Transplant Center Supply System Design Final Reportioe481/ioe481_past_reports/W1301.pdf · 2013. 5. 8. · of Engineering Industrial and Operations Engineering Program to create a

Transplant Center Supply System Design

Final Report

Submitted To:

Helen Costis, Client Director of Operations, Transplant Center

University of Michigan Health System 1500 E. Medical Center Drive

Ann Arbor, MI 48109

Dianne Sodt-Davitt, Client Nurse Manager, Transplant Center


Ann Arbor, MI 48109

Patricia Dare, Client Lead Medical Assistant, Transplant Center


Ann Arbor, MI 48109

Chris Kafantaris, Coordinator Engineer at the Lean Center

2101 Commonwealth Ann Arbor, MI 48105

Mary Duck, Class Instructor

Department of Industrial and Operations Engineering 1205 Beal Ave.

Ann Arbor, MI 48109

Submitted By:

IOE 481 Practicum in Hospital Systems Team 1

Dongfang Lan, Student Ann Schumar, Student Joseph Winn, Student

Date Submitted: April 23, 2013

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Table of Contents

Executive Summary ........................................................................................................................ 1 Background ................................................................................................................................. 1

Methodology ................................................................................................................................ 1

Findings ....................................................................................................................................... 2

Conclusions ................................................................................................................................. 2

Recommendations ....................................................................................................................... 3

Introduction ..................................................................................................................................... 4

Background ..................................................................................................................................... 4

Key Issues .................................................................................................................................... 5

Goals and Objectives .................................................................................................................. 5

Project Scope .............................................................................................................................. 5

Data Collection ............................................................................................................................... 6

Literature Search ....................................................................................................................... 6

Obeservation ............................................................................................................................... 6

Materiel Specialists Interview ..................................................................................................... 6

Data Analysis……………….......…….…………………………………………………………………..7

Data Analysis .................................................................................................................................. 7

Par Level Calculations ................................................................................................................ 7

Quality Assurance ....................................................................................................................... 8

Lean Manufacturing .................................................................................................................... 8

Findings and Conclusions ............................................................................................................. 10

Recommendations ......................................................................................................................... 10

Expected Impact ........................................................................................................................... 11

Appendix ....................................................................................................................................... 12

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List of Figures and Tables

Figure 1: Current Materiel Flow for Transplant Operations ........................................................... 4

Figure 2: 5S process ........................................................................................................................ 9

Table 1: Par Level Calculation and Example ................................................................................. 7

Table 2: Restocking Schedule ....................................................................................................... 11

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Executive Summary

Transplant services at the University of Michigan Health System (UMHS) currently take place in three areas: the Kidney Clinic, the Liver Clinic, and the General Surgery department. To streamline transplant operations and simplify the patient care process, UMHS is consolidating all transplant services into a single Transplant Center (TC) due to open September 2013. The new TC lacks a complete materiel, and hospital staff needed to establish a central supply system and a layout for materiel storage in the TC to support TC operations. IOE 481 Team 1 was asked to determine the materiel necessary for the new transplant area, establish par (periodically automatically restocked) stock levels for the materiel, and design layouts for materiel storage throughout the TC.

Background

All materiel supply and stocking at UMHS is managed by the Materiel Services Department. Materiel Services is in charge of ordering materiel from vendors, delivering to the various hospital departments, and restocking materiel as needed. Materiel supply chain policies for the current transplant areas vary, with some areas having established par levels, and others requiring weekly custom orders from area staff to replace depleted stock. In areas where par levels have been established, Materiel Services restocks on a regular basis to a pre-determined optimum par level. The team was informed that Materiel Services would have usage data that could be used to complete our task of building the materiel list and par levels for the new TC. The team will build materiel lists, par levels, and layouts for the three areas that will hold materiel from Materiel Services:

• 1 clean room • 34 exam rooms (all containing identical materiel) • 17 supply carts (all containing identical materiel)

Methodology

The team performed six types of tasks to design and validate a materiel supply chain for the TC.

1. Literature Search: The team conducted a literature search of past IOE 481 projects and related academic literature to identify useful methods of data collection, and for reference on final report formatting.

2. Observations: The team observed each of the current transplant areas for two hours to better understand existing materiel storage and usage procedures.

3. Materiel Specialist Interviews: The team interviewed materiel specialists from each of the four areas involved in the process:

• The Kidney Clinic • The Liver Clinic • The General Surgery area • The Materiel Services group

4. Usage Data: Usage data for the 3 hospital departments containing the transplant services

areas were obtained from the Materiel Services Manager. Each of the 3 usage data lists

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contained roughly 200 items. The team sorted the usage data by usage level using statistical software.

5. Par Level Calculation: The team utilized a par level calculation methodology recommended by the team coordinator and the Materiel Services Department.

6. Quality Assurance: To ensure the materiel lists and par developed were accurate, mock-up versions of the supply carts and exam room supply caddy were built. The mock-ups were put into use during actual transplant clinic periods over the course of a week. The team collected feedback both verbally from staff and via feedback forms the team constructed and left with the mock-ups during the trial week.

7. Lean Manufacturing (5S): The team applied lean manufacturing principles, specifically, 5S, to improve the layout and accessibility of the supply cart and caddy. The team sorted, straightened, shined, standardized, and sustained the contents of the supply carts and caddies.

