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Developing sustainable supply chains for healthcare
No full textThe focus of this thesis is to provide hospitals and local authorities in an urban setting with a set of recommendations for sustainable methods of supply for healthcare institutions, to minimise the negative externalities of freight associated with urban hospitals. The structure and nature of the healthcare supply chain engenders unsustainable freight patterns as a result of the poor communication and unpredictability of inventory demand from hospitals to suppliers, resulting in high freight volumes (403 freight movements recorded over a 5-day period during a November 2011 survey), and the mixing of urgent and non-urgent goods within the same supply chain. In addition to this ancillary hospital services such as hospital laboratory couriers are found to be a large traffic generator with 476 individual services booked over a 3 month period (January – March 2014). In fulfilment of these issues three solutions are proposed to improve the economic and environmental sustainability of freight: mobile consolidation, to address the high numbers of deliveries received by hospitals; unattended locker bank delivery, to separate urgent goods from the supply chain; and, consolidation of laboratory courier services. Assessment of the mobile consolidation centre for GOSH only operating over 1 site to 4 sites, using 93 records from the 2011 freight survey indicated savings for the week between: 10,591 VKm (1 site operation) and 12,173 VKm (4 site operation); 181.53 – 225.05 journey time hours for 2 site and 4 site operations, respectively; and, 2 – 2.33 tonnes of CO2 equivalents between 1 site and 4 site operations. Implementation of a London-wide scenario indicated reductions of 64,204 VKm, 579 Journey Time Hours and 89 tonnes of CO2e. Assessment of the proposed electronic locker bank was assessed using a hill climbing model operating with a database of consignment movements; and qualitatively using staff interviews. Results indicated that a locker bank measuring 3.69m length, 1.7m height and 0.8m depth, comprising 19 partitions would be required to accommodate all urgent consignments for any given day. Staff perceptions of the concept were positive suggesting the locker would potentially improve the speed and quality of healthcare delivered to patients. Current hospital and courier service providers’ practices centre on collecting items as and when they arrive for outward journeys at the hospital. Using a database of 323 courier journeys at Great Ormond Street Hospital, 8 different consolidation scenarios, varying the length of time an item is delayed (ranging between 30 minutes to 10 hours). Findings indicated that consolidated approaches yielded reductions in vehicle numbers, between 120 and 255, compared to the current model of operation, but that the current model of operation is actually more environmentally efficient, generating 0.42 to 0.84 fewer metric tonnes of CO2 than consolidated approaches. Assessments of other hospitals such as University Hospital Southampton indicated that the three proposed solutions may be considered relevant to other hospitals. However, in the citywide context, the benefits for each solution when implemented at a single hospital site were minimal suggesting a greater number of hospital sites would be required to deliver larger gains
Can locker box logistics enable more human-centric medical supply chains?
No full textThere are a range of non-clinical support services within hospitals, such as catering, linen / laundry and supply logistics, which are widely considered to have a significant effect on the delivery and quality of patient care. Supply chain activities are regarded as one of the most important owing to the potentially fatal consequences of ‘stock-outs’ (Özkil et al. 2009; Costantino et al. 2010) where key inventory becomes temporarily unavailable. As a result, hospitals typically employ inventory buffers but in spite of such practices, stock-outs still occur due to disparities in inventory requirements between the hospital and suppliers; the presence of unusual demand for specific items (Jarret 2006); and, receipt of goods which are faulty, contaminated or otherwise unfit for purpose. In such events, the supply chain needs to be agile, responding quickly in order to cater for demand. However, due to the structure of the healthcare supply chain which consists of an external chain (delivering goods to the hospital) and internal hospital chain (distributing delivered goods to end users throughout the hospital), the fast flow of goods is often stalled by the interface between the two (Aronsson et al. 2011).This paper critically assesses the current supply chain practices implemented at Great Ormond Street Hospital (GOSH) NHS Trust in London in relation to those that could be utilised, whilst presenting a new concept of supply for key lines and items to the trust using unattended electronic locker boxes to create a more individualistic human-centric service for users, with the overall aim of improving the speed of the distribution of goods both internally (between players once inventory has arrived at the hospital) and externally (for inventory being delivered into the hospital from outside)
The Internet of Things for efficient medical logistics: a best practice review
