Transport - Analysis - Diagnostics
Medical products – such as sample material from the operating theaters, patient files or medications – are transported over a total of six kilometers of pneumatic tube system. An outstanding feature is the delivery speed of 30 kilometers per hour.
The result: the pneumatic tube system shortens transport times, so that, for example, analysis results from the laboratories required for diagnostics are available more quickly. The pneumatic tube system is part of a change in logistics, the first construction phase of which was completed in 2019. The next phase of these construction measures concerns the pharmacy and is to be completed by 2024.
Benjamin Reppe is Project Manager of the 'Pneumatic Tube System' in the contractor's team of the University Hospital Carl Gustav Carus at the Technical University of Dresden. He began with the construction of the modern pneumatic tube system as early as 2016. The aim: To reduce the service level to 10 minutes. This corresponds to a reduction of transport times by 50 percent. Today, this service level is a reality.
Benjamin Reppe also explains in an interview with RFID & Wireless IoT Global, which modernizations were implemented during the past 4 years to complement the pneumatic delivery system.
Complicated and Long Transport Routes
"Prior to the realization of the pneumatic tube system, the samples were transported on foot, by bicycle or by car, depending on the distance of the destination. The procedure was inefficient, errorprone and time-consuming. The faster a blood or tissue sample is analyzed in the laboratory, the faster the patient can be treated. Within a single building, walking minutes add up very quickly. Additionally, the distances between the buildings are greater. The solution increases transport speed and transparency, and guarantees the tracking of medical products," explains Benjamin Reppe.
The Pneumatic Tube System in Operation since 2019
The feasibility study of a pneumatic tube system was already carried out in 2009. The new building – House 32 – with a surgical emergency room and adjoining OR center as well as the pneumatic delivery system was realized in parallel. The new construction began in 2014, two years later, the basis for the pneumatic post system was integrated into the existing route.
"The surgical emergency room opened in June 2019. Additionally, the radiology department, nursing stations with a total of 128 beds and interdisciplinary outpatient clinics were integrated into the new building. Over 720 employees work in the new building complex. Other buildings about 500 meters away - including laboratories and the pathology department - were integrated into the pneumatic tube system in 2017. Since June 2019, House 32, with its 10,700 square meters, has been fully operational, which includes the pneumatic delivery system," summarizes Benjamin Reppe.
6-Kilometer Route Length
At present, six kilometers of piping have been installed. Half of it underground. In the ring-shaped installation, the pipes run parallel. 19 stations are in operation so far. 500 canisters are dispatched or received daily. The canisters are transported with a slight distance between them in the plastic pipes, which have a diameter of 160 millimeters. At the terminals of the pneumatic post stations, the RFID tag on the canister is labeled with the destination and priority information.
The transport speed is up to eight meters per hour, which corresponds to about 30 kilometers per hour. Each canister reaches its destination within 10 minutes – regardless of the distance covered. This corresponds to a 50 percent reduction in transport times.
"Currently, the surgical emergency room, the pathology department, the Institute of Clinical Chemistry, the house 59, and the medicine laboratory are linked. The installation and commissioning of the entire system was handled by Aerocom, the company for transport automation," explains Benjamin Reppe.
How are the Logistics Organized?
The hospital premises are equipped with WLAN throughout the whole area. A digital locking system with specific access authorizations, depending on the area and employee, controls access. The authorizations are assigned by a central administration according to categories and stored in the RFID transponder of the respective employee. Readers installed at the doors detect the transponders with a reading range of up to 30 centimeters. Only a few areas are currently still offl ine. Most of the staff also have another RFID chip for time recording and parking access.
The hospital also relies on automated solutions for handling laundry. All items of laundry are fi tted with RFID transponders and dispensed via automatic laundry machines. "The loading of the machines is still done manually, but the removal of laundry by the staff is already fully automated," explains Benjamin Reppe. The logistic processes were analyzed in cooperation with Fraunhofer IML. The recommendations were and are being implemented in the subprojects.
Asset Management with Data Matrix Codes
The maintenance of the inventory is recorded digitally. For this purpose, the assets are provided with a Data Matrix Code and manually read by a handheld device.
Sterile Goods Processing is Digital with an In-House ID
The automation process also takes place in the sterile supply area. Surgical instruments must be properly reprocessed before each use. In the past, the procedure and the length of the cleaning process of surgical instruments was documented by hand. Currently, all surgical instruments and instruments in the hospital are provided with a Data Matrix Code and the required information is stored digitally.
The hospital has also integrated an inhouse ID into the barcode, which reveals the affi liation to the Dresden University Hospital when read out by handheld. The entire history of the medical instruments can thus be viewed and tracked.
Patient Data are Stored Digitally
The goal of the digitalization measures is the paperless hospital with complete electronic medical records. Digital process control and quality control should be ensured at all times. All patient data are already digitally stored. Staff can, for example, view the daily schedules for all operations. This not only facilitates internal coordination, but also leads to time and cost savings.
Furthermore, the issuing of prescriptions is simplified. Prior to digitalization, these could only be signed by specialists. Now they can also be issued by nurses and subsequently confirmed by a specialist. The medical staff can view all relevant information digitally
Internal Networking Thanks to the 'Orbis' IT Platform
Repetitive paper-based processes within the hospital are converted into automated, digital solutions. The internal IT department has designed the IT system 'Orbis' in cooperation with external consultants. "The platform bundles all data digitally, minimizing paper printouts," explains Benjamin Reppe, adding that "every clinic and institute will be modernized as part of the integration of this management platform. Since everyone involved uses the same system, the individual wards are digitally linked to each other and data can be viewed and exchanged".
Step-by-Step Expansion of the Pneumatic Tube System
By 2024, the pharmacy and other institutes and clinics will be connected with 15 to 20 kilometers of piping. This corresponds to a total distance of around 20 kilometers. If all buildings were to be connected to the pneumatic tube system, about 100 kilometers of pipe would have to be installed. However, this is not planned
Future RFID Integration in Transfusion Medicine
In the next stage of expansion, blood reserves are to be sent directly from the blood bank via the pneumatic tube system. The challenge here is the necessary cooling of the transported goods. In the future, RFID technology is planned to be used for tracking and tracing of blood reserves. However, an RFID chip in transfusion medicine is not yet cost-effective. There are also considerations about the use of RFID wristbands in the infant ward. This should ensure a higher safety standard.
Comparing Quality Standards Worldwide
Within the next 5 years, level 7, the highest level, of the Electronic Medical Records Adoption Model (EMRAM) should be reached. One of the fi rst stages of digitalization includes the use of laboratory information and management systems, a radiology information system and pharmaceutical knowledge software. The goal and ultimate goal of digitalization is the paperless hospital with a complete electronic medical record, where digital process control and quality control are possible at any time. The model indicates the degree of digitalization of hospitals for an international comparison.
University Hospital Carl Gustav Carus Dresden in Facts and Figures
- Hospital of maximum treatment with 26 clinics and polyclinics
- 850 stationäre Klinikbetten und 9.700 Mitarbeiter
- Over 1,000 doctors
- Over 1,410 beds
- 57,000 inpatients and 277,000 outpatients annually
Benjamin Reppe: “The solution increases transport speed and transparency, guarantees the tracking of medical devices and minimizes the error rate. Transport in the pneumatic tube system is carried out at 30 kilometers per hour. Within 10 minutes – regardless of the distance covered – each canister reaches its destination. The faster a blood or tissue sample is analyzed in the laboratory, the faster the patient can be treated.”