Sygehus Lillebælt
Better Patient Pathways with Optimised Logistics
4 min read
Logistics is the Lifeblood of the Hospital
October 2018
Herlev HospitalHospital logistics is a complex system with many interdependencies. Even the smallest changes in daily operations can quickly spiral out of control. So, what do you do when faced with changing something as fundamental as the existing operational model itself? This is the challenge that Herlev Hospital is currently addressing as part of its expansion, which, according to the plan, is set to be completed in the second half of 2020. One of the operational tasks that will need to be handled differently in the future than it is today, is bed logistics. Langebæk, in collaboration with Service & Logistics at Herlev, has laid the foundation for the future operations.
When the media focuses on or when the conversation turns to hospitals, it is extremely rare for logistics to be the topic. In fact, it would not be entirely wrong to say that the importance of logistics is often overlooked in the public debate, which has for many years primarily focused on treatment guarantees and compassionate care. This is despite the fact that logistics is crucial for nearly everything that takes place in a modern hospital. The daily operational tasks, ranging from the delivery of medicines, equipment, and consumables to the preparation of operating theatres, are carried out by a dedicated staff working tirelessly in the background. One area of this complex system that plays a significant role in the daily operations is bed logistics.
At Herlev Hospital, there are currently about 700 beds in circulation. This might not seem like a lot, but on any given day, roughly half of them need to go through the system. Simplified, bed logistics focuses on three main tasks: 1) Bed washing, 2) preparation, storage, and transport of clean beds, and 3) handling and transport of dirty beds. These tasks involve many employees who go into every corner of the hospital, where they have to navigate several bottlenecks, particularly the elevators to the high-rise building. Today, the bed washing facility is located in the same building as when the hospital opened in 1976. The service building is connected to the Emergency Department via a long corridor in the basement. This area is used both for storing clean beds until they are needed and for transporting beds from the bed washing facility to the emergency department via a specially built monorail.
As the Head of Service & Logistics, Louise Lindelof, explains, the existing structure makes a lot of sense: 'Up to 85% of all patients admitted to the hospital are admitted via the emergency department, and therefore it is there that most of the clean beds are used. The challenge for us is that one of the primary goals of the hospital’s expansion is to establish a new and improved emergency department in one of the new buildings. It goes without saying that this has enormous implications for bed logistics, and thus for the efficiency of daily operations across the hospital,’ she says, continuing: ‘We simply had to ensure that bed logistics were integrated into the new construction from the very start.’
Early in the process, it became clear that neither renovating the existing bed washing facility nor connecting it to the new emergency department would be practical or cost-effective from an operational perspective. 'Since the optimal structure in the future still involves a close connection between bed washing and the emergency department, it was therefore decided to establish a new bed washing facility in the basement, directly beneath the new emergency department. However, this led to a series of stricter requirements for daily logistics, all of which are interconnected in one way or another, making them extremely complicated to meet.'
'First of all, we will have a lot less storage space than we have today, which made it necessary to look at the entire flow of beds through the hospital in order to streamline it. Secondly, the expansion of the hospital and the new bed washing facility meant we had to evaluate the existing workflows down to the smallest detail in order to adjust or replace them according to the new requirements. Thirdly, there was enormous uncertainty regarding the new requirements. And fourthly, we had to consider how all these changes would affect the various employee groups at the hospital, from doctors, nurses, and other clinicians in the different departments to the staff directly involved in bed logistics.'
‘At that point, it became pretty clear that we couldn’t tackle the task without an external partner. We are an operations department and do not have the right competencies for the kind of analysis and planning that this task requires. Given how many employees would be affected by the changes, it was also very important for us to find a partner who could handle the task properly. That was when we explored the market for consultants and were connected with Langebæk. It was a new acquaintance for me, but I quickly got a good impression of them and also heard positive things from colleagues who knew them from projects, including the new university hospital in Odense and the new North Zealand Hospital in Hillerød.’
For Langebæk, the task initially involved gathering and analysing an enormous amount of data. Then, they developed an analytical tool capable of handling both the volume of data and the interdependencies in the many variables the tool needed to account for. This allowed them to establish different future scenarios, taking into account the great uncertainty associated with them, and based on that, come up with the recommendation that the steering group for the hospital expansion chose to follow.
'We have gained an incredible amount from our collaboration with Langebæk,’ says Louise Lindelof. 'The primary benefit is, of course, that we have validated that the plan for the new bed washing facility is sound, so to speak. At the same time, we’ve gained a much deeper understanding of the system as a whole, which has allowed us to optimise efficiency compared to where we are today. This has in turn made it possible for us to become more flexible in the new bed washing facility, which, in addition to standard beds, will also be able to accommodate special beds, special mattresses, and various types of medical aids. Additionally, Langebæk has been a huge help in supporting us to implement the necessary changes among the various employee groups. But most importantly, we’ve become better at thinking systemically, so we are now less likely to be restricted in our thinking, such as by falling into habitual thinking or assuming that certain things cannot be changed.'
'Now, there’s just a little time left before we’ll see if the scenario, we are working with, actually holds true. But we are left with the feeling that Langebæk has done their absolute best and have been very careful not to promise more than they could deliver. At the same time, we’ve felt incredibly well informed and very involved in the calculations and decisions that have been necessary to plan the project. This has helped create a great deal of credibility around the project team and confidence, both in the steering group and among the affected employee groups. So, we are very optimistic for the future,’ she concludes.
Severin’s passion for Bed Logistics
Isn’t bed logistics a strange thing for a young man to be passionate about? Not if you ask Rasmus Severin Hansen, a Consultant at Langebæk. His interest stems from his university days at DTU, where, as part of his thesis, he carried out an in-depth analysis and optimisation of the same at Bispebjerg Hospital. Today, Rasmus is one of the Consultants at Langebæk who has built up extensive experience and expertise in logistics in the healthcare sector, including hospitals, pharmacies, and pharmaceutical companies.