No full textThe purpose of this review is to explore how supply chain management, specifically within the NHS, can be improved through the use of emerging information and communications technologies (ICT). There are a range of technologies, such as Radio Frequency Identification (RFID) and barcodes, available to logistics providers which expedite the processing of inventory at key nodes along a supply chain. However, the evolution of 2-D coding and new applications of RFID and ‘near field’ technologies, pairing them with sensors and the Internet, is enabling such devices to communicate between one another at all times wherever they may be. This ‘Internet of Things’ is allowing for greater levels of visibility and automation within logistics, therefore increasing the potential efficiency of supply chains across all industries
Does mobile consolidation solve the traditional consolidation centre conundrum? A feasibility study in the context of UK healthcare
No full textIn 2010, the UK National Health Service (NHS) was responsible for 30% of all public sector emissions and 3% of the total CO2 emissions in England (European Centre for Environment & Human Health 2011), 65% of which were attributable to the procurement of goods and services (NHS SDU 2012). Previous research has linked this to an agile supply chain structure, better able to accommodate the unpredictable nature of demand within the medical supply chain (Bailey et al. 2013), which encourages sub-optimal product flows, leading to low vehicle load factors (McKone-Sweet et al. 2005; Jarret 2006; Costantino et al. 2010; Black and Zimmerman 2012; Azzi et al. 2013). As is typical with high delivery frequencies and low-fill rates, freight consolidation is often considered a viable solution (Woodburn 2005). However, despite the NHS Supply Chain (NHS SC), having a freight consolidation network established in 2006 (NHS Supply Chain 2014), supplier participation remains low with approximately 70 per opting-out according to annual hospital spend reports at Great Ormond Street Hospital. Increased supply chain costs, loss of visibility and control of products, and sub-optimal supplier logistics services were often cited as the main reasons for poor uptake resulting in high numbers of ad-hoc direct deliveries to hospital trusts. This paper attempts to address these issues by proposing a novel mobile consolidation centre (MCC) model for healthcare supply, using Great Ormond Street Hospital for Children’s NHS Foundation Trust (GOSH) as a case stud
Can locker box logistics enable more human centric medical supply chains?
Full text linkThe fast flow of goods into hospitals is often stalled by the external-internal supply chain interface (i.e. the receipts department). This issue is particularly pertinent regarding the delivery of urgent items for specific patients or in the event of low inventory levels. An unattended electronic locker bank to which individual urgent items can be delivered and subsequently collected by the ‘user’ was proposed for Great Ormond Street Hospital in London, UK. The feasibility of this concept is quantified using a hill climbing model operating with a significant database of consignment movements; and, qualitatively using staff interviews. Results indicate that a locker bank measuring 4m length, 1.7m height and 0.8m depth, comprising 11 partitions would be required to accommodate all urgent consignments for any given day. Staff perceptions of the concept were positive suggesting the locker would potentially improve the speed and quality of healthcare delivered to patients
The hidden life saver? Unattended locker box logistics for faster and more efficient hospital supply
No full textThe efficient flow of goods into hospitals is disrupted by the presence of time critical (urgent) items in the chain encouraging sub-optimal vehicle fleet operations. Furthermore, the fast delivery of such items can often become stalled by the transition between the external and internal supply chains, leading to duplicate ordering. These issues result in increased volumes of hospital-related traffic and a delay in the delivery of care to patients. An unattended electronic locker bank, comprising individual lockable boxes to which different urgent items can be delivered is proposed as a potential solution with the aims of: separating urgent and non-urgent goods in the chain, thereby enabling consolidation of non-urgent consignments; and, bypassing the traditional route of supply. The feasibility of this concept was tested in the context of Great Ormond Street Hospital for Children in London using a database of consignment movements to assess physical requirements of the locker bank, using a hill climbing optimization technique; and, qualitatively using interviews with key members of staff. Results of the quantitative analysis indicated that a locker bank measuring 3.33m (10.93ft.) in length, 1.7m (5.58ft.) height and 0.8m (2.62ft.) depth, comprising of 11 partitions would be required to accommodate 100% of all urgent consignments passing into the hospital during a typical week. Staff perceptions of the locker bank concept were largely positive suggesting the locker box could improve the speed and quality of healthcare delivered to patient
‘Shop and we'll drop’ - Understanding the impacts of student e-shopping on deliveries to university halls of residence during Black Friday week