Findings and Conclusions

The findings and conclusions corresponding to each of the data methods are listed below:

Literature Search Findings: Observations, specialist interviews, and past usage data were common methods for data collection in past supply system projects. Conclusions: Observations, specialist interviews, and past usage data should be the primary means of data collection for this project. Observations Findings: There was a large variety of materiel in the clean rooms utilized by each of the transplant services areas, and the general staff did not know which materiel was used by transplant services. Conclusions: Interviews should be conducted with materiel specialists from each of the transplant services groups and Materiel Services to identify materiel specific to transplant services. Materiel Specialist Interviews Findings: The team developed a list of materiel necessary for the TC through interviews with the specialists from the transplant services groups. The team learned par level calculation methodology, and that the TC clean room would be restocked on Monday, Wednesday, and Thursday evenings through an interview with the Manager of Materiel Services. Conclusions: Usage data should be collected to calculate par levels. A complete materiel list for the clean room, exam rooms, and supply carts could be compiled from the input of the transplant services specialists. The supply carts and exam room supply caddies should be restocked Tuesday and Friday evenings in order to not interfere with Materiel Services restocking of the clean room. Usage Data Findings: The usage data that was available for fiscal year 2012 was separated by entire departments, not by the transplant services groups within each department. Using the information

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gathered from the materiel specialist interviews, the usage data list could be narrowed down to just the materiel used by the transplant services groups within these departments. Conclusions: Par levels should be developed from the usage data. Par Level Calculation Findings: Accurate par levels can be developed using the methodology recommended by the team coordinator and materiel services. Conclusions: The developed materiel lists and par levels needed validation. Quality Assurance Findings: The supply cart and caddy contained all the needed materiel, but the materiel organization could be improved. Conclusions: 5S principles should be applied to improve the organization and accessibility of the supply cart and caddy. Lean Manufacturing (5S) Findings: The 5S methodology improved the organization and accessibility of the supply carts and caddies. The materiel locations can be easily coded for easy reference. Conclusions: The materiel lists, par levels, and layouts are complete. The materiel location codes can be used to standardize all supply carts and caddies.

Recommendations and Expected Impact

The team recommends that the TC utilize the materiel lists, par levels, restocking schedule, and standardized storage location (supply cart and caddy) layouts that the team has devised.

By utilizing the recommendations, organization in the TC should be much improved from the current transplant services areas because of the standardized materiel lists, par levels, storage locations, and restocking schedule. Non-value added work should be significantly reduced because employees will not have to waste time manually ordering or traveling to retrieve materiel (complete materiel lists and par levels exist for all materiel), and searching for materiel in the supply carts and caddies (storage locations are all standardized).

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Introduction

The Transplant Center of the University of Michigan Hospital System currently holds clinics in three locations in the Taubman Center. In September 2013, a new clinic for the Transplant Center will open to consolidate staff and faculty into one location. Since the Transplant Center presently functions out of different clinics, it is not responsible for maintaining any type of supplies. Therefore, the Nurse Manager of the current Transplant Center would like to know the type, quantity, and optimum storage location of supplies needed for the new consolidated center. The Transplant Center asked an IOE 481 student team from the University of Michigan College of Engineering Industrial and Operations Engineering Program to create a central supply system that manages the supply replenishment and deployment process for the new consolidated transplant center. This final report presents the background information, the methods of data collection and analysis and our final conclusions and recommendations.

Background

Transplant Services currently take place in three locations around the University Health System: the Kidney Transplant Clinic, Liver Transplant Clinic, and the General Surgery Department. Starting in the Summer of 2013, these services will be consolidated into a single area: the Transplant Center. A new formal Transplant Center will open on Taubman 1st floor and will include adult liver, kidney and pancreas programs, non-transplant surgery services, pediatric transition clinic for liver/kidney, and clinical research. It will consist of 34 clinic rooms, in which 17 of these rooms will be large in size and contain supply carts. The storage in the clinical examination rooms will be limited, with only cabinets above sinks. There will also be a clean room, which will be restocked daily.

The hospital does not know the list and volume of supplies that will be needed to operate the Transplant Center. This is because each current transplant area (kidney, liver, and General Surgery) only keeps track of their own materials. The material volumes are unknown because the current transplant areas do not all have standard stock (par) levels set up to track their material usage. The team worked closely with the Materiel Services Department, who are responsible for the order processing and stocking of materials for the entire hospital, so that the materials usage of the current transplant areas could be determined. The current materiel flow is seen in figure 1.

Figure 1: Current Materiel Flow for Transplant Operations

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The Transplant Center requires diverse range of supplies. These range from wound care materiel (such as gauzes), surgical instruments (scalpels, scissors), general medical supplies (Band aids, tape), and sanitary supplies (gloves, hand sanitizer). The supplies will be stored in one of three locations within the Transplant Center based on accessibility and storage requirements: the supply carts, the exam rooms, or the clean supply room. The team has been tasked to determine a list of supplies needed in the Transplant Center, the supply volumes, the optimal storage area for each of the supplies, and the layout of each of the storage areas.

