrobial properties, and utilized improved manufacturing technologies to create safer, more durable carts at lower costs while dramatically expanding the range of options available to address unique new applications.”
Rick Dana Barlow | Senior Editor
Rick Dana Barlow is Senior Editor for Healthcare Purchasing News, an Endeavor Business Media publication. He can be reached at [email protected].