No full textPurpose: using the University of Southampton as a case study example, this paper presents analysis of incoming parcel deliveries to four of its largest student halls of residences, accommodating around 5,000 students, and results from a questionnaire about student online purchasing behaviour and attitudes. Together, these surveys provided insight into student online shopping for the week immediately following Black Friday (27th November 2015) and the resulting impact in terms of numbers of delivery visits made to the halls. Research approach: a week-long survey of halls of residence reception points was undertaken to determine: (i) delivery times; (ii) couriers used; (iii) consignment details (e.g. size and type of package); (iv) suppliers; (v) vehicles used; and (vi) some vehicle round details (origin, destination, previous and next drops). The surveys involved both observation and brief interviews with delivery drivers, using a common survey form to record all information. At the same time, all students living in University of Southampton halls were sent a link to an online questionnaire asking about their typical purchasing practices and their opinions about goods transport and related environmental issues, with 486 students responding. Findings and originality: the findings illustrate the extent of courier visits, with the largest hall visited on 90 separate occasions over the week-long period, by 13 different ‘main’ couriers and by several other smaller carriers. The main couriers typically visited every day and sometimes more than once on the same day. Around 3,500 parcels were delivered to the four sites during the week with the largest numbers (around 500 each) being delivered by two carriers (Hermes and Amazon). Total parcel volume was estimated to be 137m3. Numerous deliveries were made throughout the day (9am to 5pm was surveyed), placing a burden on the reception staff who often had to drop other duties to attend to them. Originality lies in the in-depth data collection and analysis of parcel receipt in the higher education sector which constitutes a major freight generator in urban areas and has been little researched up to now. Research impact: the main research impact lies in establishing whether and how deliveries to student halls of residence could be made more efficiently, potentially through third-party consolidation, with the aim of improving the working and living environment. An off-site consolidation service could theoretically have reduced the 275 observed courier visits during Black Friday week to around three visits per day (93% reduction) assuming that the delivery service via a local consolidation centre could be mandated by the university.Practical impact: the study has a strong practical focus, providing the university sector with detailed information and analysis about the impact their students are having on goods transport and the associated carbon footprint, and suggests practical measures university managers can take to address the issues and make improvements in this area. Off-site consolidation also has parallel applications for any large municipal organisations where a wide range of purchases are being made by multiple buyers using many suppliers and for other forms of high density urban living (e.g. high-rise buildings) <br/
A simulated annealing approach to explore temporal consolidation of healthcare courier services to reduce carbon emissions
No full textThe purpose of this paper is to investigate the effects of temporal consolidation (the intentional delay) of hospital laboratory samples / equipment for couriering to people and healthcare institutions worldwide, using a hill climbing genetic algorithm with integrated travelling salesman optimization function to determine the optimal configuration of vehicles in which to consolidate items, and the optimal route for each vehicle. Current hospital and courier service providers' practices centre on collecting items as and when they arrive for outward journeys at the hospital. Using data from a major London hospital this study evaluates 5 different consolidation scenarios, varying the length of time an item is delayed (ranging between 30 minutes to 10 hours). Findings indicate that consolidated approaches yielded reductions in vehicle numbers, between 116 and 258, compared to the current model of operation, but that the current model of operation is actually more environmentally efficient, generating 0.45 to 0.83 fewer metric tonnes of CO2, than consolidated approaches
Boxed up and locked up, safe and tight! Making the case for unattended electronic locker bank logistics for an innovative solution to NHS hospital supplies (UK)
No full textThe lack of separation between urgent and non-urgent medical goods encourages sub-optimal vehicle fleet operations owing to the time critical nature of urgent items. An unattended electronic locker bank, to which individual urgent items can be delivered thereby separating urgent and non-urgent supply, was proposed for the Great Ormond Street Hospital in London, UK. This concept was quantified using 'basic' and 'intuitive' hill climbing optimisation models; and qualitatively using staff interviews and expert reviews. Results indicated that a locker bank with a fixed height (1.7 m) and depth (0.8 m) required a length of 4 m (basic model) and 3.63 m (intuitive model), to accommodate 100% of urgent consignments for a typical week. Staff interviews indicated the wider benefits such as staff personal deliveries
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