Key issues

The following key issues are driving the need for this project:

• The Transplant Group is unsure what material is needed for the new Transplant Center because the materials for the current transplant service areas are only known by nurses and specialists within those areas.

• The Transplant Group is unsure what volume of material will be necessary to stock because accurate par levels have not been established in all of the current transplant service areas

• The materiel needs to be located in standardized locations, and easy to access

Goals and Objectives

The main goal for this project was to develop a central supply system for the new Transplant Center. This will include:

• Determining materiel lists for the supply carts, exam rooms, and clean room • Developing par levels for all materiel and locations • Formulating a restocking schedule for the three locations • Designing the layouts and optimal locations of the materiel in the three areas

Project scope

This project included only the material stocking and supply process for the Transplant Center. The process consisted of identifying the material needed to maintain operations within the transplant facility, deciding where these material should be stored, calculating the par levels (the amount of material kept in stock) of the material, and implementing a schedule for material resupply. Finally, the project consisted of building and testing the effectiveness of a supply cart.

Initially, the team was asked to include radiology materiel in the project scope because the radiology department would be sharing the TC clean room. However, after radiology materiel list was generated, the team was instructed to not continue work with the radiology materiel, and it was removed from the project scope. The radiology materiel list can be viewed in appendix 7.

Any task not connected with the material stocking and supply in the Transplant Center was not included in this project. Specifically, the procedures that occur within the Transplant Center were not influenced. The staffing levels required in the Transplant Center were not considered. The medication room was not included in this project, and laundry was kept out as well. Any material stocking and supply that takes place outside of the Transplant Center was not studied under this project. The financial impact of the materiel stocking and supply process was not included.

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Data Collection Methods

The project methods included performing a literature search, taking observations of the current transplant areas, conducting interviews with various materiel specialists, and taking data.

The Transplant Supply System Team identified the type and quantity of material needed in the Transplant Center. The team determined the storage location of the material, the location layout, and the par levels for each materiel and location. The primary parties involved in this stage of the project included the Transplant Group, the Materiel Services group, and the Kidney and Liver Transplant groups. The primary project participants within these areas were Nurse Managers, Nurses, Nurse Practitioners, Physician Assistants, and Medical Assistants.

Literature Search

A literature search was conducted for past IOE 481 projects that were tasked with materiel supply systems within the hospital. Five materiel supply projects were identified, read, and analyzed to find useful data collection methods. All five of the past projects included observing the areas in which the materiel will be used, conducting interviews with the materiel specialists from these areas, and collecting past usage data. Accordingly, the team decided that observation, specialist interviews, and usage data collection methods should be utilized to collect data for this project. The complete bibliography and additional information on the past projects can be seen in appendix 8. The literature search was completed on February 15.

Observations

The team observed each of the current transplant areas, for two hours each, to gather information on the distribution and storage of materiel. The procedures performed in each area were also explained to the team. During this time the team took pictures of the layouts of the clean rooms, storage rooms, medication rooms, procedure rooms, and supply carts in each transplant area. The observation stage was completed from mid-January through early March. From the observations, it was clearly evident that there was a large variety of materiel that would be needed for the day to day operations of the new Transplant Clinic. The next step was to interview different materiel specialists, who would be able to specify the exact materiel needed for their respective areas.

Materiel Specialist Interviews

The team first met with the Materiel Services Department, who provided the information on the restocking process of materiel, the reordering process, and also how par levels were calculated. The Materiel Services Warehouse Manager provided a detailed list of all of the materiel and par levels for every location within every department in the hospital. In order to get a more precise list of materiel that each transplant area needed, specialists from these areas would have to be consulted.

The next interviews were conducted with materiel specialists from the kidney and liver clinics. They included:

• The Lead Medical Assistant from the Kidney Transplant Clinic • The Head Nurse from the Liver Transplant Clinic • The Nurse Practitioner from the Transplant Services Department of General Surgery

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These specialists frequently used the materiel and were able to specify exactly which materiel would be needed in the new Transplant Center. They were not able to provide exact usage data, since those records aren’t kept. It was recommended that the team look at historical data in order to better calculate the par levels for the materiel and locations.

Data Collection

The Materiel Services Department provided historical data on the areas within the hospital, and it was provided on a Microsoft Excel spreadsheet from July 2011-July 2012 in a monthly format. The data were not categorized by specific clinic (i.e. “Liver Clinic”), but instead by general area (i.e. “Taubman Surgery Area”). This list needed to be broken down by specific area and categorized, and the information gathered from the materiel specialist interviews made this process possible. It was concluded that the team would be able to calculate par levels from this information.

Data Analysis Methods

The team completed analysis of the collected data using par level calculations, optimization, and lean manufacturing principles to formulate conclusions and recommendations.

Par Level Calculations

It was determined from the materiel specialist interviews that Materiel Services would restock the clean room three times a week on Monday, Wednesday, and Thursday evenings from 3-10 p.m. The team did not have any input regarding the restocking times, and were assigned by Materiel Services. The longest time between restocking is four days (from Thursday to following Monday), so it was determined that the clean room should hold a four day maximum of materiel. The team decided that the supply carts and exam room cabinet caddies should hold a four day maximum of materiel as well for consistency.

