By Monica Perez and Hilary Bales, Contributing Writers

Healthcare facilities managers know that for their organizations to provide world-class patient care, their staff must be properly equipped with the right materials, tools and supplies. Even before the COVID-19 pandemic, supply chain issues plagued hospital systems. Inefficient operational workflows, unreliable vendors, labor and supply shortages and a lack of proper supply tracking are among the challenges managers have faced in keeping a fully stocked facility. 

These compounding issues have encouraged many managers to re-evaluate their facilities’ storage and flow within the materials management department. Several healthcare clients — including regional hospitals, large academic healthcare campuses, and U.S. Department of Veterans Affairs (VA) medical centers —engaged our firm to improve the efficiency and functionality of their supply management areas. 

Some managers asked us to identify opportunities within existing footprints, while others were looking for new designs to improve storage capacities and operational workflow. Here is what we gleaned from these projects. 

Maximize storage, streamline distribution 

We worked closely with a major Mid-Atlantic region hospital that could not effectively manage its daily volume of supplies, linen and mail while simultaneously processing outgoing materials —such as soiled linen, trash and recyclables — from its existing loading dock area, which was approximately 19,000 square feet. 

As the facility grew, its central stores had become more decentralized, with multiple storage sites around campus and constantly shuffling supplies. With management focused on patient care and revenue generation, logistic integration was not a priority until it impacted care delivery. 

To help resolve these issues, our team was asked to streamline the design and develop construction phasing to increase the capacity and size of the loading dock, receiving and staging space and adjacent materials management and environmental services areas. 

The team designed a larger, central storage materials management department that provides greater flexibility while improving inventory controls by locating more supplies in a centralized, monitored location. If additional supplies are required — in case of a patient surge, for instance — the space can accommodate higher quantities of specific supplies and account for their distribution to departments due to improved inventory control and monitoring. 

If enlarging the central storage site on campus is not possible, another solution that has worked is an off-site, centralized supply strategy where underground tunnels connect the central warehouse to the medical facilities to aid in materials distribution. We also have had facilities successfully use storage pods, which can be effective and inexpensive ways to provide locally centralized materials. 

Automate and secure deliveries 

To address unreliable deliveries by third-party vendors, a hospital system we worked with purchased its own distribution trucks to handle multiple daily deliveries to its portfolio of facilities. This approach improved on-time arrivals and kept rising supply chain costs at bay. It also made it easier to balance supply and demand across the system and build reserves for so-called black swan events, which are almost impossible to predict but after the fact seem to have been inevitable. 

To reduce staff time spent on restocking or searching for and gathering supplies, our work with a Houston hospital included implementing a mobile robot made specifically for healthcare facilities. The robot uses a built-in map and sensors to navigate hospital corridors and communicates with elevators, fire alarms and automatic doors via Wi-Fi. These robots can transport carts and other supply compartments, and they can deliver medications from the pharmacy. They move around the hospital autonomously, giving employees more time to interact with patients. 

Security is also critical when it comes to tracking materials and supplies for invoicing and maintaining proper accounting of hospital costs. Materials are often left unsecured on pallets on loading docks, corridors, supply rooms and wherever additional storage can be found. Controlled handling of material goods is critical throughout the supply chain process. 

Goods originating from the central supply center are delivered to the facility loading dock and unpacked in staging areas before being organized in a central showroom. Materials management and environmental services staff then gather their required daily supplies and put them on rolling carts to distribute to different clean supply and linen rooms. 

To help with accountability of used items and tracking costs per department, a VA medical center we worked with in Florida purchased vertical carousels and high-density storage for inventory management. Supplies on the carousels were secured through password protection, access logs and physical protection of stored goods. 

The vertically stacked carousels also save up to 75 percent of floor space by using the full height of the room for storage. Some facilities use barcode-based medical asset tracking systems, which provide useful data for budgeting and procurement of supplies. 

Engage staff to optimize workflow 

Healthcare facilities managers can streamline workflow processes by asking staff to identify pinch points and obstacles encountered when performing specific tasks. Our team then can help reduce friction and improve support processes. Even when a healthcare facility’s order of operations is well planned, a lack of space and erratically timed deliveries can gum up the flow of operations. 

For instance, regular mail deliveries such as the U.S. Postal Service, Amazon, FedEx and UPS run on their own distribution route schedules. A large quantity of packages arriving while material management staff members are stocking the units could mean items sit on the loading dock blocking access for other timed deliveries. Facilities need a dedicated or secure space for these packages to sit in holding until they can be sorted and distributed. 

Bringing it all together 

For these and other operational challenges, our team’s approach is to identify client goals through immersion and client interviews, analyze processes and verify user needs and supply circulation to inform the needed architectural interventions. 

For the Mid-Atlantic region hospital project, our team spent multiple days interviewing key staff from each department and shadowing operations to better understand roles and responsibilities. Every department that used the off-stage corridor for any reason was shadowed and interviewed. Materials management, environmental services, morgue operations, the emergency department and patient transport were engaged. 

Once we analyzed the flow of people, we created flow charts and got feedback on the state of operations, which helped the design team facilitate discussions about the best workflow for the future. 

Goals included: streamline deliveries and ensuring constant supply stock; upgrade and enlarge storage spaces on site and consolidating program functions; secure all storage areas with cameras and card reader access; verify that interior and exterior architecture support incoming and outgoing supply demands; and maintain 24/7 operations during construction through careful phase planning. 

We were able to use the facility’s existing loading dock space and rearrange the material management departments to facilitate the delivery, storage, distribution and disposal of daily supply loads, helping them mitigate supply logistics challenges and move forward. 

Now is the time for hospital systems to invest in a more flexible, efficient and secure supply chain that will optimize normal daily operations and position them for crises that might bring supply shortages, delivery disruptions and patient surges. Healthcare facilities managers, architects and medical planners can help hospital systems evaluate their supply needs and workflows so they do not have to trade efficiency for resilience. 

Monica Perez is a project manager with Page. Hilary Bales is a senior healthcare planner with the firm.