Matching Form and Function in Hospital Storage Room Design

by Fred Crans

Over the years, as hospitals have expanded and undergone renovations, the question of "how big should the supply room be?" has often been driven by immediate clinical needs, rather than considering how clinical care is evolving and the implications for the necessary products to support patient care. It's widely acknowledged that most supply rooms across the country have been undersized for many years. In many cases, the original design intent for these rooms no longer aligns with their current use.

Unfortunately, the stakeholders, particularly the caregivers on the unit, are often excluded from discussions about how much space is needed to accommodate the supplies and equipment.

The picture above presents a pristine and spotless supply room. In reality, however, there could be four nurses in there simultaneously pulling out supplies, returning unused items haphazardly, and navigating around two or three utility carts along with several pieces of small portable equipment. Suddenly, the space doesn’t seem so pristine, does it?

Recently, I had the opportunity to discuss this topic with three of St. Onge’s experts in storage space design—Tom Redding, Aimee Watson, and Hue Roach—about how the design of these spaces (form) needs to align with the activities performed there (function).

All three agreed on a critical point: the space allocated for supplies and moveable equipment should be designed to adequately serve the functions carried out on the unit.

These discussions brought back memories of my own experience. In 1976, I was the young Director of Central Processing and Distribution at Baptist Hospital of Miami, a 350-bed facility with four patient floors and a fifth Cardiac Pavilion located in a separate building. To reach the pavilion, one had to walk outside via a partially covered walkway exposed to the elements.

Each floor had a traditional clean and soiled utility room, with floor stock items stored on Exchange Carts in the clean rooms. Every night, during the 11 PM to 7 AM shift, these carts were taken downstairs to Central Processing for replenishment, and new, fully stocked carts were left in their place. The nursing unit floors were made of linoleum or terrazzo tile, which became relevant when we briefly piloted an Automated Guided Vehicle called “Transcar.” The vehicle was quickly nicknamed “Cranscar” after the kid in charge of Central Processing.

Transcar followed a 1-inch strip of metallic tape on the floor to the elevators, summoned the elevator, traveled to the designated floor, disembarked, and emitted a beeping sound to alert the nursing staff to unload it, place the used cart on, and send it back to Central Processing. The goal was to eliminate one full-time employee.

Unfortunately, several issues arose. If the elevator didn’t arrive exactly level with the door, two things could happen: if it was lower than level, the cart would hit the back wall and stall; if higher, the cart would bang into the elevator on the ground floor and stall, never boarding the elevator.

But that’s not the point of this story.

In 1978, the hospital commissioned an architect to design a new 200-bed addition connected to the old hospital via a crossover. This addition was to be state-of-the-art, incorporating a revolutionary point-of-use patient care supply system—the Nurse Server, designed by Gordon Friesen. Nurse Servers were remote supply storage units placed to support a “pod” of four rooms. The idea was to provide convenient supply access so nurses could care for patients without returning to a central storage area. Suddenly, instead of one supply area supporting 28 patients on a floor, there were now seven.

And, of course, the new unit’s hallways were carpeted, making it impossible to lay tape for Cranscar, so that idea was quickly abandoned.

I share this 48-year-old story not to criticize those who have long since left healthcare (and many who have passed away), but to illustrate a point Hue Roach made: “It’s amazing how people manage to make things work.”

And indeed, we did make things work.

However, as Tom Redding and Aimee Watson emphasized, it’s crucial to involve stakeholders from the very beginning of the process to minimize surprises and ensure storage areas are designed to meet the unit's functional needs.

Considerations: Here are some factors to address when designing a storage area:

• What are the most common supplies needed for the department/unit’s function?
• How many of these are kept in an onsite storage area, such as a warehouse?
• How many are delivered directly from the manufacturer/supplier to the point of use?
• How frequently is the point-of-use site re-stocked—both from onsite support and from the manufacturer/supplier? Stocking amounts will be determined by re-supply frequency, average daily use, and the size requirements of each item.
• What is the system’s strategy concerning inventory management? Are remote supply caches counted as official inventory or expensed upon arrival?
• Who is responsible for managing the inventory?

These are just a few questions to consider when laying out Point of Use supply storage areas. The key takeaway is that the earlier and more consistently key stakeholders and users are involved, the better the design will be for creating an area that truly meets the unit's needs.

Let Us Help. For over forty years, the St. Onge Company has been helping organizations both large and small craft solutions to make it possible for their supply chains operate at peak efficiency. Our Healthcare Team is currently working with many of the nation’s leading HCOs to help them optimize their supply chains of the present and to plan, design and implement the supply chains of the future.

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Our goal is to improve operations at each step along the way until it reaches its ultimate destination- the patient’s bedside.?

For information on how we can help your organization, contact Fred Crans at [email protected] to set up an exploratory conversation.?

The full discussion with Tom Redding can be heard on the St. Onge, “Taking the Supply Chain Pulse” podcast. Here is the link: https://takingthesupplychainpulse.buzzsprout.com.

Please listen, subscribe and provide comments. If you know anyone we should talk with, or any topic we should address, please contact us.

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