The four day maximum storage was used to calculate par levels for each of the locations. Because the number of supply carts (17), exam room cabinet caddies (34), and clean rooms (1) was different, it was necessary to develop separate par levels for each location. The team utilized a par level methodology recommended by our coordinator and the Materiel Services Manager. The par level calculations are explained below.

Table 1: Par Level Calculation and Example Step Example 1. Identify individual item and location Item = staple remover, location = supply cart 2. Identify highest monthly usage of item Highest Monthly Usage = 106 3. Divide by 30 to find the daily usage Usage per day = 106/30 = 3.54 4. Multiply by 4 to find 4 day max contents 4 day max contents = 3.54*4 = 14.17 5. Add 20% safety stock to calculation 14.17*1.2 = 17.00 6. Divide by number of locations to find final par level

17.00/17 supply carts = 1 staple remover/supply cart

The highest monthly usage of the item was used as the basis for par level calculation because the team wanted to err on the safe side. Because the usage data available was for the year 2012, it

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was unsure how the numbers would compare to 2013. The highest month was chosen as the basis to ensure there would always be enough of each materiel in stock. The 20% safety stock was recommended by the team coordinator, as a precaution to ensure there would never be a materiel shortage. The total is divided by the number of locations to find the final par level because it is assumed that materiel consumption will be uniform throughout the clinic. Par levels were developed using this methodology for all the materiel in the clean room, exam room cabinet caddies, and supply carts. The complete lists can be seen in Appendix 3. It was concluded that the materiel lists and par level calculations needed validation to ensure that the correct materiel was in the most optimal location.

Quality Assurance

The team needed a way to validate the developed materiel lists and par levels. It was suggested by the client that the best testing procedure would be to build a mock-up supply cart and exam room caddy. The mock-ups would contain all of the materiel on the developed materiel lists in the levels developed using the par level calculations. The team built the mock-up supply cart the week before spring break (February 25th to March 1st) and the cart was put to use in the Liver and Kidney Clinics from March 2nd to March 11th. During this time, the doctors, nurses, and Medical Assistants were able to review the cart’s contents and provide constructive feedback about its deficiencies through a standardized form (Appendix 5) the team developed. The form asked general questions like:

• What materiel is on the cart that should not be? • What materiel is not on the cart that should be? • Should any of the items on the cart be moved to different locations and why?

The feedback received from the forms was largely positive, with the only suggestions being that certain high usage materiel be moved to more accessible locations within the supply cart. The team made the suggested changes to the supply cart.

The team built the mock-up exam room caddy the week after spring break. The actual caddy that would be used in the exam room had not yet been chosen by the client, so a small caddy from the current Kidney Clinic was used. The caddy was then taken to four different Nurses and Medical Assistants from the Liver and Kidney Clinics for review. The feedback from the reviewers was positive, though the suggestion to add a single staple remover kit and suture kit to each caddy was made several times. The team heeded the suggestions and added the items to the exam room caddy materiel list.

The team did not build a mock-up version of the clean room because the clean room layout would be completely designed by the Materiel Services department according to their hospital-wide standards.

With the supply cart and exam room caddy materiel lists and par levels validated, the team concluded that the organization of these locations should be optimized using the lean manufacturing principle of 5S.

Lean Manufacturing (5S)

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The team used the organizational concept of 5S to improve the layouts of the supply carts. 5S aids in keeping the area neat and organized, and ensures location standardization and process sustainment. The steps of the 5S process and the corresponding actions taken by the team are displayed in Figure 2 and explained below:

Figure 2: 5S Process

• Sorting: The materiel was sorted into size specific groups so that items could be placed in

size specific compartments. High usage materiel was placed towards the top of the supply cart whenever possible for easier accessibility.

• Straightening: The materiel was straightened into size specific compartments and each compartment was labeled with its contents.

• Shining: The materiel was checked to confirm it was within its usage date, the materiel packaging was undamaged, and the supplies were clean.

• Standardizing: The team gave each location within the supply cart a numeric code. For each coded location the team recorded the item, par level, and compartment depth, width and height. This information has been shared with the client so that each supply cart can be built identically.

• Sustaining: The team has shared all information with the client so that the building of standardized supply carts can be sustained. The team also designed an informatory form to help the client train TC staff on how to properly restock the supply cart. The form can be viewed in Appendix 6.

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The team was unable to apply 5S concepts to the exam room caddies (because the caddy to use had not been chosen by the client) and clean room (because the clean room is designed by Materiel Services). This should not be a problem because the number of items in the supply caddy is small, so organization should not be a major issue, and the 5S concept is well known by Materiel Services, and integrated into their standardized clean room design process. The team concluded that the data collection and analysis were complete.

Findings and Conclusions

From the interview with Materiel Services, the team received a rudimentary list of materiel necessary for the new Transplant Center. The Transplant Center will be responsible for restocking the supply carts and rooms themselves from materiel in the clean room. From the historical data provided by the Materiel Services Manager and the interviews with Nurses and Medical Assistants, the team finalized the list of materiel with the items that would be necessary in the new clinic. The clean room would have 192 items, the exam rooms would each contain 22 items, and the supply carts would hold 57 items each. The list of materiel and locations are provided in Appendix X.

It was determined that par levels would have to be calculated for all materiel and locations, and the historical data usage would be used for these calculations. Identification of recommended locations for all the materiel would be determined, and the materiel and their locations would all need to be standardized.

In the quality assurance stage, feedback on the mock up cart and mock up exam room was collected. The team learned that the materiel in the cart and room was adequate, but some of the materiel was not in convenient locations. For example, the staple removers, which were located in the bottom drawer of the cart, should be put at a more convenient location because it was frequently used. It was concluded that the location of five items would need to be changed in order to optimize the location for every materiel in the supply carts and exam rooms.

Recommendations

The clean room will be restocked Monday, Wednesday, and Thursday evenings between the hours of 3:00PM and 10:00PM by Materiel Services. It is recommended that the supply carts and exam rooms be restocked Tuesdays and Fridays between the hours of 3:00Pm and 10:00 PM for three reasons:

1) It will eliminate the chaos of Materiel Services restocking the clean room the same time that the nurses and Medical Assistants will be restocking the exam rooms and supply carts from the clean room.

2) The longest these locations will go without being restocked is four days (Friday to Tuesday), which incorporates the par level calculations. Anything different than four days would change the par levels for the materiel and their locations.

3) The later in the evening these locations are restocked, the less patients there will be in the clinic, thus reducing the chance of interrupting patient appointments when attempting to restock the exam rooms and supply carts.

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Figure 3 displays the sample restocking schedule for the supply carts and exam rooms.

It is also recommended that Materiel Services build the clean room to their satisfaction, when given the complete list of materiel.

The required par levels are provided in Appendix 1, 2 and 3 for all of the different transplant center locations. If the restocking schedule is changed, for example, if it is restocked more than twice a week, the par levels would change.

Table 2: Restocking Schedule

Location Day Time Clean Room Monday 3:00-10:00PM

Clean Room Wednesday 3:00-10:00PM

Clean Room Thursday 3:00-10:00PM

Exam Rooms Tuesday 3:00-10:00PM

Exam Rooms Friday 3:00-10:00PM

Supply Cart Tuesday 3:00-10:00PM

Supply Cart Friday 3:00-10:00PM

Expected Impact

The impact is expected to increase organization in the new Transplant Center. Within the Transplant Center, the exam rooms, new supply carts, and clean room will all have a list of materiel, with specific locations and recommended par levels.

Standardization of the materiel and locations will make the materiel more accessible and easier to find. If one item is in the top drawer of one cart, it will be in the top drawer of every other cart. All materiel is placed in the same spot in every cart and exam room. This will reduce non value added work, and should save time and effort on the provider’s behalf, making their job easier and more efficient.

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Appendix 1: Supply Cart Materiel List

Item No. Item Description Par Level

6090 SCISSORS, IRIS CURVED 4

1707 SPONGE, DRAIN TRACHEOTOMY 6

PLY STERILE 4IN X 4IN 8

1109 SWAB, 10% POVIDONE IODINE

1.7ML 10

1766 NET, STRETCH NONSTERILE 18IN 10 6

1054 REMOVER, ADHESIVE 1/2OZ 3

1732 GAUZE, ROLL KERLIX STERILE 2

1/4IN X 3YD 2

1715 GAUZE, FINE MESH PACKING

STERILE 1/2IN X 5YD 3

2889 TUBE, PINK STERILE SALINE 15ML 20

4023 TAPE, SURGICAL SOFT CLOTH

MEDIPORE H 2IN X 10YD 3

6054 FORCEP, RATTOOTH 8


STERILE 1IN X 5YD 3

2015 SCALPEL, DISPOSABLE STERILE #10

SAFETY 1

2528 OINTMENT, TRIPLE ANTIBIOTIC

.9GR 5

2050 APPLICATOR, SKIN BARRIER FILM

CAVILON 3ML 10

1728 GAUZE, ROLL KERLIX STERILE 4

1/2IN X 4YD 2

1741 Sponge, GAUZE STERILE 8 PLY 4IN X

4IN 8

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34002 SUTURE, PROLENE 4-0 BL MONO PS-

2 18IN 2

4450 TRAY, PREP FOLEY 16FR & 2L BAG 1

5269 Bottle, IRRIGATION WATER 1000 mL 1

6066 Hemostat, mosquito curved halstead 5

6068 Hemostat, kelly straight 5 1/2 in 5

6011 SET, GLAND SALIVARY 1

6094 SCISSORS, STRAIGHT LARGE 6 1/4 5

2016 SCALPEL, DISPOSABLE STERILE #11

SAFETY 4

1640 BANDAGE, FABRIC FLEXIBLE

STERILE 1IN X 3IN 50

1738 PAD, PREP ALCOHOL ISOPROPYL

70% 50

1691 DRESSING, NON-ADHERENT W/

TELFA 3IN X 8IN STERILE 7

2511 ADHESIVE, LIQUID MASTISOL 2/3

CC AMPULE 15

1719 STRIP, SKIN CLOSURE STERILE

1/2IN X 4IN 14


1/4IN X 4IN 5

1149 DEPRESSOR, TONGUE

INDIVIDUALLY WRAPPED ADULT 6

1107 APPLICATOR, COTTON TIP 6IN

STERILE 11

1739 SPONGE, GAUZE STERILE 8 PLY 2IN

X 2IN 20

14

PAD, ABDOMINAL STERILE 8IN X

10IN 14

6058 FORCEP, THUMB 2

6064 HEMOSTAT, KELLY CURVED 5 1/2IN 1

6079 HOLDER, NEEDLE MAYO-HEGAR 8

1266 SET, SUTURE REMOVAL 2

4602 TRAY, STAPLE REMOVER TWEEZER

STERILE 6

46520 TOWEL, BLUE 17IN X 27IN STERILE

1/PK 1

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Appendix 2: Exam Room Caddy Materiel List


1740 SPONGE, ALL PURPOSE

NONSTERILE 3PLY 4IN X 4IN 1

2965 SUB/ GLOVE, CHEMO SENSICARE

ICE NITRILE MEDIUM 1


ICE NITRILE LARGE 1

44217 COVER, PROBE ORAL/RECTAL

THERMOMETER 1


ICE NITRILE SMALL 1


1/8IN X 3IN 4

1014 TAPE, MEASURING METRIC AND

INCH NONSTERILE 1

608 DISINFECTANT, SURFACE

DECONTAMINATE VIREX 32OZ 1

603 CUP, PLASTIC CLEAR 7OZ 1

1031 CONTAINER, SPECIMEN W/LID

STERILE 4OZ 1

1529 TAPE, SURGICAL SOFT CLOTH

MEDIPORE H 1IN X 10YD 1

1126 BASIN, EMESIS 700CC NONSTERILE

10IN 2

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Appendix 3: Clean Room Materiel List


6092 SCISSORS, OR SHARP/BLUNT 44

2965 GLOVE, CHEMO SENSICARE ICE

NITRILE MEDIUM 4


1203 EXERCISOR, VOLUMETRIC 1


NITRILE LARGE 4


1040 PAPER, EXAM TABLE SMOOTH 18IN

X 225FT 8

1578 DRESSING, SILVER AQUACEL AG 4IN

X 4.7IN 1

2025 WIPE, SKIN BARRIER FILM CAVILON 2

1694 GAUZE, PETROLATUM XEROFORM

STERILE 5IN X 9IN 24

1407 COLLECTOR, WOUND DRAINAGE

MEDIUM 6.9IN 1

6067 HEMOSTAT, MOSQUITO STRAIGHT

HALSTEAD 4

2655 DISINFECTANT, METRICIDE GALLON 2

43834 DRESSING, SILVER LAYER RESTORE

4IN X 5IN 1

1311 Holder, tube catheter foley 68

6091 SCISSORS, OR SHARP/SHARP 85

2579 LUBRICANT, JELLY WATER

SOLUBLE 4OZ W/FLIP-TOP CAP 8

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STERILE 1/4IN X 5YD 6

6071 HANDLE, KNIFE 3 4

1284 KIT, THORACENTESIS ARROW-CLARKE 8FR X 19CM SAFETY

1


1796 SYRINGE, W/O NEEDLE 60CC 2

31190 DRESSING, HYDROCOLLOID

DUODERM EXTRA THIN CGF 2IN X 4IN

1

1582 WAFER, CONVEX W/ FLOATING

FLANGE 2 1/4IN 1


RESTORE 6IN X 6IN 1

1063 ALCOHOL, RUBBING 70% ISOPROPYL

16OZ 6

2535 STRIP, BLOOD TEST GLUCOSE 1

2033 PASTE, STOMAHESIVE 2


NITRILE XLARGE 1

1415 APPLICATOR, CHLORAPREP 3ML

W/ORANGE TINT 8

27224 TUBE, TRACH SHILEY 6

FENESTRATED UNCUFFED 1


NITRILE SMALL 2

1463 POUCH, OSTOMY 1PC 2 1/2IN POST-

OP 1

2589 CLEANER, PRESOAK INSTRUMENT 1

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ASEPTIZYME

2577 TEST, FECAL HEMOCCULT SENSA 1

4441 LINER, SUCTION 1500CC W/O TUBE 8

2571 BANDAGE, ELASTIC CONFORM 2IN X

75IN STERILE 12

5335 PLUG, ADAPTER MALE PREPIERCED

W/LOCKING LUER 16

26048 CANISTER, SUCTION 1200CC FOR

ARMSTRONG 4

2526 DEVELOPER, HEMOCCULT SENSA 2

0

11561 NEEDLE, 25GA X 1.5IN SAFETY 1

1911 TUBING, SUCTION 5MM X 10FT

STERILE 8

2760 OTOSCOPE, SPECULUM 4MM 1


RESTORE 4IN X 4IN EXTRA THIN 1

2538 LUBRICANT, JELLY WATER

SOLUBLE 3GR 17

1481 POUCH, UROSTOMY 1PC 2 1/2IN

POST-OP 17

2557 GOWN, PROTECTIVE PLASTIC

DISPOSABLE 17

1787 SYRINGE, CATHETER TIP 2OZ 35

2552 SOLUTION, HYDROGEN PEROXIDE

3% 16OZ 17

1759 UNDERPAD, DISPOSABLE 23IN X 24 10

19

2523 MASK, PROCEDURE EAR LOOPS 17

5714 TUBE, PINK STERILE SALINE 5ML 336

2851 Bag, Urinary Drainage 17

1699 DRESSING, TRANSPARENT 2 3/8IN X 2

3/4IN 48

2036 REMOVER, ADHESIVE 17

1757 TAPE, SURGICAL PAPER POROUS

WHITE 1IN X 10YD 16

1997 EVACUATOR, RESERVOIR 100CC 17

1307 SUB/ GLOVE, CHEMO SENSICARE ICE

NITRILE XLARGE 1

751 BINDER, ABDOMINAL 4 PANEL12IN X

60-75IN 1

1638 BANDAGE, ELASTIC W/CLIP 3IN X

5YD 7

1123 BAG, URINARY LEG W/18IN TUBING

500ML 2

2689 STOPCOCK< 4-WAY W/SWIVEL

ULTRA HYPER 17

1893 STRAP, MONTGOMERY NONSTERILE

7 1/4 IN X 11 1/8 IN 103

1751 TAPE, SURGICAL SILKIE 1 IN X 10

YDS 68

4449 TRAY, PREP URETHRAL 15 FR &

1000ML BAG 17

1574 CREAM, MOISTURE BARRIER 8OZ 1

1570 CLEANSER, SKIN CARE FOAM 8OZ 1

1598 LANCET, SAFE-T-PRO 1

20

1052 MIRROR, REGULAR VIEW AND 3X

MAGNIFYING 4 1/2IN 1

46258 BINDER, ABDOMINAL 3 PANEL 9IN X

60-75IN 1

30208 BAG, PATIENT SETUP 1

4601 SUTURE, VICRYL RAPIDE 4-0 RB-1

UNDYED 27IN 1

43084 VIAL, C&S 4

713 BINDER, ABDOMINAL 4 PANEL 12IN

X 46-62IN 1

750 BINDER, ABDOMINAL 4 PANEL 12IN

X 30-46IN 1


46-62IN 1

2548 SLIPPER, SLIP RESISTANT DOUBLE

TREAD XX-LARGE ADULT 4

1729 TOWEL, MUSLIN/GAUZE STERILE

18IN X 27IN 1

1495 CEMENT, SKIN BOND 40Z 1


30-46IN 1

2028 GAUZE, ROLL STERILE 2IN X 131IN 8

2567 GOGGLES, EYESHIELDZ 4

1971 BASIN, WASH FACE DISPOSABLE

NONSTERILE 7 QT 4

43085 SWAB, FLOCKED IN AEROBIC

TRANSPORT 4

2769 DRESSING, WOUND ADHESIVE CLOTH MEDIPORE 2 3/8IN X 4IN

8

21

2755 SOLUTION, GLUCOSE MONITORING

HIGH AND LOW 1

1970 SET, STOPCOCK 3 WAY LOW

PRESSURE SMALL BORE W/6IN TUBING & M

2

2014 RAZOR, PREP SHAVE 8

1146 GEL, ULTRASOUND LIQUASONIC 8OZ 2

43086 TUBE, ANAEROBIC 1

614 BATTERY, ALKALINE AA 8

25210 DEV-O-LOOPS, MAXI RED 1

600 FLASHLIGHT, 2-CELL 1

1246 MARKER, SKIN STERILE SURGICAL 4

617 BATTERY, ALKALINE D 4

2986 SYRINGE, SALINE POSIFLUSH 10ML

IN 10ML 1

11545 NEEDLE, 25GA X 1IN SAFETY 1

11547 NEEDLE, 21GA X 1 1/2IN SAFETY 1

2044 URINAL, MALE W/COVER PLASTIC

DISPOSABLE 2

4457 TRAY, DRESSING CENTRAL/PICC 17

2854 TUBE, CONNECTING VINYL 30CM 17

6052 FORCEP, IRIS 4

5266 BOTTLE, IRRIGATION SODIUM

CHLORIDE 0.9% 1000ML 5

1060 TOWELETTE, PREMOISTENED 1

2886 WRAP, SELF ADHERING NONSTERILE

3in 35

22

6128 TOWEL, BIOPSY STERILE 1

1498 DRESSING, COLOSTOMY 4IN X 4IN 1

615 BATTERY, ALKALINE AAA 4

610 PUMP, VIREX BOTTLE 1

11548 NEEDLE, BLUNT FILL 18GA X 1.5IN 1

1032 COLLECTOR, SPECIMEN TOILET HAT 4

2547 SLIPPER, SLIP RESISTANT DOUBLE

TREAD LARGE ADULT 2



1794 SUB/ SYRINGE, W/O NEEDLE 20CC 1

1034 CONTAINER, SPECIMEN W/LID

NONSTERILE 6.5OZ 8

1242 PACK, COLD INSTANT 6IN X 9IN 2

1767 NEEDLE, 26GA X 1/2IN 1

1137 PLUG, MALE/FEMALE LUER LOCK 4

2010 BEDPAN, FRACTURE DISPOSABLE 1

2047 KIT, PREP IV 1

2751 OTOSCOPE, SPECULUM ADULT 4MM 1

1820 VACUTAINER, RED 4ML W/CLOT

ACTIVATOR SAFETY 4

25438 TAPE, SURGICAL PAPER POROUS

WHITE 2IN X 10YDS 0

43853 TRANSDUCER COVER, BULK PROBE 0

1290 TISSUE FACIAL 0

1191 GEL ULTRASONIC 5L W/DISPENSER 0

23

42479 COVER, ENDOCAVITY ECLIPSE

4.6CMX24.1 CM 0

4303 CATHETER, FOLEY SILICONE 12 FR

5CCC 35

40880 CATHETER, STRAIGHT 12FR 6IN 35

4304 CATHETER, FOLEY SILICONE 14 FR

5CC 35

4404 CATHETER, FOLEY STERILE 12FR

5CC 35

1364 CATHETER, UROLOGICAL COUDE TIP

12FR 35

1808 CATHETER, UROLOGICAL COUDE TIP

14FR 35

1699 DRESSING, TRANSPARENT 4IN X 4 3/4 68

28529 BIOPSY NEEDLE 18 GA X 15CM X

22MM THROW 0

28557 TRAY BIOPSY 0

28626 NEEDLE BIOPSY 18GA X 10CM 0

6127 TOWEL, STERILE 0

1774 SPINAL NEEDLE 18GA 1 1/2 0

24

Appendix 4: Supply Carts Layout

Drawer 1

Drawer 2

25

Drawer 3:

Drawer 4:

26

Drawer 5:

Codes for the drawers were developed based on the drawer compartment and position of the item. The first number of the code represents the drawer number (1 being the top drawer), the second number represents the compartment number (1 being the farthest left), and the last number is the position within the compartment (1 being the farthest forward). For example, the bottle of sterile water in the picture above is assigned code “511”. Therefore, it is located in the 5th drawer (“5”), in the farthest left compartment (“1”), closest to the front (“1”).

27

Appendix 5: Supply cart feedback form

Transplant Center Cart Feedback Form

This cart is a prototype for the supply carts that will be located in some of the exam rooms in the new Transplant Center. The cart will hold items in addition to those standard in exam rooms (4x4’s, 2x2’s, tongue depressors, Q tips, bandaids, emesis basins, alcohol swabs, gowns, towels, sheets, washcloths, blankets, blue pads, drain sponges, sodium chloride, specimen cups, swabs, medipore tape). Please provide feedback on the cart’s contents.

Items to add to cart (and why): _______________________________________________________________________________________________________________________________________________________________________________________________________________

Items to remove from cart (and why): _______________________________________________________________________________________________________________________________________________________________________________________________________________

Other Feedback: _______________________________________________________________________________________________________________________________________________________________________________________________________________

Name and work area: __________________________________________________

28

Appendix 6: Supply cart instruction sheet

Supply Cart Restock Instructions

Move old materiel to the front and restock from the behind

Follow the layout specified in the pictures on cart

Restock according to the par level on cart

Check for expiration date

Check for damaged packaging

29

Appendix 7: Radiology Materiel List

Item No. Item Description

25438 Tape, surgical paper

28529 Biopsy needle 18ga x 15cm x 22 mm throw

28557 Tray biopsy

28626 Needle biopsy 18ga x 10cm

6127 Towel, sterile

1741 4 x 4 sterile gauze

1774 Spinal needle 18 ga 1 ½

2579 Surgical lubricant 4.5 oz w/ fliptop cap

43853 Transducer cover, bulk probe

1176 Glove vinyl medium

1290 Tissue facial

1063 Alcohol rubbing 15 oz

40706 Disinfectant wipe Quat Sanicloth

1191 Gel, Ultrasonic 5L w/ dispenser

2523 Isolation mask with earloops

42479 Cover endocavity Eclipse 4.6 cm x 24.1 cm

604 Styrofoam cups 16 oz.

1759 Underpad, blue

2557 Protective gowns disposable

Appendix 8: Literature Search Bibliography and Project Information.

30

● IOE 481, Winter 1987, Group 9, “Final Report of Clinic Utilization Project”

○ This group looked at usage levels in the Ambulatory Care Department to decide what materials should be carried on an ambulance, and how the supply system should be set up.

● IOE 481, Winter 1988, Group 1, “Future Estimates of Trash and Linen Volumes for Mott

Hospital and MCHC” ○ This group looked at usage data for trash and linen of different departments to

build an estimate of how much would be used in Mott Hospital.

● IOE 481, Winter 1990, Group 3, “Space Planning and Cost Estimate for the Consolidation of the UMH Accounts Receivable Division”

○ This group looked at the best way to organize the new space for the Accounts Receivable Department

● IOE 481, Winter 1990, Group 4, “Study of General and Office Supply Delivery”

○ This group had a broad scope project that looked at optimizing the delivery of general (non-medical) and office supply delivery to the hospital system.

● IOE 481, Winter 1992, Group 1, “Recommendations and Findings for Improving the

Efficiency of the Materiel Services Department” ○ This group examined restructuring the Materiel Services department to reduce the

number of trips required to deliver necessary supplies to various hospital departments.

Documents

Transplant Center Supply System Design Final Reportioe481/ioe481_past_reports/W1301.pdf · 2013. 5. 8. · of Engineering Industrial and Operations Engineering Program to create a